What are genital warts?
Genital warts are small, soft lumps in your genital area that are caused by the human papilloma virus (HPV). There are more than 100 different types of HPV — these viruses cause all types of warts including the common warts seen on the hands, fingers and even the face. Although only a few members of the HPV family cause genital warts, these viruses are very common in the community.
How do you get genital warts?
Genital warts are generally transmitted sexually. The wart virus, HPV, is passed on through having sex or very intimate contact with someone who already has warts. HPV can pass through small tears in the skin of your genitals that happen during sex. A wart will appear in the same area, usually within 3 months but sometimes not for years.
People can transmit the virus most easily when warts are present, but a dormant virus can also be infectious. Therefore, preventing the spread of genital warts is extremely difficult. Condoms do not offer 100 per cent protection against HPV, as they don’t necessarily cover all of the infected skin.
Diagnosing genital warts
You, your partner or a doctor or midwife may find small, soft, cauliflower-like, flesh-coloured or white lumps in or around your vagina, bottom or penis. There can be just one, or several in a clump. They can sometimes also grow deep inside your vagina and rectum where you can’t see or feel them. Your doctor may put a weak vinegar solution on the lump: it will turn white if it is a wart. The doctor may take a small piece of the wart and have it tested.
Women may also have HPV diagnosed when they have a Pap smear test.
Symptoms of genital warts
The majority of people with genital warts have no recognisable symptoms and may not know they are infected. Others may develop noticeable genital warts of different sizes.
Some people may experience itching or pain around the genital area. This pain may be aggravated by intercourse or contact. In some cases there is bleeding with sex.
What makes genital warts worse?
- Being moist and damp.
- Using drugs meant for other warts; they’re too strong.
What can help the discomfort of genital warts?
Some people find the following helpful:
- keeping the area clean and dry;
- sitting in a salty bath; or
- using zinc oxide cream (ask your doctor or chemist).
Treatment of genital warts
Currently, there is no treatment for the virus, but there are several for the warts; your doctor will help you choose the best approach for you.
- Freezing: liquid nitrogen is put on the warts. It will feel very cold, then throb and burn. A blister will form. Don’t touch or break the blister; it will heal in a few days. Keep it clean and dry. This treatment is usually used for large warts.
- Chemical paint: a chemical solution is painted on the warts. It may be a bit painful or cause a burning feeling for a few days. This method is used for small warts. Tell your doctor if you are pregnant: some wart paints cannot be used at this time.
- Cream: you may be given a cream that you put on the warts or around your genitals and bottom over several weeks. It makes the skin peel off, along with the wart. It is generally not as irritating as the chemical paints. Cream is useful if there are a lot of warts. There is also a cream for genital warts that works by improving the immune system’s response to HPV — this needs to be prescribed by your doctor, who will instruct you on how to use it correctly.
- Burning: you will be given an injection to make that area numb, then the doctor will use a hot wire or laser to burn off the wart. This treatment is usually used for large warts.
Follow your doctor’s instructions carefully. You may need several treatments to get rid of the warts. Bear in mind that genital warts can come back in the first 2 years after treatment, especially in the first 3 months. If this happens you may need to be treated again.
Genital warts and cancer
Some types of HPV infect a woman’s cervix and may increase the risk of cervical cancer, especially if the virus is present for many years. Your doctor will therefore suggest that you have more frequent Pap smear tests than usual if you have been infected with HPV. If HPV persists, your doctor will probably recommend a colposcopy, in which your cervix is examined under magnification and small pieces of tissue may be removed for further testing (this is called a biopsy).
HPV has also been linked to cancer of the penis in men.
Australian research has led to the development of vaccines (e.g. Cervarix, Gardasil) that immunise against the HPV types that are commonly linked to cervical cancer. HPV vaccination reduces your risk of HPV infection and lessens the likelihood of cervical changes that can lead to cancer, especially if you have not previously been exposed to HPV.
However, current vaccines do not protect against all types of HPV associated with cervical cancer, and you still need to have Pap smears if you’ve been vaccinated.
The Commonwealth Government currently funds a school-based HPV vaccination programme.
Genital warts in pregnancy and childbirth
Pregnancy can sometimes trigger genital warts if you have a dormant HPV infection, or it can make an active infection worse.
Some women with genital warts are concerned about passing the virus to their baby while giving birth vaginally. However, this is generally rare. Ask your doctor or obstetrician for advice if you have genital warts while you are pregnant.
What happens if genital warts are not treated?
Genital warts clear up by themselves in about a third of cases — although this can take several years. However, without treatment, the warts may stay the same or get larger or more numerous.
When warts are visible, treatment is recommended to reduce the risk of spreading the infection to others, and many people also like to have genital warts treated for cosmetic reasons.
Protecting yourself and others
- Limit the number of people you have sex with.
- Use condoms (they offer some protection, but not 100 per cent).
- If your partner has warts, have a check-up.
- If you have warts, tell your partner and suggest they have a check-up.
- Don’t have sex until you have finished treatment or make sure you use a condom.
- 1. Human papillomavirus (HPV) infection (revised February 2009). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2012 Jul. http://online.tg.org.au/complete/ (accessed Aug 2012).
2. Immunise Australia Program. Human papillomavirus (HPV) (updated 12 July 2012). http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-hpv (accessed Aug 2012).
3. Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010; Genital warts (last reviewed 28 Jan 2011). http://www.cdc.gov/std/treatment/2010/genital-warts.htm (accessed Aug 2012).
4. MayoClinic.com. Genital warts (updated 20 Jan 2012). http://www.mayoclinic.com/health/genital-warts/DS00087 (accessed Aug 2012).
5. Australian Immunisation Handbook, 9th Edition (updated 26 March 2008). http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook-hpv (accessed Aug 2012).