Genital Warts (Condyloma)

Genital warts (sometimes called condyloma), are usually caused by a sexually transmitted viral infection that is common among men and women in the United States today.

Warts in the genital area are easily passed from person to person. In fact, practitioners who examine the sexual partners of people with genital warts find that between two-thirds and four-fifths of the partners have warts. It is not suprising, then, that genital warts are now one of the most common sexually transmitted diseases in the United States. Although this infection is on the rise, much can be done to treat as well as prevent genital warts.

What causes Genital Warts?

Genital warts are caused by a virus called human papilloma virus (HPV). This wart virus may be transmitted during vaginal sexual intercourse, oral sex, and anal sex. These viruses can infect any sexually active person. However, people with more than one sexual partner or people who have had other sexually transmitted diseases are at greater risk for this infection.

How can I find out if I have Genital Warts?

Once you are infected with the virus, it may be 2-3 months before any warts appear. In some people though, the warts show up much sooner (2 weeks) or much later (2 years). In women, warts can be present in or around the vulva (outside opening of the vagina), perineum (area between the opening of the vagina and anus), cervix (opening of the uterus), vagina and anus. In men wart lesions of the penis are usually small and are not readily apparent by a simple visual exam. However, even small wart lesions can infect a female sexual partner.

When warts do appear, there are usually no symptoms at all, but occasionally cause itching, irritation or bleeding. Warts on the external genital area are often firm and flesh colored or dark pink or red. Only one or two pencil-tip-sized warts may be present, or there may be a cluster that look like tiny cauliflowers.

The appearance of the warts can vary. Those inside the vagina tend to be softer and lighter-colored than those on the outside. Warts that appear in or around the anus can sometimes be mistaken for hemorrhoids. Those on the cervix are usually flat and may not be easily visable. Any growth around the genital or anal area is a good reason to see your practitioner.

In addition to checking any growths you may have noticed, your practitioner will look for other warts that may not be easily visable.

In females, a simple Pap test can be done to look for signs of the wart virus. Occasionally your practitioner may recommend a colposcopy which is a careful examination of the vagina and cervix by a magnifying instrument.

In males, the practitioner will put a weak solution of Acetic Acid (vinegar) on the penis and then use magnification to check for lesions. This will make it easier to detect warts.

How do I get rid of Genital Warts?

Although some warts may disappear spontaneously, treatment is generally needed. There are several ways of treating genital warts. Most of thes procedures can be performed in your practitioner's office.

• Cold cautery,like liquid nitrogen, destroys the warts by freezing.
• Podophyllin- This chemical should be washed off in 4-6 hours after applied or as specified by your practitioner. It should not be used on the cervix or by pregnant patients.
• Bichloracetic acid (BCA) or trichloroacetic acid (TCA)- This chemical does not have to be washed off after application.
• Other chemicals- such as 5FU.

Other treatments are available through referral to outside providers:

• Laser treatments, in which a high-intensity beam of light is used, may also be effective.
• Hot cautery is a method in which the warts are burned off with an electrical instrument.

While these treatments can destroy visable warts, the wart virus can remain in nearby normal-looking tissue after treatment. This virus can produce new warts, sometimes weeks or even months after the old ones have been destroyed. In that case, you'll need to return to your practitioner for another treatment.

You may feel frustrated or depressed when new warts appear, but repeat treatments on a weekly basis often solves the problem.

What are the risks if Genital Warts are not treated?

Certain types of genital wart lesions have been linked to changes in cervical tissue that, left untreated, might become pre-cancerous. These changes in cervical tissue can often be seen in the cells taken from the cervix during the "Pap test"- a simple test in which cells are taken from the cervix and studied under the microscope. All women should have a Pap test once a year, especially if they have ever had genital warts, or if they are at risk for genital warts. Caught early, these cervical changes are usually easy to treat. Also, recent evidence suggests men with condyloma may have some increased risk of penile and other cancers if diagnosis and treatment does not occur.

How do I keep from spreading Genital Warts?

If your practitioner finds that you have genital warts, your sexual partner should also be examined for warts. Remember, the majority of sexual partners of people with genital warts become infected. If both you and your partner have warts, it's important that you both be treated. Also, you should use condoms for intercourse until both partners are completely free of all warts.

There are things you can do to help reduce your risk of getting genital warts in the future. One is to limit sexual partners to those you know and trust- relationships in which each partner shares a concern for the other's welfare. A relationship in which each partner limits his or her sexual contact to the other partner carries much less risk of acquiring genital warts or other sexually transmitted diseases. An intact condom worn by the male during intercourse provides a measure of protection against catching or spreading genital warts and other sexually transmitted diseases.