A genital wart is a group of pink-red to gray-white warts around the genitals or anus. The warts have a diameter of one to five millimeters and are close to each other. They are caused by a virus. The warts are contagious and sometimes quite uncomfortable, but they can do no harm. Genital warts are a sexually transmitted disease (STD).
Cause
Genital warts are caused by a virus, the Human Papillomavirus (HPV types 6 and 11). This virus is transferred during intercourse onto the skin or mucosa of the other person. Infection is also possible via the fingers or by using a towel from someone with genital warts.
Genital warts can emerge one to eight months after infection with the virus. Not everyone who is infected with the virus will get warts. The HPV may be present in the skin over many years and may, after initial healing of the genital warts, come back again after years. This makes it difficult to know by whom and when a person has been infected.
Symptoms
Because genital warts are close together in groups, the skin looks cauliflower-like. Sometimes this is just disturbing to see, but patients can also suffer from itch, pain or a burning sensation. There may also be some discharge coming out of the vagina or urethra.
In women, the warts are located especially at the entrance of the vagina, around the clitoris or around the anus. Sometimes there are warts in the vagina and on the cervix.
In men, the warts are particularly found on the penis, at the exit of the urethra, on the scrotum or around the anus.
Diagnosis
Doctors can determine the diagnosis of genital warts using various methods:
- Visual inspection. On visual inspection in women, the doctor examines the labia, vagina, cervix and the area around the anus. At these places, genital warts are most common. In men, the doctor examines the penis, urethra, scrotum and the area around the anus.
- Smear. A smear can be made from the penis, vagina, anus (anal sex) or throat (oral sex). In women, moisture is taken from the cervical mucus. In men, moisture is taken from the outer part of the urethra.
- Biopsy. By examining a small tissue sample from a wart or the surrounding area, the doctor can determine the presence and degree of abnormal cells.
- Colposcopy. A colposcope is an instrument which allows the doctor to examine the vagina and cervix through a lens with seven to twelve times magnification. When the presence of warts is suspected, the doctor applies a diluted acetic acid solution onto the suspected area. Any warts will colour white and become clearly visible.
- Blood test. A doctor may choose to do further examination into other STDs by means of blood tests. This way, the doctor can exclude or detect the presence of hepatitis B, HIV and syphilis.
Treatment
Genital warts disappear spontaneously in most instances, without treatment. But this can take years. The main reason for treating genital warts is cosmetic. Small and new warts respond better to treatment. The treatment is intensive and is prescribed by a doctor. In many cases, the patient carries out the treatment by himself. This self-treatment includes regularly, several days a week, applying a cream or liquid onto the warts. This treatment can last for five to sixteen weeks.
The doctor can also freeze, burn or cut the warts away. Cutting is especially done when there are many warts. This is done under local anesthesia.
Prognosis
Despite treatment, genital warts can return regularly, usually within six months. This is because the virus, despite the treatment, often still remains. The virus may also still be transferred to others after treatment.
Considerations
- Because genital warts are contagious, it’s wise to warn sexual partner(s).
- Use a condom during sex. A condom, however, provides no full protection against genital warts. This is because the virus and the warts are often located outside the edge of the condom.
- At the moment that warts are visibly present, there can better be no intercourse, because the risk of transfer is higher then.
- People with an STD may also have other STDs at the same time. It may be wise to have the patient and his or her partner(s) also examined on other STDs.
