Health Services
Self Care

Genital Warts

Description
Genital warts are caused by Human Papilloma Viruses (HPV). There are about 60 "types" of HPV. Most warts are specific to one portion of the human body; the viruses which cause genital warts (also called "condyloma") are associated the human genital tract. Some of the dozen or so identified types of genital HPV cause rough, wart-like growths. Others may be less visible and may be associated with dysplasia (pre-cancerous) or cancerous cell changes, especially of the cervix. This association is much less common in men.

Genital HPV is a contagious infection and is spread by skin-to-skin (usually sexual) contact. Many people may have the virus without knowing it and are contagious even with no visible warts. The wart virus may be inactive, or latent, for a period of months or even years. Visible warts, if they develop, most often appear within 2-3 months after exposure.

Symptoms
Genital warts may be raised and rough and have a "cauliflower-like" appearance. These types of warts are often called condyloma acuminata. Small, flat, flesh-colored warts, referred to as condyloma planum, may not be identifiable to the untrained eye. Some wart viruses may not be identified without the aid of magnification and biopsy. Genital warts may affect any site of either male or female genitals (e.g. vagina, cervix, external vaginal area, anus, penis, urethra, scrotum). Most people with genital warts have no symptoms. If present, symptoms may include itching and discomfort with intercourse.

Diagnosis
Diagnosis of the acuminata form of genital warts is usually made by clinical inspection. For women, a pap smear can screen for the possibility of a wart virus on the cervix. Presence of the virus may be confirmed using a procedure called  colposcopy (using a magnifying instrument called a colposcope, the clinician identifies possibly infected areas and takes biopsies to evaluate for the wart virus).

In men, clinical inspection and androscopy (magnified inspection) are often helpful in the identification of genital warts.

There is no blood test available to detect warts. Consequently, some individuals with HPV and no visible lesions cannot be diagnosed.

Treatment
Since warts are viruses, the primary "treatment" is for the body to build up antibodies to the wart virus and suppress it, much like the immune system responds to other viruses such as chicken pox. This reaction does not rid the body of the virus but will keep the virus suppressed as long as there are sufficient antibodies present.

Although there is no cure for HPV, current treatment aims to reduce the viral load by destroying the cells affected by HPV. This activity may help stimulate the immune system. Methods presently being used include surgical, chemical (topical and injected) or thermal (cautery, laser or freezing) techniques. No single technique consistently removes the virus which is often present in tissue that does not appear to be affected. Wart viruses may recur, but the rate of recurrences and the triggering factors are not well understood (although situations that are known to negatively affect the immune system such as fatigue, stress, cigarette smoking and other illnesses would be logical triggers). Resolution of HPV is probably accomplished by the immune system.

Prevention
The most effective way to prevent infection is not to have sexual contact with someone who had genital warts. Latex condoms, especially when used with the spermicide nonoxynol-9, may afford some protection. The condom must be put on before there is any genital contact. Condoms will not protect the external vaginal area or the base of the penis from infections that may be transmitted by skin-to-skin contact. Knowledge of your partner and frank discussion of past infections and sexual history may help you to evaluate your risk of infection.

More Information/Questions
Messiah College students may call Student Health Service at (717) 691-6035 for more information.