Genital warts, sometimes called venereal warts, are actually a common type of sexually transmitted disease (STD). As the name suggests, these warts affect the moist tissues of the genital area. Genital warts are typically flesh- or gray-colored and can be either raised or flat. They vary in size from too small to spot with the naked eye to large, uneven, cauliflower-like clusters.
Like warts that appear on other areas of the skin, genital warts are caused by the human papillomavirus (HPV). There are over 100 different strands of HPV, but only about 40 can cause genital warts. A subgroup of these can lead to precancerous changes and can cause cervical, vulval, penile, and anal cancer. These strains of the virus are highly contagious and spread through illicit sexual contact with an infected person. Genital warts can cause itching, burning, or tenderness in the infected area.
Genital warts can be removed in different ways, but it is best to leave treatment to a physician since it is easy to damage the sensitive genital area. Small warts can be treated with chemicals such as podofilox or trichloroacetic acid (TCA), frozen with liquid hydrogen, or removed with laser surgery. Another method of wart removal is loop electrosurgical excision procedure (LEEP), in which the physician passes a sharp, loop shaped instrument under the wart and cuts it out of the skin.
If genital warts are large or don’t go away after they’ve been treated with different methods, the doctor might try a shot of interferon, which is a chemical that stimulates the body’s immune response to fight infections and viruses. Interferon is usually injected into the warts twice a week until the warts are gone. This procedure is expensive, however.
Although all of the treatments can get rid of warts, none of them will get rid of the virus. Because the HPV will still be present in the body, the warts can return and the virus can still be spread.
Genital warts can be bothersome because of their location, size, or due to itching. The size may range from less than one millimeter (1 mm = 0.039 inches) across to several square centimeters (1 cm = 0.39 inches) when many warts join together.
Men and women with genital warts will often complain of painless bumps, itching, and discharge.
Rarely, bleeding or urinary obstruction may be the initial problem when the wart involves the urethral opening (the opening where urine exits the body.)
Warts in more than one area are common.
There may be a history of previous or concurrent sexually transmitted diseases (STDs).
In men, genital warts can infect the urethra, penis, scrotum, and rectal area. The warts can appear as soft, raised masses with a surface that can be smooth (on the penile shaft) or rough with many fingerlike projections (anal warts). Others may appear pearly, cauliflower-like, or rough with a slightly dark surface. Most lesions are raised, but some may be flat with only slight elevation above the skin surface. Sometimes lesions may be hidden by hair or in the inner aspect of the uncircumcised foreskin in males.
In women, genital warts have a similar appearance and usually occur in the moist areas of the labia minora and vaginal opening. Lesions visible on the outer genitals warrant a thorough examination of the vaginal canal, cervix, and anorectal area. Most vaginal warts occur without symptoms.
Because genital warts essentially have no symptoms other than their appearance, there is little need for home treatment. It is important, however, to recognize that the warts exist.
Take the necessary precautions to prevent trauma to the area, which can result in bleeding.
Because the warts themselves are infectious, avoid touching them. Do not pick or squeeze the warts.
There is no single effective cure for removal of genital warts. A number of treatment options exist; however, no treatment is 100% effective in eliminating warts and preventing them from coming back in all patients. It also is not possible to eliminate infection with human papillomavirus once it has occurred. Genital warts may go away on their own in about 10-20% of people over a period of three to four months.
Cryotherapy: This technique freezes the wart using liquid nitrogen or a "cryoprobe." It is an excellent first-line treatment because response rates are high with few side effects.
Laser treatment: This treatment is used for extensive or recurrent genital warts. It may require local, regional, or general anesthesia. The laser physically destroys the HPV-induced lesion. Disadvantages include high cost, increased healing time, scarring, and potentially infectious viral particles in the air caused by the laser plume.
Electrodesiccation: This technique uses an electric current to destroy the warts. It can be done in the office with local anesthesia. Of note, the resulting smoke plume may be infectious.
Genital warts are caused by the human papillomavirus (HPV). Over 100 types of HPVs have been identified; about 40 of these types have the potential to infect the genital area.
About 90% of genital warts are caused by two specific types of the virus (HPV-6 and -11), and these HPV types are considered "low risk," meaning they have a low cancer-causing potential. Other HPV types are known causes of premalignant changes and cervical cancers in women. HPV-16, one of the "high-risk" types, is responsible for about 50% of cervical cancers. HPV types 16, 18, 31, and 45 are other known "high risk" virus types. High-risk HPV types are also referred to as oncogenic HPV types. HPV is believed to cause 100% of cases of cervical cancer.
Common warts are not the same as genital warts and are caused by different HPV types that infect the skin.