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Genital Warts – Human Papilloma Virus (HPV)

Genital warts (also known as venereal warts, anogenital warts, or condylomata acuminata) are caused by the human papilloma virus (HPV). More than 100 types of HPV are known to exist. Types (6 and 11) can cause warts on the genitals or anus (genital warts), and other types (HPV 16 and 18) can cause cancer of the cervix, external genitalia, and anus. Low risk types (HPV 1, 2, and 3) cause warts on the hands, feet, and other parts of the body.

Genital warts are usually sexually transmitted through direct skin-to-skin contact during oral, genital, or anal sex with an infected partner. It can also be transferred to infants who have been delivered vaginally to mothers with HPV in their genital tracts; therefore, alternate methods of delivery should be considered. The HPV types that cause genital warts rarely cause cervical and anal cancer.

Only a small percentage of people infected with HPV will develop genital warts. Many people are “carriers” of HPV who may never develop warts, but may still be able to pass HPV to their sexual partners.  The incubation period from contracting HPV until the development of warts may be several months; although, some people may not develop warts for years after contact with HPV. People who have lower immunity due to cancer, AIDS, organ transplantation, immune suppressive medications, or certain other medications are more susceptible.

What do genital warts look like?

  • Flesh-colored spots that are raised or flat
  • Growths that look like the top of a cauliflower

In females, genital warts may be found:

  • Inside the vagina, cervix, or anus
  • Outside the vagina or anus, or on nearby skin
  • Penis, Scrotum, Groin/Thighs
  • In rare cases genital warts can also develop in the mouth, tongue or throat in a person who has had oral sex with infected persons

How are warts diagnosed?

Most genital warts are diagnosed during an examination by a dermatologist. The growth may be surgically removed and sent to the laboratory for microscopic evaluation to confirm the diagnosis.

Why should warts be treated?

Removing warts reduces the risk of passing the virus to partners.

Genital warts must be treated by a doctor.

Do NOT use over-the-counter medicines meant for other kinds of warts.

Treatment may include:

  • A skin treatment done in the doctor’s office
  • Prescription medicine that you apply at home several times per week

Prescription medicines include:

  • Imiquimod 5% Cream (Aldara). Apply thin layer to warts and rub in before bedtime 3 x’s per week; wash off with soap and water 6-10 hours later; max 16 weeks. Avoid sexual contact while cream is on skin
  • Podophyllin and podofilox (Condylox 0.5%, Wartec/Warticon 0.15%). Apply twice daily (BID) for 3 days then discontinue for 4 days.
  • Trichloroacetic acid (TCA)

The warts may be removed with surgery, including:

  • Cryosurgery (Liquid Nitrogen Freezing)
  • Laser
  • Surgical Excision (cutting them out)
  • Electrocauterization

Treatment depends on the number of warts, their specific location, and other factors. Recurrences are always possible. These methods may require local anesthesia, and time is required for healing.

Successful therapy of warts does not guarantee that all HPV is gone since the virus may be deep in the layers of the skin. After successful treatment, the possibility of transmission may still exist; however, a person is probably less contagious.

Knowing one’s sexual partner and other forms of safe sex help reduce transmission, but only abstinence is 100% effective. Transmission can be reduced by the proper use of condoms, and by the successful treatment of warts.

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