Genital Warts

What are genital warts?

Genital warts are a kind of sexually transmitted infection(STI) causing small bumps or growths to develop around the genital and rectal areas. Specific human papillomavirus (HPV) strains lead to genital warts. Although there is no HPV cure, treatments are available for the warts themselves.

Genital warts can be transmitted from one person to another through anal, vaginal, or oral sexual intercourse.

How common are genital warts?

Genital warts are among the most common STIs in the world. The World Health Organization (WHO) estimates that about 290 million females are infected with HPV with nearly 32 million experiencing genital warts in a given time. For men, there are approximately 160 million HPV infection cases, with 20 million involving genital warts.

What Are the Symptoms of Genital Warts?

Genital warts appear as rough, skin-colored, or whitish-grey growths on the skin. They often resemble bumpy cauliflower, though they can sometimes be flat. Usually, genital warts are not painful; however, they can occasionally cause:

• Mild bleeding
• A burning sensation
• Discomfort or pain
• Genital irritation or itching

Some genital warts are very tiny, yet one can usually see or even feel them. They may sometimes collectin groups or grow large and form a stalk-like look. Most of the warts start as small, soft growths that might go unnoticed.

What do genital warts look like?

The appearance of genital warts normally varies based on factors like the person's immune response and the particular HPV strain involved. They can present as tiny, elevated bumps that look like cauliflower or as flat, smooth lesions. Their color can range from flesh-colored to red, pink, or brown. However, it's crucial to understand that not all warts can be seen with the naked eye, as some might be found inside the vagina or even the anus.

What Causes Genital Warts?

Genital warts are caused by the human papillomavirus or HPV. Basically, over 40 HPV strains are affecting the genital area. These warts are almost always transmitted through sexual contact. Also, even warts that are too small to see can still spread the infection to sexual partners.

Risk factors

Most sexually active individuals will contract genital HPV at some point in their lives. Factors that are likely to contribute to the infection include:

• Not receiving the HPV vaccination.
• Having intercourse without using a condom or with multiple partners.
• Having had a different sexually transmitted infection.
• Engaging in sexual activity with a partner whose sexual history is unknown to you.
• Becoming sexually active while at a young age.
• Having a compromised immune system including from HIV or medications from organ transplant.

Complications

HPV infections can cause several health issues including:

• Cancer: Cervical cancer is closely associated with genital HPV infections. Some HPV types are also connected with cancers affecting the vulva, penis, anus, mouth, or throat.
  
  Not all HPV infections cause cancer. However, regular Pap tests for women to check for cervical cancers are important. This is especially true for those infected with higher-risk HPV kinds.

• Pregnancy problems: Though rare, warts may enlarge during pregnancy, making urination difficult. Warts that develop on the vaginal wall can interfere with the widening of vaginal tissues during delivery. In addition, bigger warts in the vagina or on the vulva may bleed during childbirth.
  
  In very rare cases, a baby born to a woman with genital warts can develop warts in the throat. This could potentially require surgery to prevent airway blockage.

How Are Genital Warts Diagnosed?

Doctors usually detect genital warts through a physical examination. In some cases, they may have to remove a small tissue sample and examine it in the lab, a process known as a biopsy.

Other diagnostic tests for genital warts include:

Pap tests

Regular Pap tests are crucial for women, as they help detect any changes in the cervix and vagina that genital warts could cause. These tests also help identify early warning signs of cervical cancer.

The practitioner performs a Pap test using a device known as a speculum to keep the vagina open. This allows them to view the pathway between the vagina and uterus, referred to as the cervix. They will then use a long-handled device to collect a small cell sample from the cervix. These cells will be examined under a microscope for any irregular changes.

HPV test

Just a few forms of genital HPV are associated with cancer of the cervix. The cervical cell sample obtained during a Pap test may be examined for these cancer-causing strains of HPV.

Usually, this test is recommended for women aged 30 and above. This is because it is not very helpful for younger females as HPV often resolves on their own without any treatment.

Treatment

What are the different types of treatment for genital warts?

