Genital warts


Definition

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 spread through sexual contact.

Alternative Names

Condylomata acuminata; Penile warts; Human papillomavirus (HPV); Venereal warts; Condyloma; HPV DNA test; Sexually transmitted disease (STD) - warts; Sexually transmitted infection (STI) - warts; LSIL-HPV; Low-grade dysplasia-HPV; HSIL-HPV; High-grade dysplasia HPV; HPV; Cervical cancer - genital warts

Causes

This EM Should be displayed at the top of the article section "Causes"

The virus that causes genital warts is called human papillomavirus (HPV). HPV infection is the most common sexually transmitted infection (STI).There are more than 180 types of HPV. Many cause no problems. Some cause warts on other parts of the body and not the genitals. Types 6 and 11 are most commonly linked to genital warts.

Certain other types of HPV can lead to precancerous changes in the cervix, or to cervical cancer. These are called high-risk types of HPV. They can also lead to vaginal or vulvar cancer, anal cancer, and throat or mouth cancer.

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, sexual abuse should be suspected as a possible cause.

Symptoms

Genital warts can be so tiny, you cannot see them.

The warts can look like:

In females, genital warts can be found:

In males, genital warts can be found on the:

Genital warts can also occur on the:

Other symptoms are rare, but can include:

Exams and Tests

The health care provider will perform a physical exam. In women, this includes a pelvic exam.

An office procedure called colposcopy is used to spot warts that cannot be seen with the naked eye. It uses a light and a low-power microscope to help your provider find and then take samples (biopsy) of abnormal areas in your cervix.

The virus that causes genital warts can cause abnormal results on a Pap smear. If you have these types of changes, you may need more frequent Pap smears or a colposcopy.

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:

Make sure you are screened for cervical, vaginal, vulvar, or anal cancer if you have been diagnosed with genital warts.

Treatment

Genital warts must be treated by a doctor. Do not use over-the-counter medicines meant for other kinds of warts.

Treatment may include:

The warts may also be removed with minor procedures, including:

If you have genital warts, all of your sexual partners should be examined by a provider and treated if warts are found. Even if you do not have symptoms, you should be treated. This is to prevent complications and avoid spreading the condition to others.

You will need to return to your 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 your 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.

Outlook (Prognosis)

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. They can still pass it on to current and sometimes future sexual partners.

Even after you have been treated for genital warts, you may still infect others.

Possible Complications

Some types of HPV can cause cancer of the cervix and vulva. They are the main cause of cervical cancer.

Genital warts may become numerous and quite large. These will need further treatment.

When to Contact a Medical Professional

Call your provider if:

Women should begin having Pap smears at age 21.

Prevention

HPV can be passed from person to person even when there are no visible warts or other symptoms. Practicing safer sex can help reduce your risk of getting HPV and cervical cancer:

An HPV vaccine is available:

Ask your provider whether the HPV vaccine is right for you or child.

References

Berman B, Amini S. Condyloma acuminata. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 46.

Bonnez W. Papillomaviruses. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 146. 

Centers for Disease Control and Prevention. 2015 sexually transmitted diseases treatment guidelines: anogenital warts. Updated June 4, 2015. CDC.gov Web site. www.cdc.gov/std/tg2015/warts.htm. Accessed December 2, 2016.

Centers for Disease Control and Prevention. Press Release: CDC recommends only two HPV shots for younger adolescents. Updated October 20, 2016. CDC.gov Web site. www.cdc.gov/media/releases/2016/p1020-hpv-shots.html. Accessed December 2, 2016.

Committee on Adolescent Health Care of the American College of Obstetricians and Gynecologists; Immunization Expert Work Group of the American College of Obstetricians and Gynecologists. Committee opinion No. 588: human papillomavirus vaccination. Obstet Gynecol. 2014;123(3):712-718. PMID: 24553168 www.ncbi.nlm.nih.gov/pubmed/24553168.

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