A B C D E F G H I J K L M N O P R S T U V W

WARTS : GENITAL

What are Genital Warts ?

Genital warts are caused by a family of viruses called human papilloma viruses. They can be found anywhere on the skin of the genitals. In males they are most common on the head of the penis and under the foreskin. They are rare on the scrotal skin. In females they are most common around the entrance to the vagina (front passage) which is called the vulva. Visible warts on the cervix (neck of womb) are rare. Genital warts can also be found inside and around the back passage (anus) in men and women. This tends to be more common in people who practise anal intercourse. Genital warts appear as lumps. They can be soft and frilly, or flat and hard. There is often irritation or itchiness around the warts. They can bleed if knocked. Some patients do not notice the warts and they are found as part of a routine examination.

How do Genital Warts occur ?

Genital warts are usually caught through having sexual intercourse with an infected person. Infectious virus from your partner's warts get in through the skin. Approximately 1% of virus results in warts and these appear after 1 to 3 months.

Why do Genital Warts occur ?

The risk of catching genital warts increases with the number of sexual partners. However, it is not uncommon to find genital warts occurring in a monogamous (one partner) relationship. This is because of the variable time between contact with an infected person and appearance of the warts. Using a condom offers some protection depending on the site of the warts.

Treatment Involved

The doctor may make the diagnosis after a clinical examination. He may refer you to a department of genito- urinary medicine (special clinic, STD clinic). If an infection is suspected, a visit to the local clinic is possible without a referral letter. The address of the clinic can be found in the telephone book.

INVESTIGATIONS There are no specific tests to confirm genital warts. It is a diagnosis which your doctor can make quite readily without special tests. A biopsy (small cutting of skin) may be neede but this is rare. However, women may have a smear test taken (cervical cytology) at the time of examination. Cervical wart virus infection can be diagnosed in this way.

TREATMENT Genital warts can be treated by painting, freezing or removal. The choice of treatment depends on the type and number of warts. The three most common types of paint: are podophyllin, podophyllotoxin and trichloracetic acid. Podophyllin and podophyllotoxin are usually coloured and trichloracetic acid is a clear solution. Freezing is done using a liquid nitrogen which is applied with a metal tip to the wart. It is not necessary to use local anaesthetic. Removal by surgery or electrocautery (heated loop) requires a local or general anaesthetic. Warts like a moist environment, so it helps to get rid of them if the area is kept clean and dry. This can be done by bathing in salt water. A handful of salt can be added to the bath. Alternatively, 1 tablespoon of salt in a cup of water will do as well. Your partner should also be examined. While treatment is being carried out, a condom is recommended.

During Treatment

Genital warts can be very difficult to get rid of. They may go with one course of treatment (six to eight applications of paint or one to two freezing treatments). However, several courses of treatment are often required. Your doctor will change to another type of treatment if the first choice has not been successful. All types of paint can cause burning of the normal skin around the warts. Podophyllin and podophyllotoxin can be washed off with water, but trichloracetic acid cannot. Podophyllin and podophyllotoxin should not be used on pregnant women. After freezing, surgery or electrocautery the area may be sore for 1 to 2 days. Podophyllotoxin can be used at home but the other treatments have to be done in the clinic. This may mean attending two to three times per week.

After Treatment of Genital Warts

Genital warts rarely get better without treatment.

If Genital Warts are Left Untreated

Genital warts frequently come back again. There is an association between human papilloma virus and cervical cancer. However the genital warts do not increase the risk of cervical cancer. It is important to have smear tests (cervical cytology) as frequently as the National Guidelines recommend.

Effects on Family of Genital Warts 

Sexual partners are the only people who need to know. It is the responsibility of the infected person to inform them. The information given to the doctor is treated in the strictest confidence. He or she is not allowed to pass this on to the partner(s). The doctor will recommend that condoms are used whilst warts are present.

Help for those with Genital Warts

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