Genital Warts

Genital Warts – Causes, Effect, Treatment

Genital warts (condylomata acuminata) are little tumors in the anal and genital area. They are caused by a human papillomavirus (HPV) infection. Transmittance of the pathogen normally takes place during unprotected sexual intercourse. The warts, also called venereal warts or condyloma, are among the most frequently occuring sexually transmitted diseases (STD) in addition to Herpes and Chlamydia.

Facts on Genital Warts

Condyloma are often diagnosed within the sexually active population of people aged 20 to 24 years. About 60 percent of all people have an antibody to HP viruses which indicate an earlier infection or occurrence of genital warts.
The HP virus is most often transmitted through sexual contact. It then nests in the upper layer of the skin, inducing the affected cells to multiply. Tiny injuries or tears to the skin or mucous membranes, discharges, eczema or fungal diseases in the genital area increase the risk of infection. In extremely rare cases, infection can also take place in warm and humid places such as saunas, solariums, swimming pools or public changing rooms. Weeks and months can go by before an outbreak of the warts occurs, which can be brought on by a weak immune system. Some people are spared such an outbreak although they carry the virus themselves. The tumors can also disappear on their own. Usually, a very thorough treatment helps to remove the warts entirely.

In the beginning, genital warts appear as little nodules in the genital area. In the labia or vagina of women; in the foreskin, glans or scrotum of men – or in both sexes on the anus. Normally, genital warts do not lead to any ailments or pain. However, they can lead to itching or burning of the skin and bleeding in some cases. Even when the tumors do not cause problems, they definitely pose an aesthetic problem for those affected in the long term. This can lead to feelings of guilt and shame in many people who then restrict their sexual life for fear of infecting their partner.
Individual genital warts usually have a grey or brown color. If they remain untreated, they grow in time to larger, red-whitish growths that have a cauliflower like form. Small injuries to the warts can lead to their spread in the genital area to regions previously not affected. This is another reason why this disease should be treated as early as possible.
There are about 200 known types of human papillomavirus. Genital warts are triggered through an infection with the so-called low risk types HPV 6 and HPV 11. Most health experts consider it highly unlikely that malignant tumors will develop from this. However, there are also high risk types of HPV (16 and 18) that can lead to cervical cancer. Women must, therefore, be particularly cautious and get an examination immediately if infected with these virus types.

The Treatment of Genital Warts

First of all, it must be said that genital warts should definitely be treated.  Although they heal on their own in about 30 percent of the cases, the HP virus can lead to certain types of cancer in women or a malignant tumor on the penis of a man. Any new formations of condyloma in the genital area should be examined and treated by a dermatologist or gynaecologist as quickly as possible, since the HP virus can trigger cervical cancer.

If genital warts go untreated, they can lead lead to a large accumulation of tumors over the years.  This are not only very unpleasant, it can also be dangerous in certain conditions.  A consultation with a specialist is absolutely essential and any feelings of shame are completely unnecessary.

There are many options for the treatment of genital warts, independent of the location and extent of their development. The warts can be removed with trichloroacetic acid, for example, if they occur on the mucous membrane of the vagina, the urethral orifice or in the anal canal.  Here, the attending physician applies acid to the growths with a swab in weekly intervals until they have completely died off.

A further method of therapy is the eradication of the virus and/or regression of the affected cells using creams and lotions with active agents such as podophyllotoxin, epigallocatechin gallate or Imiquimod. These medications are applied by patients themselves over a more extended period of time. This, of course, requires constant discipline.  Skin irritations can sometimes arise meaning that the treatment must be interrupted for a few days to sooth the affected areas. In addition, removal can take place in a simple operation with a local anaesthetic or by means of obliteration through cryotherapy.

The most modern and gentle method, currently, is the treatment of genital warts by laser.  This procedure has been tried and tested and is particularly well suited to advanced growths. The therapy is carried out on an outpatient basis under local anaesthetic. The doctor removes the wart tissue with a laser, using the heating effect of the laser impulses on the tissue to remove it layer by layer. The big advantage of employing lasers is that they can be implemented with great precision against the warts and any additional proliferation. Surrounding areas, which may seem healthy on the surface, may in fact be infected by the virus and can be included in the treatment.  This significantly reduces the probability of a relapse in comparison to other types of therapy.  As mentioned above, the laser treatment takes place on an outpatient basis so it is possible to go home on the same day of the treatment. Following the treatment, a scab develops on the treated area which disappears after a short time but should not be touched.  The healing period is much shorter than with all the other therapeutic methods and normally leaves no permanent scar.

After the Removal of Genital Warts

Hygiene is very important after the treatment, so patients should take care to wash their hands regularly and take a shower at least once per day.  Condylomas can reappear after their removal, independent of the type of therapy implemented.  If they are larger than 1 cm, it makes sense to take a tissue sample to check for possible malignant changes.  Women affected by genital warts should definitely have a thorough examination from their gynaecologist.  About a fourth of all women affected also have warts in their cervix.

It is recommended after treatment to use a condom during sexual intercourse for about two months as a precaution.  Furthermore, the sexual partner should also undergo an examination to prevent mutual reinfection. Unprotected intercourse is only possible when both partners are free of the HP virus.

Persisting Risk of a Genital Warts Relapse

As mentioned at the start, the high risk HP virus types, 16 and 18, trigger life-threatening cervical cancer (cervical carcinoma).  For this reason, women who have been infected with genital warts should definitely consult a gynaecologist. Since 2006, a vaccine for these viruses has been available, so doctors recommend that girls and young women get the vaccine before they have their first sexual intercourse. The costs are covered by state health insurance agencies in Germany for girls aged 12-17.

If genital warts occur during pregnancy, a doctor should also be consulted. Here it is important to note that because of the greatly altered hormonal levels of the mother, the growth of the warts can increase so dramatically that a Cesarean section becomes necessary. Although the baby will suffer no damage in the mother’s womb, an infection can occur at the time of birth.  Gynaecologists therefore recommend that genital warts be treated around the 34th week of pregnancy.  This ensures total healing by the due date and also reduces the risk of a renewed occurrence.

Take Advantage of Expert Advice from Dr. Hilton!

Genital warts are not a dangerous disease from a medical standpoint. If they are detected early and get treatment, no complications are to be expected.  Our team of experts can provide answers to all your questions on the topic.  Don’t be shy for any reason – there is truly no reason for embarrassment – and get in contact with us to set up an appointment.