Genital warts

Genital warts: The warts appear in various sizes and shapes.

Genital warts: Overview

Also called condylomata acuminata
Genital warts are warts that appear in the genital area. There can be 1 wart or a cluster of warts. People get these warts by picking up the human papillomavirus (HPV) from someone who is already infected with this virus.

HPV is a common sexually transmitted infection. It is possible to spread or get these warts even when you cannot see them.

Of the 100 or so types of HPV, just a few can cause genital warts. Some HPV types can cause cervical cancer. Other types can cause anal cancer, cancer of the penis, or mouth and throat cancer. You can get more than one type of HPV.

There are many ways to treat genital warts. Since warts are often stubborn, you may need more than one visit to the dermatologist.

Images used with permission of Dermatology DDxDeck, card #55. (Habif TP, Campbell JL, Chapman, MS et al. Dermatology DDxDeck. 2006; Mosby Elsevier.)

Genital warts: The warts appear in various sizes and shapes.

Genital warts: Signs and symptoms

Genital warts appear in various sizes and shapes. Some people get a few warts. Others get many warts. The most common signs (what you see) of these warts are:

• Small, scattered bumps that are skin-colored or a bit darker.
• A cluster of bumps that look like cauliflower.
• Growths in the genital area that can be raised or flat and smooth or rough.

Genital warts often have no symptoms (what someone feels). Sometimes the warts itch, burn, hurt, or bleed.

Genital warts can appear on the following areas of the body:

Females

• Vulva (external female genitals).
• Vagina.
• Cervix.
• Groin.

Males

• Penis.
• Scrotum.
• Thigh.
• Groin.

Females and males

• In the mouth or throat after having oral sex with an infected person.
• In or around the anus after anal sex with someone who has HPV.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Genital warts: Who gets and causes

Who gets genital warts?

Anyone who has sex can get human papillomavirus (HPV), the virus that causes genital warts. At least half of people who have sex have had an HPV infection. It is most common before age 30.

Not everyone who gets an HPV infection gets genital warts. Most people never get these warts because the body’s immune system fights the virus. Most people get rid of the virus in a few years and then are no longer contagious.

People who have a weakened immune system may not be able to fight the virus. When the body cannot fight HPV, genital warts can grow. A person’s immune system can become weak from a disease such as cancer or AIDS. Some medicines, such as those to prevent organ rejection, also weaken the immune system.

Research has found that smokers have a higher risk for getting genital warts than people who do not smoke. It is not clear why.

Sometimes a child gets genital warts. It is rare, but an infected mother can pass the virus to her baby during childbirth. The warts may not show up right away. Genital warts in a child also can be a sign of sexual abuse.

What causes genital warts?

Genital warts spread from a person who has HPV to another person through:

• Sex (vaginal, anal, or oral).
• Genital contact (people's genitals touch).
• Childbirth (from infected mother to baby).

Warts may not appear until weeks or months after sex with an infected person.

Genital warts: Diagnosis and treatment

How do dermatologists diagnose genital warts?

People often feel embarrassed by growths in their genital area and do not see a doctor. But seeing a dermatologist can provide peace of mind because you can get a proper diagnosis and treatment.

A dermatologist can diagnose genital warts by examining the warts during an office visit. Sometimes a dermatologist will remove a wart or part of it and send it to a laboratory. This can confirm that a patient has genital warts.

How do dermatologists treat genital warts?

Some genital warts clear without treatment. But removing warts has benefits because treatment:

• Lowers the risk of spreading the virus.
• Can relieve any pain and itching.
• Lets a person know that the growths are genital warts, not cancer.
• Removes warts that can be hard to keep clean.

If you want to treat your genital warts, it is best to see a dermatologist. You should not use a wart medicine that you can buy without a prescription. These medicines treat other types of warts. Genital warts require different treatments.

There are quite a few treatments for genital warts. Before choosing your treatment, a dermatologist will consider many things, including the number of warts, where the warts are, and your overall health.

Treatment may involve a procedure in the dermatologist’s office or a medicine you put on the warts. The following describes the different treatments for genital warts:

Medicine: Often the dermatologist prescribes medicines that you will apply to the genital warts at home. These prescription medicines include:

• Podofilox for external warts (to stop the wart cells from growing).
• Imiquimod (boosts the body’s immune system so it can fight HPV).
• An ointment made of green tea extract (sinecatechins) for external warts and warts around the anus.

Procedures: A dermatologist may perform one of these procedures during an office visit:

• Cryosurgery (freeze off the warts with liquid nitrogen).
• Excision (cut out the warts).
• Electrocautery (destroy the warts with an electric current).
• Laser treatment (destroy the warts with laser light).

Sometimes treatment requires more than 1 office visit.

Other treatments: Sometimes medicine is injected into the warts. Interferon, an antiviral medicine, may be injected into genital warts. This treatment is usually used if other treatment fails.

Ask your dermatologist about possible side effects (health problems that can result from the treatment).

Outcome

Treatment can remove the warts you see, but it may not get rid of the virus. If the virus remains, the warts can return. If you still have the virus, you can spread it through sex. Wearing a condom during sex can reduce the risk of spreading the virus.

Genital warts: Tips for managing

Prevention

You can reduce your risk of getting HPV and genital warts by doing the following:

• Get an HPV vaccine. If you are between the ages of 9 and 26, you may be eligible for an HPV vaccine. There are 2 HPV vaccines.

One of them is “quadrivalent,” meaning it can protect against 4 types of HPV. This vaccine is for males and females ages 9 to 26. It can prevent the types of HPV that cause most genital warts. To be fully vaccinated, you get 3 shots. For the vaccine to be most effective, you should get all 3 shots before your first sexual encounter.

Both HPV vaccines can help protect women from most types of cervical cancer.

• Use a condom during sex. A latex condom may help reduce the risk of getting genital warts. Condoms do not cover all the skin in the genital area. Therefore, they do not always prevent an infected person from spreading HPV.
• Limit your number of sex partners. Having many sex partners raises your risk of getting HPV. Being in a faithful relationship with one person reduces this risk. The only sure way to prevent HPV is to remain celibate (never have sex — oral, anal, or vaginal).
• Quit smoking. Research has found that smokers have a higher risk for getting genital warts than non-smokers.

Coping with genital warts

If you have (or had) genital warts, dermatologists recommend the following:

• Do not use medicine meant for treating other types of warts. Other medicines are good for treating common warts and foot warts, but not genital warts. See a dermatologist for treatment of genital warts.
• Tell your sex partners you have genital warts. They should see a doctor.
• Use a condom during sex. A latex condom may help reduce the risk of spreading genital warts. Condoms do not cover all the skin in the genital area. This means that condoms do not always prevent an infected person from spreading HPV.
• Women: Get Pap tests (smears). Women who have received treatment for genital warts should get Pap tests (smears) as recommended by their doctor. Pap tests are the best way to find early abnormal changes in the cervix. This can prevent death from cervical cancer. If you have an abnormal Pap test, you should follow up with your doctor.

Support groups

Getting genital warts can be life-changing. Talking with others can help.

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