Condylomata
What You Should Know About Genital
Warts
Can the wart virus cause cancer?
Certain
types of HPV have been linked with a variety of premalignant and malignant
conditions. Genital warts are the greatest cause for concern. Women who have
had genital warts, or sexual contact with someone with genital warts, have a
significantly increased risk of developing cervical neoplasia. For this reason, it is critical that
genital warts be treated.
Are men and women always aware
that they are infected with genital warts?
No.
The infection can be asymptomatic. This may help explain why genital warts are
the most common sexually transmitted disease today.
How are genital warts diagnosed?
We
now know that some genital warts, called microsize warts, are invisible to the naked eye. In women, a Pap smear will usually
reveal the presence of genital warts. For best results, the physician may apply
acetic acid to the affected area, then, may examine the tissue under high
magnification. For women, this can be performed at a gynecologist's office. Men
who have been exposed to genital warts should go to a dermatologist, who can
detect the warts using a similar procedure.
Should women with a history of
genital warts be followed up more closely by their physician?
Yes,
because of the increased risk of cervical cancer, these women should have a Pap
smear at least annually, perhaps every six months. Genital warts have become a
very common sexually transmitted disease (STD), particularly among young
adults. Genital warts look very much like the warts that might develop on other
parts of the body. But the human papillomavirus (HPV) that causes genital warts
can be dangerous to overall health. Most significantly, it can increase the risk of cervical cancer in women. It is important that all
sexually active people know what genital warts are and why it is important to
seek prompt attention from a physician or clinic if genital warts do develop.
What is the difference between
genital warts and other types of warts on other parts of the body?
Genital
warts can develop on the cervix, penis, or in the vaginal or rectal area. They
look very much the same as warts that might appear on the hands, feet, or other
parts of the body. All warts are infections caused by one or another strain of
the virus. Some types of HPV cause genital warts whereas other types cause
common skin warts. It is therefore important that anyone with genital warts,
and their sexual partner(s), be diagnosed and treated as soon as possible.
How common are genital warts?
Millions
of people in the United States are infected with HPV, and genital warts are the
most common STD caused by a virus. They occur more frequently than genital
herpes, which is also caused by a virus. The number of HPV or
genital wart cases continue to increase each year. Many sexually active
people are unaware of genital warts and the potential health risks of this very
common STD.
How does a person develop HPV?
The
genital strains of HPV, which cause genital warts, are primarily spread through
sexual intimacy. Transmission can occur through all forms of sexual
intercourse, including oral or rectal intercourse, and through heterosexual or
homosexual contact. Genital warts generally develop an average of two to three
months after exposure to a person with HPV infection.
What do genital warts look like?
Genital
warts, like warts on other parts of the body, are dry and painless, firm and
rough in texture, and usually flesh or grayish in color. Some genital warts can
be small and difficult to detect, even during a medical examination. Small and
flat warts on a man's penis or a woman's cervix are particularly likely to go
unnoticed. Warts can vary widely in appearance. They can be large or small,
flat or raised, multiple or single. Untreated genital warts
can grow large and numerous, and perhaps grow together to form an ugly growth
that looks like a very small cauliflower.
Where do genital warts usually
develop in women?
Genital
wart infection most commonly develops on the vulva (the outer part or lips of
the vagina), or inside the vagina, or on the cervix (the small opening leading
from the vagina to the uterus), or on or near the anus. Genital warts often
develop in several areas at the same time, and the cervix is involved in about
half of the cases of genital warts in women.
Where do genital warts usually
develop in men?
Genital
wart infection in men most commonly occurs on the penis, but it also may
involve the urethra or bladder. Infection of the urethra may cause bleeding,
discharge, and the need to urinate frequently. Genital warts can also develop
on or near the anus, or within the rectum. This is particularly likely among
homosexual men who practice anal intercourse. Also, as is the case with women,
wart infection often occurs in more than one genital area at a time.
Can a person have a genital wart
virus infection and not know it
Yes.
In fact, recent research suggest these most HPV infections, may be completely
asymptomatic, that is, they never cause recognizable warts. Such persons
probably can infect their sexual partners and may develop cervical cancer.
Do genital warts pose serious
health risks?
Genital
warts can be very dangerous to one's health, and all genital warts should be
promptly treated. The most serious consequence is the possible development of
cervical cancer in women. There are 40 known strains of HPV and several of
these are strongly linked to the development of cervical cancer. Specifically,
an abnormal cellular condition known as dysplasia often occurs among women with
genital wart infection of the cervix. This condition poses a high risk for
subsequent development of cervical cancer. Prompt diagnosis and treatment of
genital warts is essential in order to avoid this precancerous condition on
cervical cancer itself. Physicians usually remove a sample of genital wart
tissue and have it examined under a microscope to determine possible
abnormalities, dysplasia, and other pre-cancerous signs that can be detected by
Pap smear.
