Genital warts are warts that form on the skin of the genital area. They are caused by certain subtypes of the human papilloma virus (HPV), the same virus that causes warts on other areas of the body. Genital warts are spread through sexual intercourse, so they are classified as a sexually transmitted disease (STD), and can affect both men and women. Genital warts also are known as condyloma acuminata or venereal warts. They can develop anywhere near the vagina, cervix, genitals or rectum.
Because genital warts can take six months to develop, you can have the infection without having any symptoms. Human papilloma virus also causes virtually all cases of cervical cancer worldwide. The subtypes that are most likely to cause cancer are different from those that usually cause warts. However, many people are infected with more than one subtype. Therefore, people with genital warts are more likely to be infected with a cancer-causing virus as well.
Genital warts appear on moist surfaces, especially at the entrance of the vagina and rectum in women. In men and women, they can appear anywhere in the genital or anal area. They may be small, flat, flesh-colored bumps or tiny, cauliflower-like bumps. Individual warts usually measure 1 millimeter to 2 millimeters in diameter -- much smaller than the diameter of a pencil eraser -- but clusters can be quite large. In some cases, warts can be so small that you can't see them. Genital warts may not cause any symptoms, or they may cause itching, burning, tenderness or pain.
Your doctor will ask about your medical history and about your sexual habits and any prior episodes of STDs. Your doctor will then examine you to look for evidence of genital warts. A vinegar-like solution placed on the skin turns the warts white and makes diagnosis easier. Other diagnostic tests may include:
- Tissue biopsy A small piece of tissue is removed and examined in a laboratory.
- Colposcopy - An instrument called a colposcope is used to magnify and inspect possible warts in the vagina and on the cervix.
- Papanicolaou (Pap) smear
All sex partners also should be tested for the infection.
Genital warts may go away on their own or with treatment, or they may last for years. It is common for genital warts to return after they are removed.
The best way to prevent genital warts is to avoid sex or have sex with only one uninfected partner. Using condoms also may help to prevent infection. However, condoms can't always cover all affected skin. Factors that increase your risk of becoming infected include:
- Having other STDs (because the risk factors are the same)
- Multiple sex partners
- Certain vitamin deficiencies
- Medications or medical conditions that suppress the immune system, such as AIDS
If you have had genital warts, you should be tested for cervical cancer at least once every year. Cervical cancer can be prevented with regular screening (Pap smears), and can be cured in most cases when it is detected in early stages.
In June 2006, the Food and Drug Administration approved a vaccine against HPV for use in women. The currently available vaccine (several pharmaceutical companies are developing a version) targets HPV strains 6 and 11, which cause 90% of genital warts -- as well as the major cervical cancer-causing strains, 16 and 18. Given as a set of 3 shots over 6 months, the vaccine will protect against only those four strains, and will not cure existing infections.
The Centers for Disease Control and Prevention (CDC) added the HPV vaccine to its official vaccination recommendations in July 2006. It proposed that all 11- and 12-year-old American girls get the shots, although girls as young as 9 could receive it if they're sexually active. For "catch-up," the CDC also recommends that girls and women ages 13 to 26 be vaccinated against HPV, regardless of their Pap test results.
The vaccine works best before an individual has been exposed to HPV. Early vaccination provides the greatest chance of preventing cervical cancer and genital warts. Older girls and young women were included in the CDC recommendations because even if they've had some exposure to HPV, it may not be to the strains contained in the vaccine, so they'll get some protection.
Treatment depends on the size and location of the warts. Even though the warts may be removed, there may still be some virus remaining in the skin, which is why the warts often return. Some of the medications used to treat genital warts cannot be used during pregnancy, so it's important to tell your doctor if you could be pregnant.
Small warts may be treated with medications applied to the skin. In some cases, applying liquid nitrogen (cryotherapy) to warts will freeze the tissue and make warts disappear. Some larger warts require laser treatment, or surgical removal. Do not treat genital warts yourself with nonprescription drugs used for wart removal on hands, because these chemicals can make the genital area very sore. Your doctor may prescribe a medication that you can apply to the warts at home. Apply this medication carefully to avoid damaging surrounding healthy tissue, keep it out of your eyes and wash it off after the number of hours your doctor instructs you to leave it on. Your doctor also may suggest that you apply a protective coating of petroleum jelly on delicate surrounding tissue before you apply your prescribed medication. In some cases, your doctor may use a small needle to inject alpha-interferon into each wart. Alpha-interferon injections are usually considered only if other treatment methods are unsuccessful or if warts come back after being removed. You will be told to avoid sexual relations until treatment is completed.
Contact your physician if you notice warts or bumps on your genital area, or if you have itching, burning, tenderness or pain in that area. Call your doctor immediately if you develop signs of infection, such as fever, chills or muscle aches.
Genital warts may go away on their own or with treatment. It is common for them to return. Certain strains of the virus (HPV), which causes genital warts, cause virtually all cases of cervical cancer worldwide, though only a small percentage of the women who become infected will develop cancer. Cervical cancer develops slowly over decades. If you have genital warts, you are also likely to have been infected with a cancer-causing strain of the virus. You should be sure to get Pap smears regularly.
Centers for Disease Control and Prevention (CDC)
National Immunization Program
NIP Public Inquiries
1600 Clifton Road, NE
Atlanta, GA 30333