Genital warts are a very common sexually transmitted infection caused by the human papillomavirus (HPV). Although women are slightly more likely to contract genital warts than men, experts estimate that at least one-half to one-third of all sexually active adults in the US will contract HPV at some point in their lives, even if that infection does not lead to genital warts.
Genital warts can develop on the vulva, vagina, anus, and cervix. In some cases, warts may be too tiny to be seen. In other cases, warts can appear as fleshy, rounded bumps or they can have an irregular, cauliflower texture.
Symptoms of Genital Warts
It’s possible to carry and transmit a strain of HPV that causes genital warts, even if no genital warts appear.
Symptoms of genital warts include:
- Small, half-dome shaped singles or clusters (may be white, grey, pink, or red)
- Clusters of cauliflower-like growths
- Flat patches of skin discoloration in the genital areas
- Itching or burning
- Bleeding during sex
Genital warts may appear in one or more areas of a woman’s body, including:
- Vaginal walls
- Perineum (the tissue between the anus and vagina)
- Mouth and throat
In men, genital warts may break out on the shaft or tip of the penis and the scrotum as well. If you notice any of these symptoms on your or your partner’s body, make an appointment with your health care provider.
Diagnosing Genital Warts
If you suspect you may have genital warts, make an appointment for an examination. At your appointment, your doctor may apply an acetic acid solution to the affected area in order to whiten the appearance of warts. A colposcope may be used to examine the area under magnification.
A diagnosis of genital warts should also come with a more thorough examination for the presence of high-risk strains of HPV, which may cause cancer.
Your OB-GYN will likely want to conduct a Pap test. HPV can cause abnormal cell changes in the cervix, which can be detected by a Pap smear. During a Pap smear, your OB-GYN will collect a sample of your cervical tissue with a swab and send it to the lab to be examined under a microscope.
Women may also have their Pap sample tested for HPV. This test can detect most of the high-risk strains of HPV.
Risk Factors for Genital Warts
Experts estimate that 50-75% of Americans will contract HPV in their lifetimes. In most cases, the body’s immune system eliminates the virus before it causes any major issues. However, if the infected person is immune-deficient, there is a higher likelihood that they could develop genital warts.
You can reduce your risk of contracting HPV by practicing safe sex and:
- Limit sexual contact with multiple partners
- Use condoms to reduce skin-to-skin contact. Female condoms may provide more protection than male condoms.
- Know your partner and their sexual history. Having a partner who has multiple partners puts you at risk for infection.
- Delay initiation of sexual activity. Teens and young adults are in the highest risk group for HPV infection.
Preventing Genital Warts
The HPV vaccine, Gardasil, can protect against the strains that are responsible for most cases of genital warts, as well as the strains that cause a high percentage of cervical cancer. Pediatric health experts recommend that all girls and boys ages 11-12 receive the HPV vaccine.
Young women up to age 26 and young men up to age 21 should also be vaccinated, even if they are already sexually active. Studies have shown that the vaccine can decrease your risk of contracting genital warts by up to 50%.
Complications of Genital Warts
Enlarged warts may obstruct the path of urine, causing urinary problems in pregnant women. Warts affect the skin of your vaginal walls and vulva. They may bleed or make it difficult for your tissues to stretch during delivery.
Genital warts can also pass from mother to child when the baby passes through the vaginal canal. Infants who develop warts on their mouth or throat may need to have them surgically removed, especially if there is a danger to the baby’s airway.
Genital warts and HPV are associated with cervical cancer, and other cancers of the vulva, anus, throat, and mouth.
Treating Genital Warts
Not all cases of genital warts require treatment. If your condition isn’t causing you any discomfort and you and your partner are not concerned about transmission, you may wish to forgo treatment.
However, if you’re experiencing itching or pain, or you’re concerned about the appearance of warts, you may wish to treat your outbreaks with medicine or surgery. Treatments are usually not a permanent solution since warts can return even after removal.
Unfortunately, there are no effective over-the-counter treatments for genital warts. Do not attempt to use any over-the-counter treatments, as they are not indicated for use on the genital tissue. There are, however, a number of prescription topical treatments available.
- Imiquimod (Zyclara or Aldara). This is a cream that you can apply directly to your warts. It boosts your immune system and may reduce the appearance of warts. Abstain from sex for a few hours after applying the cream, as it may break down condoms or irritate your partner’s skin.
- Podofilox and podophyllin (Condylox). Podofilox contains a chemical derived from plants that can destroy wart tissue. It can be applied at home, although your doctor may want to help you with the first application as it can damage the surrounding healthy tissue. Podophyllin contains the same active ingredient, but must be prescribed by a doctor.
- Trichloroacetic acid. Your doctor can use this treatment to chemically burn off genital warts.
Some warts may not respond to medication and may need to be removed surgically. Surgical removal is also recommended for pregnant women, who may not be able to use drugs. Side effects of all surgical treatments include pain, tenderness, and swelling.
- Electrocauterization. Your doctor uses a special electrical tool to burn off genital warts.
- Cryotherapy. Your doctor can freeze off genital warts using liquid nitrogen. The extremely cold chemical applied directly to the area causes your skin around the wart to blister. When the blister falls off, new, healthy skin appears underneath.
- Laser therapy. A tiny, but powerful beam of light is directed at warts. Laser treatment is expensive and is usually a last resort for especially widespread or severe warts.
- Surgical excision. Your doctor can physically excise warts with special instruments. You may receive a local numbing agent or general anesthesia, depending on the extent of your condition.