What are Genital Warts?

Genital warts (also known as condyloma acuminta) are small lumps that develop around the genital region for both. Typically, these warts are transmitted through sexual encounters with a person positive for human papillomavirus (HPV). Symptoms can begin to appear weeks, months or even years after infection. For many, these warts will resolve over time. However, treatments are available to assist with a faster recovery. However, seeing a GP is crucial for ensuring that you receive an accurate diagnosis and guidance about the necessary treatment.
 

Genital Warts Symptoms

Many people who have been infected with HPV do not have any symptoms [8]. However, the appearance of warts around the genital regions is the most common sign of infection. Generally, warts will appear 3-4 months after catching HPV, although they can occur as early as a month or as late as two years [9]. Although most warts will disappear over time, they reappear within months or years afterwards [6]. Other symptoms that can accompany warts are itching, redness and discomfort. It’s not uncommon for those with genital warts to be self-conscious and distressed about their physical appearance.

What Do Genital Warts Look Like?

Genital and anal warts can visually be seen as pinkish and/or whitish-grey lumps which appear in areas that are exposed during sexual activity. These warts are small in size and can roughly span 5mm in diameter. The penile shaft, labia, vagina, scrotum and anus are areas where warts can develop [6]. These benign lumps can often be found either individually or clustered together in small groups.

Source

 

What Causes Genital Warts?

Genital warts are caused by the Human Papillomavirus (HPV). HPV is considered a sexually transmitted infection that does not do not lead to symptoms until later on. There are over 100 types of this virus which vary in severity. For example, HPV 6 and 11 are responsible for over 90% of genital warts [1]. Whereas HPV 16 and 18 lead to more severe conditions, such as genital and cervical cancer [2].
 

Genital Warts Transmission

Genitals warts can occur once contracting HPV. This virus is primarily transmitted during sexual intercourse during either vaginal or anal penetration [3]. The primary source of transmission is skin-to-skin contact in these genital regions. While less common, HPV can be transferred orally during sexual activity. Microtrauma caused by the friction of these activities causes the virus to enter the person being infected [4]. However, the appearance of warts may not appear until sometime after the infection. Many people infected with HPV do not have symptoms at all.

How Do You Get Genital Warts?

As noted earlier, genital warts are transmitted during sex, particularly in the absence of contraception, such as a dam or condoms. Although using these contraceptives does not guarantee protection from HPV [5]. Infections also become more likely with an increased number of sexual partners [3].

Are Genital Warts Contagious?

Genital warts are very contagious. Unprotected sex with an HPV-positive partner (even without warts at the time) leads to a 70% chance of infection [6]. In fact, up to 80% of sexually active individuals will contract some form of HPV. Those who have more sexual partners, regularly smoke and/or are immunocompromised are more likely to contract HPV and genital warts [3][6].
 

Tests and Diagnosis

Genital warts can be diagnosed visually during a physical assessment by a GP [7]. Your GP may ask you about your sexual history (e.g. using protection, sexual activity, etc.) and medical history for a more accurate diagnosis. An internal vaginal and/or anal assessment may be required to assist diagnosis. Although not always necessary, a biopsy or sample of the affected tissue may also be taken for laboratory analysis [6].
 

Genital Warts Treatments

Most warts will disappear without treatment over time. However, because genital warts are contagious, treatment is important. Consulting a GP is essential for discussing the available and appropriate treatment for your circumstances.

Genital Wart Creams and Ointments

Antiviral ointments and creams that are applied to the skin can be prescribed by GPs [10]. Depending on the type of cream, multiple applications will be required over a specific period of time. Adherence and consistency to the recommended cream will be necessary for increasing the chance of genital wart removal.

Genital Warts Freezing

Freezing warts or cryotherapy using liquid nitrogen can be another treatment that GPs often deliver [10]. Generally, this is a safe and affordable treatment option. However, GPs may require specialised training and equipment. Multiple sessions are required for the successful removal of warts.

Surgery

Surgical removal of the wart(s) may also be another option, although scarring may be present after treatment [10]. A local or general anaesthetic may be recommended depending on the severity and appearance of the lumps.

Other Treatments Available [6]

• Electro cauterisation
• Laser therapy
• Photodynamic Therapy

 

Recovery - Are Genital Warts Curable?

While genital warts can resolve, HPV is not always curable [6]. There may be periods where there are no symptoms, especially if the virus is dormant or asleep. However, warts can reappear when the virus is active once again - particularly if immunocompromised or unwel. Leading a healthy lifestyle and adhering to safe sexual practices can help prevent warts.

How Long Do Genital Warts Last?

Most genital warts will disappear over 2 years [10]. Research has also suggested that 30% will fully resolve as early as 4 months after its first appearance [6].
 

Complications

Although most genital warts resolve over time, it can present as an aesthetic problem - particularly for those who are sexually active. However, if left untreated for a long time, there is an increased risk that genital and cervical cancer can develop [6]. Seeking treatment and support from your GP is vital for managing symptoms and preventing complications.
 

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  References

1. Koutsky LA, Ault KA, Wheeler CM, et al. A controlled trial of a human papillomavirus type 16 vaccine. New England Journal of Medicine 2002; 347(21):1645–1651. [PubMed Abstract]
2. https://www.everydayhealth.com/hpv/what-are-hpv-16-18/ 
3. Sendagorta-Cudós, E., Burgos-Cibrián, J., & Rodríguez-Iglesias, M. (2019). Genital infections due to the human papillomavirus. Enfermedades infecciosas y microbiologia clinica (English ed.), 37(5), 324-334.
4. https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer
5. https://www.cdc.gov/condomeffectiveness/latex.html
6. Leslie SW, Sajjad H, Kumar S. Genital Warts. [Updated 2021 Sep 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441884/
7. Heley, S. (2003). Human papillomavirus: beware the infection you can't see. Australian family physician, 32(5).
8. https://www.sahealth.sa.gov.au/wps/wcm/connect/abe39680418877a2ae43ef67a94f09f9/ASHC-Genital+Warts+and+HPV-pamphlet+C%2BR+20180308.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-abe39680418877a2ae43ef67a94f09f9-nwKEHEQ
9. https://global.ihi.com/alarm+service/health+fact+sheets/human+papillomavirus.aspx
10. Leung, L. (2010). Treating common warts: Options and evidence. Australian family physician, 39(12), 933-937.