What Are Genital Warts

Although genital warts is not as popular as herpes and AIDS, it is a sexually transmitted disease that creates a great concern.

Aetiology

The technical name of genital warts is condyloma acuminate. Genital warts look like cauliflower and they are present near the genitals. Genital warts are caused by the human papilloma virus (HPV). There is a possibility of infection of the genital tract due to more than 80 types of HPV.

Most of the HPV infections are not recognized yet. They are asymptomatic or sub clinical. Among more than 80 types of HPV, types 6 or 11 are considered as the major cause of visible genital warts.

The infection causing genital warts can spread through sexual contact because of the occurrence of active virus on the genitals. It is found that if people have genital warts; their sexual partners have 60-90 % chances of having warts too within three months.
There are many instances in which people have this virus but they do not have any knowledge of it.

It is also possible that warts do not appear for several years despite the fact that the active virus is infecting cells for years. It is found from many studies that when women go for their routine Pap smears reception, in which HPV infection is revealed, most of them are found to have this virus.

The virus might not harbor recently and there is a possibility that it had been acquired many years ago.

There are various places, at which a genital wart may appear such as it may appear internally in the upper vagina or cervix, and it may also appear in the male urethra. It may also appear externally on the genitalia, in the anal area.

Several social and emotional problems arise due to the location of a wart and its transmission through sexual mode. Its patients may suffer from severe psychological disorders; they may feel guilty, embarrassed and angry.

Risk Factors

Any body can be infected with HPV if that person has ever had sex. If immune system of a person is suppressed, there is a chance to have visible lesions due to that virus.

It is not necessary that the virus must flare up with an obvious trigger. HPV infection can also occur if a person is taking medicines for cancer chemotherapy or some medicines that are used for the prevention of rejection of the transplantation of an organ.

This infection can also occur due to other diseases that could be transmitted sexually.

Symptoms

• Any age group may be affected, but genital warts are more common in the young and the sexually active.
• The warts are fleshy pink, may be pointed, papular or macular, and may occur singly or in clusters.
• Usually painless, but are occasionally itchy or tender.
• The warts may bleed after intercourse.
• The vulva, penis, cervix, vagina, perineum and perianal region are the areas that are usually affected, but lesions can occur on the face and mouth.
• Genital warts in children raise concerns about the possibility of sexual abuse.

Investigations:

• Genital warts are often associated with other STIs, so referral for full screening is advisable.
• Colposcopy, proctoscopy or histology may be needed.
• Laboratory tests may identify HPV DNA in latent cases.
• A cervical smear may pick up changes in cervical intraepithelial neoplasia that require follow-up.

Treatment

• Untreated warts usually grow and spread, but occasionally resolve spontaneously.
• The patient should use condoms in any new sexual relationship.
• Treatment aims to destroy the warts but recurrence rates are high.
• Podophyllotoxin or podophyllin paint must be applied weekly by a doctor or nurse.
• With instruction, men can apply podophyllotoxin to penile warts.
• Freezing with liquid nitrogen or nitrous oxide every three weeks is an alternative.
• Surgical removal under general anesthetic may be needed if the warts are extensive.