What are the consequences of
genital warts?
By
far the most important is cervical cancer. HPV is closely associated with
cervical cancer and may be the most common cause of this disease. Untreated
genital warts can grow and multiply and perhaps group together to form
cauliflower-like growths. These large growths can be very difficult to treat,
and unfortunately, treatment, which might include surgery, may damage the
tissue. There is a risk of damage to the
woman's reproductive system, which might reduce or eliminate her ability to
have children. Untreated genital warts may simply disappear over time. But even
if HPV infection seems to resolve itself, there is a strong risk of recurrence,
transmission, and more extensive wart development. Diagnosis and treatment is
essential.
How are genital warts diagnosed?
Dr.
Jacobs can often diagnose genital warts by simple observation. But the fairly
common small or flat warts can pass unnoticed by the physician or the patient,
particularly because genital warts do not have symptoms of pain or irritation.
For many women, the first indication of genital warts may be an abnormal Pap
smear. For many men, the first clue to HPV infection might be an unusual
discharge or the need to urinate often. Accurate diagnosis might require a
colposcopy examination. This is a painless procedure in which a gynecologist
uses a colposcope (a magnifying device with bright
lights) to clearly identify the area(s) of infection. This diagnostic method is
used for women and sometimes for men. One diagnostic difficulty with HPV
infection is that genital warts can be readily confused with other conditions.
Genital warts resemble the sores associated with syphilis. Skin cancer on a
woman's vagina can also resemble genital warts. If there is any question about
the diagnosis, a physician may recommended a colposcopic examination, a blood test, or a biopsy.
Clinicians may also recommend tests for not only genital warts but also for
other STD's such as chlamydia, gonorrhea, or syphilis. The reason for several
tests is that sexually active people often have more than one STD at a time. In
addition, researchers have recently learned that genital warts might increase
the risks of acquiring or transmitting the AIDS virus, and many doctors
routinely recommend an AIDS virus test for people with HPV.
How are genital warts treated?
There
are several treatment methods. The severity of infection, the location of the
warts, and other factors will influence the decision about which treatment
might be best for a patient. Genital warts can be frozen with liquid nitrogen
or cryosurgery. Although these techniques for freezing off the infection are
effective, they can cause a temporarily annoying blistering of tissue. Some
cases of genital wart infection are treated by applying certain caustic
chemicals to the infected area. Genital warts can also be burned off, a
procedure that requires the use of an anesthetic to reduce or eliminate pain or
discomfort. Laser treatment or possible interferon therapy might be recommend for recurrent warts that have been resistant to
other treatment methods. Most of these treatments must be repeated several
times, sometimes over several months. All methods of treatment have high
failure rates. Therefore, repeated reexaminations are sometimes recommended, even after the warts seem
to go away.
Are there special guidelines for
treatment?
Yes.
Remember that early diagnosis and treatment offer the best option for thorough
elimination of genital warts infection. Other important guidelines include the
following: - The sexual partner(s) of an infected person should undergo prompt
examination. This will reduce the risks of reinfection or recurrence, as well
as the risk of spreading HPV infection
to other people. - Women who are pregnant, or who suspect that they are
pregnant, should be particularly careful about prompt treatment of genital
warts, as warts can be transmitted to the baby. - Pregnant women should not
undergo treatment with podophyllin. - HPV infection
often co-exists with other genital infections such as vaginal infections, or
with other STD's such as chlamydia, syphilis, or gonorrhea. These infections
must be diagnosed and treated as well. - Irritation of genital tissues by tight
clothes or by moisture such as vaginal secretions can reduce treatment
effectiveness and can encourage recurrence. To speed your recovery, wear loose
fitting clothes, bathe regularly, and avoid sexual intercourse.
How can someone reduce the risk of
acquiring genital warts?
Genital
wart infection is highly contagious. The use of safe sex guidelines will reduce
the risk of transmission and acquisition. Use condoms during intercourse. Limit
the number of sexual partners, preferably to one monogamous relationship.
Discuss STD's with a possible new sexual partner before you embark on an
intimate relationship. Avoid intercourse if you or your partner(s) have or
suspect you have genital warts or any other STD. To reduce the risk of
recurrence or further spread of genital wart infection, the sexual partner(s)
of anyone with genital warts should also undergo treatment. Avoid sexual
intercourse during treatment and until a follow-up examination confirms cure.
Remember, prompt diagnosis and treatment are essential. Genital warts are
likely to grow, spread, and recur. Untreated infections will increase one's
health risks and make eventual treatment more difficult, more expensive, and
more inconvenient.
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