Genital warts also known as venereal warts or Condylomata acuminate are described as fleshy/soft growth, sometimes bumps or significant skin changes that occur on or close to the genital and/or anal area (anal warts). It also occurs in the mucous membrane of the rectum, vagina and cervix.
The warts are among the most common types of sexually transmitted infections affecting about 20 million Americans.
Causes of this infection
The wart is transmitted by the human papilloma virus (HPV) in at least half of all sexually active individuals. Over 100 different types of HPV exist with a few causing genital warts. HPV types that are not spread by sexual contact usually cause warts on the hands, feet and/or face. Human papilloma virus types 6 and 11 are responsible for the majority of genital warts.
Genital warts usually affect the moist tissues of the genital/genital area and occur more in women than in men. Warts can occur elsewhere on an individual’s body and are also caused by the human papilloma virus. HPV lives inside the host’s body cells where it replicates and spread out to infect other cells. The human papilloma virus is the leading cause of cervical cancer.
Some of the risk factors of genital warts are:
- Engaging in unprotected sexual intercourse;
- Uncontrolled sexual encounter especially with people of unknown sexual history;
- Stress and viral infections.
Some of the complications of this disease include cancer and problems during pregnancy. Diagnosis is usually done by a healthcare professional who examines the possible sites of the disease onset. In women, warts can occur on the vulva, cervix, upper thighs, inside the vagina, on and inside the anus. For men, they occur on the penis, urethra, scrotum, anus and upper thighs.
In paraphrase, the diagnosis of genital warts is done visually and may require, in some cases, confirmation by biopsy. DNA tests are also done for the diagnosis of high risk HPV infections. However, genital warts are caused by low risk HPV; hence DNA test is not employed for diagnosis in this case.
It has been documented that a vaccine; Gardasil, marketed by Merck and Co is preventive against the human papillomavirus types 16, 6, 18, as well as type 11. HPV types 11 and 6 cause genital warts whereas types 18 and 16 cause cervical cancer. The Merck vaccine is recommended to be administered prior to exposure to either of the virus type to be effective preferably before sexual activity.
Gardasil is not therapeutic for HPV rather it is preventive. It has been approved by the United States Food and Drug Administration to prevent the progression of HPV in both male and female. Irrespective of the fact that HPV pose more health risk in women, it can cause some health problems in men as well. Genital warts men can increase a man’s risk of cancer in affected area. So, it also necessary that the men understand the different modalities geared towards reducing the risk of HPV.
How to get rid of warts
There are different HPV treatment modalities and in most cases, the infection is cleared off by the body. Studies have shown that HPV cannot be cured. However, treatments are directed towards the eradication of visible warts which sometimes are capable of regressing in the absence of therapy. No study has proved that removing the visible growth will reduce the transmission of existing HPV infection. Body clearance of the infection may occur in 80% of infected subjects within 18 months.
Depending on the wart size, number, location and other factors, a healthcare professional may provides several approach to its treatment most of which may lead to de-pigmentation, scare formation and itching.
Treatment for this infection is either done by using topical agents or by physical ablation. The latter is known to be more effective for removing initial infection but the recurrence rate is significant.
Another treating modality is by employing folk remedies and there are little evidence that support that safety and efficacy.
This method is more effective for treating keratinized warts and is usually used in patients with fewer numbers of smaller warts.
- Scissors can be used for excision under local anesthesia.
- Liquid nitrogen cryosurgery can be done on a weekly basis.
- Electro-cauterization also known as loop electrical excision procedure is as well considered effective.
- Laser ablation, though less effective, can be employed as a last line treatment option.
- Surgery by specialists.
Topical agents can be used externally to manage genital warts and others. These include:
- 0.15–0.5% podophyllotoxin marketed as Condylox(0.5%), Wartec (0.15%) and Warticon (0.15%)
- Imiquimod (Aldara), a topical immune response cream. This is to be used on the affected area.
- Sinecatechins marketed as Veregen and Polyphenon E. It has a higher clearance rates than podophyllotoxin and imiquimod. Clearance usually takes longer time than with imiquimod but it cause less irritation.
- Trichloroacetic acid (TCA) is less effective than cryosurgery. This is not recommended for use in the vagina, cervix and in the urinary meatus.
- Interferon can be used, though has inconsistent effect, can be used to treat warts.
Genital wart is a serious infection in both men and women and may progress beyond expectation if not properly diagnosed and treated. Abstinence from unprotected sex and proper hygiene will go a long way to preventing the disease onset. Talk with your health professional, talk with us; you will be glad you did.