Genital Warts

Genital Warts This viral infection is symptomatic of clusters of pink or brown warts on and around the genitals and is caused by the human papilloma virus.

What is it?

Genital warts are the most common sexually transmitted infection in the UK and are caused by the human papilloma virus (HPV). There are over a 100 different strains of HPV, of which 40 are known to cause genital warts. Some versions of HPV may cause warts, while others don't display any visible symptoms.

HPV causes small solitary or grouped projections of skin around both male and female genital areas and sometimes the anus. The warts may vary from pink to brown, depending on the area of skin they are on. They don't normally tend to hurt, however they could become itchy.

Genital warts are passed on from one person to the next through sexual intercourse or skin-to-skin contact. This means that people who have multiple sexual partners are at a higher risk of catching the infection. The highest occurrence is in men between the ages of 20 and 24 and women between the ages of 16 and 19 years.

What are the symptoms?

Genital warts generally start appearing around two to four weeks after infection, but sometimes it could take months. Some people may not experience any symptoms of genital warts at all.

In men, the signature mounds of skin tend to appear on the glans, shaft or under the foreskin of the penis. In some cases HPV may cause the warts to grow in the urethra or around the anus and scrotum.

Warts usually appear on the lips of the vulva, vagina and near the urinary opening, as well as around the anus in women. They may also develop inside the vagina or on the cervix where they are less visible.

What are the risks?

The virus doesn't just spread through penetrative sex, as it can also be passed through skin-to-skin contact or sharing sex toys. To reduce your risk of getting genital warts, apart from remaining celibate, it's recommended that you use a condom as this can reduce your risk of spreading or getting the infection. Although you can still catch HPV from a person not displaying any symptoms, it's more likely that you'll get genital warts from someone with visible warts, because the virus is at its most active in areas where the warts are visible.

Genital warts aren't dangerous and are very common. However, if you think you may have genital warts, it is best to visit your doctor for treatment. This will help the visible projections to disappear, and also allow you to ensure you don't have any other STIs.

Can it be cured?

HPV can't be cured, but it can be treated very successfully by a doctor, who would normally recommend one of two methods of treatment after conducting a physical examination to establish whether you have genital warts or not. These methods could include topical creams and gels such as Aldara, Condyline and Warticon or physical ablation.

One of the creams a doctor could recommend is podophyllotoxin, or Warticon, which has a toxic effect on the genital warts. This is usually the preferred method of treatment for clusters of warts. Condyline is a gel version of this cream and works in much the same way to treat genital warts. Larger warts that tend to come back after treatment may be treated with imiquimod, or Aldara, which stimulates your body's immune system to attack the HPV responsible for causing the warts. Trichloroacetic acid can be used on smaller harder genital warts, but it's not recommended that you apply it yourself, so you may be asked to visit your GUM clinic once a week for application. It works by dissolving the proteins within the genital wart cells.

Physical ablation involves removing the genital warts through cryotherapy, excision, electrosurgery or laser surgery, similar to the topical ointments mentioned. Which method is recommended to you will largely depend on the nature of the genital warts being treated.

HPV can also be prevented (but not treated) by the Gardasil vaccine. This is not a standard childhood vaccine, but can be requested privately as a genital warts prevention method. It offers 90% protection for both men and women between the ages of 9 and 26 against the four main strains of HPV that cause genital warts. Gardasil can also help to prevent young girls and women against vaginal and vulvar cancers. A full treatment of Gardasil is administered as three shots over a period of six months.

How do I get tested for genital warts?

Unfortunately, there is no do-it-yourself test available to test for genital warts. If you suspect you may have genital warts, you will need to visit your doctor for an examination. The doctor who carries out the examination will check your genital area and anus, both through an internal and external examination. This is the only way that genital warts can be conclusively diagnosed. If the warts are not yet visible, it is likely that you will need to go back for a secondary examination.