Genital warts are soft growths on the skin and mucus membranes of the genitals. They may be found on the penis, vulva, urethra, vagina, cervix, and around and in the anus.
Genital warts are a sexually transmitted infection (STI).
The virus that causes genital warts is called human papilloma virus (HPV). More than 70 different types of HPV exist. Certain types of HPV can lead to precancerous changes in the cervix, cervical cancer, or anal cancer. These are called high-risk types of HPV.
Not all types of HPV cause genital warts. Other types of HPV cause warts on other parts of the skin, such as the hands. This article focuses on warts on the genitals.
HPV infection around the genitals is common. However, most people have no symptoms. In women, HPV can spread to areas inside the walls of the vagina and cervix. They are not easy to see without special procedures.
Important facts about HPV:
You are more likely to get genital warts and spread them more quickly if you:
If a child has genital warts, you should suspect sexual abuse as a possible cause.
Genital warts may be so tiny, you might not see them.
The warts may look like:
In females, genital warts may be found:
In males, genital warts may be found on the:
Genital warts may also occur on the
Other symptoms are rare, but may include:
The health care provider will perform a physical exam.
In women, this will include a pelvic examination. Magnification (colposcopy) is used to spot warts that cannot be seen with the naked eye. Your doctor may place watered-down vinegar (acetic acid) on the area. This helps better see any warts.
The virus that causes genital warts can cause abnormal results on a Pap smear. If you have these types of changes, you will probably need more frequent Pap smears for a while.
An HPV DNA test can tell if you have a high-risk type of HPV known to cause cervical cancer. This test may be done:
Genital warts must be treated by a doctor. Do NOT use over-the-counter medicines meant for other kinds of warts.
Treatment may include:
Prescription medicines include:
The warts may be removed with surgery, including:
If you have genital warts, all of your sexual partners must be examined by a health care provider and treated if warts are found. Even if you do NOT have symptoms, you must be treated to prevent complications and spreading the condition to others.
You will need to return to your health care provider after treatment to make sure all the warts are gone.
Regular Pap smears are recommended if you are a woman who has had genital warts, or if you partner had them. If you had warts on your cervix, you may need to have Pap smears every 3 to 6 months after the first treatment.
Women with precancerous changes caused by HPV infection may need further treatment.
Young women and girls ages 9 - 26 should be vaccinated against HPV, even if they already have genital warts, though the vaccine is somewhat less effective in preventing cervical cancer if you have already had an infection with high risk HPV.
Many sexually active young women become infected with HPV. In many cases, HPV goes away on its own.
Most men who become infected with HPV never develop any symptoms or problems from the infection. However, they can pass it on to current and sometimes future sexual partners.
Even after you have been treated for genital warts, you may still infect others.
Some types of HPV have been found to cause cancer of the cervix and vulva. They are the main cause of cervical cancer.
The types of HPV that can cause genital warts are not the same as the types that can cause penile or anal cancer.
The warts may become numerous and quite large, requiring more extensive treatment and follow-up procedures.
Call your doctor if:
Women should begin having Pap smears at age 21.
Not having sexual contact is the only foolproof way to avoid genital warts and other STIs. You can also decrease your chance of getting an STI by having a sexual relationship with only one partner who you know is disease-free.
Male and female condoms cannot fully protect you, because the virus or warts can be on nearby skin. Nonetheless, condoms reduce your risk and you should still use them at all times. HPV can be passed from person to person even when there are no visible warts or other symptoms. See: Safe sex
Two vaccines are available that protect against four of the HPV types that cause most cervical cancers in women. The vaccine is given as a series of three shots. It is recommended for girls and women ages 9 to 26.
See: HPV vaccine for more detailed information.
Condylomata acuminata; Penile warts; Human papilloma virus (HPV); Venereal warts; Condyloma; HPV DNA test; Sexually transmitted disease (STD) - warts; LSIL-HPV; Low-grade dysplasia-HPV; HSIL-HPV; High-grade dysplasia HPV; HPV
Diaz ML. Human papilloma virus: prevention and treatment.Obstet Gynecol Clin North Am. 2008;35(2):199-217.
Mayrand MH, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J, Ferenczy A, et al. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med. 2007;357:1579-1588.
Kahn JA. HPV vaccination for the prevention of cervical intraepithelial neoplasia. N Engl J Med. 2009;361:271-278.
Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine.
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