Classification and external resources

Severe case of genital warts around the anus

Genital warts (known as condylomata acuminata or venereal warts) may be small, flat, flesh-colored bumps or tiny, cauliflower-like bumps. In men, genital warts can grow on the penis, near the anus, or between the penis and the scrotum. In women, genital warts may grow on the vulva and perineal area, in the vagina and on the cervix (the opening to the uterus or womb). Genital warts vary in size.

Genital warts are caused by the human papillomavirus (HPV). There are many kinds of HPV. Not all of them cause genital warts. HPV is associated with cancer of the vulva, anus and penis. However, it's important to note that HPV infection doesn't always lead to cancer.

Cause

HPV is a sexually transmitted infection (STI). The most common way to get HPV is by having oral, vaginal or anal sex with someone who is infected with HPV. The only sure way to prevent genital warts is to have sex. Sex only with a partner who is not infected with HPV.

Just because you can't see warts on your partner doesn't mean he or she doesn't have HPV. The infection can have a long incubation period. This means that months can pass between the time a person is infected with the virus and the time a person notices genital warts. Sometimes, the warts can take years to develop. In women, the warts may be where you can't see them--inside the body, on the surface of the cervix.

Using condoms may prevent you from catching HPV from someone who has it. However, condoms can't always cover all of the affected skin.

Symptoms

In many cases genital warts do not cause any symptoms, but they are sometimes associated with itching, burning, or tenderness. They may result in localized irritation.
Women who have genital warts inside the vagina may experience bleeding following sexual intercourse or an abnormal vaginal discharge. Rarely, bleeding or urinary obstruction may occur if the wart involves the urethral opening.

Treatment

Depending on the sizes and locations of warts (as well as other factors), a doctor will offer one of several ways to treat them. Podofilox is the first-line treatment due to its low cost.

Podofilox solution in a gel or cream can be applied by the patient to the affected area and is not washed off. Podofilox is safer and more effective than podophyllin.

Podophyllin and podofilox should not be used during pregnancy, as they are absorbed by the skin and could cause birth defects in the fetus.

Cryotherapy: This technique freezes the wart using liquid nitrogen or a "cryoprobe." It is an excellent first-line treatment because response rates are high with few side effects.

Laser treatment: This treatment is used for extensive or recurrent genital warts. It may require local, regional, or general anesthesia. Disadvantages include high cost, increased healing time, scarring.

Electrodesiccation: This technique uses an electric current to destroy the warts. It can be done in the office with local anesthesia. Of note, the resulting smoke plume may be infectious.

Surgical excision is best for large warts, and has a greater risk of scarring.