If your genital warts aren't causing discomfort, then treatment might not be necessary. However, medications or surgery could be helpful in clearing an outbreak if you experience burning, itching, or pain. Also, you can consider treatment if you are worried about transmitting the infection to others.

It's important to note that warts tend to come back after treatment, and there is no cure for the HPV virus itself.

Medications

Treatments for warts that can be applied to the skin are:

• Imiquimod (Zyclara): This is a cream that helps stimulate the immune system to fight off genital warts. You should avoid sexual activity while using the cream, as it can weaken condoms as well as the diaphragms. It may also irritate the skin of your partner.
  
  The common possible side effects include skin color changes in areas where medications have been applied. Blisters, body aches, rashes, coughing, or fatigue may also occur.

• Podophyllin (Podocon-25) and podofilox (Condylox): Doctors can use Podophyllin, a plant-based component, to destroy the tissue of the genital wart. They can apply the solution on the skin as a treatment option. Podofilox, containing a similar active element, can be used at home.
  
  Never use podofilox internally, and it is not recommended during pregnancy. Possible side effects are mild skin irritation, pain, and sores.

• Trichloroacetic acid: Doctors recommend this chemical treatment to burn off genital warts. It may also be used internally. The potential side effects are mild skin irritation, discomfort and sores.
  
  
• Sinecatechins (Veregen): You can use this ointment to treat warts all over the body and those around or inside the anus. Possible side effects are changes in skin color, burning, itching, and discomfort.

Avoid treating genital warts with over-the-counter wart removers from stores, as these products are not suitable for use in the genital area.

Surgery

A surgical procedure might be necessary to remove bigger warts or those that aren't responding to medication. Pregnant women may require surgery to take out warts that could come into contact with the baby during delivery.

Surgical options for genital warts are:

• Freezing with liquid nitrogen (cryotherapy): This procedure create a blister around the wart, causing it to slough off as the skin heals and a new one emerges. Freezing may need to be repeated for it to be effective. The common side effects are discomfort and swelling.
  
  
• Electrocautery: This procedure burns off genital warts using an electric current. Pain and swelling may be experienced afterwards.
  
  
• Surgical excision: This involves surgically cutting off warts. Anesthesia may be administered to prevent pain during the procedure. Afterwards, you will likely experience discomfort.
  
  
• Laser treatments: This method utilizes a powerful beam of light and can be costly. It is usually reserved for extensive and difficult-to-treat genital warts. The potential side effects are scarring and discomfort.

How Long Does It Take to Treat Genital Warts?

The treatment duration for genital warts varies based on factors like the size as well as number of warts, the treatment option chosen and the response of the person to treatment.

Improvement might be noticed within a few weeks for some people, while others may need several months of treatment. Following the doctor's instructions and completion of the full course of treatment is essential in ensuring effective warts clearance.

Can Genital Warts Come Back After Treatment?

Although treatment is effective in removing visible warts, they can return. This is because the HPV virus-causing genital warts may linger in the body even after the clearance of warts. The rate of recurrence varies based on factors like the immune response of the person and the specific HPV strain involved. Frequent follow-ups with the doctor and persistent monitoring are thus essential in ensuring the detection of any reappearance while still early and providing proper treatment.

Can Genital Warts Be Prevented?

Receiving HPV vaccinations is important in preventing genital warts. Also, limiting the number of sexual partners lowers the risk. It is considered safe to have intercourse with only one person who has sex with you alone.

In addition, using condoms each time you engage in sexual activity is generally a wise option. However, this will not completely prevent you from developing genital warts since the HPV virus can infect other body parts that are not covered by the condom.

Conclusion

Genital warts are the most widespread sexually transmitted infection that could significantly affect a person's sexual health. Certain HPV strains cause the warts and can occur in both males and females.

Understanding the symptoms, look, spread, prevention and available treatment options for genital warts is important. It's also essential to seek medical help for detection and treatment in order to avoid complications and maintain optimal sexual health.

In general, practising safe intercourse, getting a vaccination against HPV, and going for regular screenings can help lower the risk of genital warts along with other sexually transmitted infections.