Genital warts are one of the most common sexually transmitted infections. The warts are harmless and affect the genital and anal area of both men and women and are most common in young sexually active adults.
What causes genital warts?
Genital warts are caused by a group of viruses called Human Papilloma Virus (HPV). There are over 100 types of HPV, most of which do not cause disease in healthy people.
About 80% of sexually active people have HPV infection at some stage in their lives. Most HPV infections clear by themselves under the influence of the immune system.
Two of the sexually transmitted HPV types (6 and 11) are known to cause genital warts.
About one in ten people carry these HPV types but only one in a hundred will develop visible warts.
The HPV types that cause genital warts are harmless but other invisible high-risk HPV types, which are sexually transmitted, can increase a woman’s risk of cervical cancer.
This can be prevented by having regular cervical smear tests.
What do genital warts look like?
Genital warts are growths or bumps that appear on the vulva, in or around the entrance to the vagina or anus, on the cervix, and on the penis, scrotum, groin or thigh. The appearance of the warts can vary from person to person. There may be a single wart or a cluster, they may be raised or flat, can be itchy or painless and can vary in size, shape and colour.
Can you have HPV infection with no visible warts?
HPV can be present in the skin without causing any warts to grow. The high-risk HPV types do not cause genital warts.
How do you get HPV or genital warts?
HPV and genital warts are most commonly spread by direct, skin-to-skin contact during vaginal, anal or oral sex with someone who already has the infection.
Genital warts most commonly affect sexually active men and women between the ages of 18 to 25, but the infection can be found in all age groups and in both homosexuals and heterosexuals.
Because the virus can sit dormant on the skin without causing warts, they can affect people who have not been sexually active for a number of years.
Genital warts tend to appear two to three months after exposure to the virus but this varies from person to person.
How are genital warts diagnosed?
Warts can be diagnosed by visual examination by your doctor in most cases.
How are warts treated?
There are a number of treatments available and the aims of treatment are to remove visible genital warts and reduce the amount of virus. Reducing the amount of virus will help the body fight the infection.
Treatment options include treatments performed in clinic or at home.
Clinic treatments include:
Cryotherapy: Freezing of the warts by liquid nitrogen. Once weekly treatments are recommended and it may be necessary to make multiple visits to the clinic.
Home treatments:
These include creams or solutions, which are applied on to the surface of the warts. These treatments can be prescribed by your doctor and can take from 4 to 16 weeks to work.
If there are a number of large or very persistent warts, referral to hospital for laser therapy, electro-cautery or surgery may be necessary.
Is treatment painful?
Treatment may cause damage to the healthy tissue surrounding the wart and can be painful. It is advisable to discontinue the treatment until the tissue heals. Keeping the skin clean and dry, taking salt baths and/or using Calendula cream will help the healing process.
Will the virus go when the warts are cleared?
The virus may still remain in the body once the warts are removed. Treating the warts will however destroy a considerable number of virus cells. This means the virus is weaker which should allow the body to fight the remaining cells. Boosting your immune system by eating a healthy diet and not smoking will help the body to fight the virus.
Can genital warts be treated in pregnancy?
Pregnancy hormones can cause genital warts to grow in size and number. These can be treated with cryotherapy but are sometimes removed to avoid problems during delivery.
What are the risks of having another STI?
If you have been infected with the virus that causes genital warts then you are at risk of other infections. Screening for these infections, Chlamydia for example, is advised and can be carried out at the Well Woman Centre or at Genito-Urinary Medicine clinics around the country.
What are the risks of developing Cervical Cancer if I have genital warts?
The precise cause of pre-malignant cervical cellular changes is unknown but it is assumed that it is associated with agents potentially transmitted by sexual intercourse.
Most experts believe that HPV is necessary for the development of cervical cancer. The high-risk viruses include types 16, 18, 31 and 45. These types do not cause genital warts but you may have been exposed to these types of HPV.
It is therefore very important to have regular smear tests i.e. 3 yearly to pick up any abnormal changes on the cervix i.e. neck of the womb.
Should partners be informed?
If you are diagnosed with genital warts your partner should be also checked.
Are any complementary therapies recommended?
Yoga, massage relaxation and not focusing on your problem can also help
The homeopathic remedy Thuja can also be helpful in the treatment of genital warts,
The prescription for Thuja is as follows:
One 30c tablet to be taken three times a day for three days over 4-5 weeks. Tablets should not be touched but dispensed into the lid of the tablet bottle, placed in the mouth and sucked not swallowed. Thuja should not be taken with food or drink.
What can I do to help myself?
Complementary health methods which include eating a healthy diet, not smoking and exercising will help your body’s immune system which in turn will fight the HPV virus. Smoking affects the body’s ability to fight infection and women who smoke often take longer to clear the wart virus. Smoking is also a risk factor for the development of cervical cancer.
How can HPV or genital warts be avoided?
The number of sexual partners increases the risk of STIs. Condom use will provide some, but not complete protection from the HPV virus.
Is it normal to feel upset about having genital warts?
Some people feel upset and angry so it is important to know that you are not alone and it is a problem that can be managed.
Finally, if you have been diagnosed with genital it is important to:
• Ask your doctor or nurse for an explanation about genital warts.
- Ask about treatment options available and their side effects.
- Ensure you make a follow up appointment.
- Be aware that it can take a number of treatments to clear the warts.
- Inform your doctor if you are pregnant, as this will affect your treatment options.
Carol Falvey
Clinic Nurse, Well Woman Centre, Liffey Street
July 2006
- wart treatment