Sexually Transmitted Diseases

Genital Warts

In women, the warts occur on the outside and inside of the vagina, on the cervix (the opening to the uterus), or around the anus. In men, genital warts are less common. If present, they are seen on the tip of the penis; however, they also may be found on the shaft of the penis, on the scrotum, or around the anus. Rarely, genital warts also can develop in the mouth or throat of a person who has had oral sexual contact with an infected person. Genital warts often occur in clusters and can be very tiny or can spread into large masses on genital tissues.

If left untreated, some cases of genital warts disappear, but more often they develop a fleshy, small raised growth with a cauliflower-like appearance. Because there is no way to predict whether the warts will grow or disappear, people who have them should seek medical evaluation and treatment.

Diagnosis

A doctor usually can diagnose genital warts by direct visual examination. Women with genital warts also should be examined for possible HPV infection of the cervix. The doctor may be able to identify some otherwise invisible changes in the tissue by applying a weak vinegar-like solution (acetic acid) to areas of suspected infection. This solution causes infected areas to whiten, which makes them more visible, particularly if a procedure called a colposcopy is performed. During a colposcopy, a magnifying instrument is used to view the vagina and uterine cervix. In some cases, it is necessary to do a biopsy of cervical tissue. This involves taking a small sample of tissue from the cervix and examining it under the microscope.

A Pap test also may indicate the possible presence of cervical HPV infection. Abnormal Pap test results are sometimes associated with HPV infection. Women with abnormal Pap smears should be examined further to detect and treat cervical problems.

Treatment

Depending on factors such as their size and location, genital warts are treated in several ways. Although treatments can eliminate the warts, none completely get rid of the virus and warts often reappear after treatment. Patients should consult their doctors to determine the best treatment for them.

Complications

Low-risk papilloma viruses cause warts but not cervical cancer. High-risk viruses, however, cause cervical cancer and also are associated with vulvar cancer, anal cancer, and cancer of the penis (a rare cancer). Although most HPV infections do not progress to cancer, it is particularly important for women who have cervical dysplasia to have regular Pap smears. Potentially pre-cancerous cervical disease is readily treatable.

Prevention

The only way to prevent HPV infection is to avoid direct contact with the virus, which is transmitted by skin-to-skin contact. If warts are visible in the genital area, sexual contact should be avoided until the warts are treated. Using a latex condom during sexual intercourse may provide some protection.

Researchers are working to develop two types of HPV vaccines. One type would be used to prevent infection or disease (warts or pre-cancerous tissue changes); another type would be used to treat cervical cancers. Clinical trials are in progress for both types of vaccines.

This information is excerpted from public documents available at
The National Institute of Allergy and Infectious Disease.

To learn more about their organization, click here.