1. What are genital warts?

Genital warts begin as small growths on the skin in the genital area and may be found on or around the penis, rectum or vagina. The appearance of the lesions (growths) varies. They may have an irregular cauliflower like surface or they may be flat and slightly pigmented (like a mole). Generally, warts do not cause any discomfort; however, occasionally they are associated with irritation and itching. (They are also known as condylomata acuminata or, because they are usually transmitted by sexual contact, venereal warts).

2. What causes genital warts?

The Human Papilloma Virus (HPV) causes genital warts. There are many different types of the virus. Some types cause common warts, such as those found on the hands and feet and other types of HPV cause genital warts. Thus, common warts and genital warts have a similar appearance yet are usually caused by a different type of HPV.

3. How many people have genital HPV infections?

Up to one out of ten Americans have genital HPV infections. Between 500,000 and one million new cases of genital warts occur every year. Almost two million Americans are treated for active genital warts each year.

4. How are warts transmitted?

Genital warts are usually a venereal disease. This means that they are transmitted through sexual contact. Genital warts are quite contagious and intimate contact of moist surfaces is ideal for transmission. The incubation period is long, from 2 to 8 months. In other words, it may take 2 to 8 months after coming in contact with a wart for you to develop one yourself. Warts are also spread by autoinoculation, from one infected area on your body to another. Vaginal secretions may be able to transport the virus from the vagina toward the rectum.

5. How do I know if I have a wart?

There is no simple test that can be done to see if you have genital warts. Examining yourself for any growths or bumps in the genital area is the only way to tell if a wart is present. If it is difficult for you to examine yourself (for women especially) or if you are not sure about something, it is best to come to the clinic and be examined by a health care professional knowledgeable about warts.

6. How are genital warts treated?

There are different methods used to treat warts, depending on where they are and of what size. If your warts are not too large and are easy to reach, we will first freeze the wart with liquid nitrogen and then apply podophyllin, a chemical that suppresses growth of the warts. Podophyllin can be very irritating to the skin and must be carefully washed off with warm water and soap 4 to 6 hours after treatment (DO NOT FORGET THIS). Most warts require several treatments before they go away, and it is very important for you to return to the clinic for wart therapy. Alternatively, Aldara Cream may be prescribed to treat the affected areas 3 times a week for 14-16 weeks.

If your warts are large or if they are inside the vagina or rectum, we will refer you to another clinic to have them removed. These warts can be removed by electrocautery, freezing or surgery.

Your sexual partners, especially female, should be checked to be sure that they do not have warts also. Besides your risk of being infected by an untreated sexual partner, pap smear screening of female partners of men with warts is important.

7. What are the complications of genital warts?

There is an association between genital warts and cancer. Women who have warts on their cervix are at increased risk for cervical cancer and men who have rectal warts are at increased risk for rectal cancer. For this reason GYN does pap smears on all women with genital warts. Women who have a history of genital warts should make sure they have a pap smear once a year. If a pap smear shows some abnormal cells on the cervix, you will be referred to another clinic so that the problem can be evaluated more clearly and solved.

8. After the warts are treated can they recur?

Yes. The wart virus can remain dormant in normal-appearing skin and reactive from time to time, causing recurrent warts. There is no way to predict if your warts will come back (called a recurrence); however, approximately 60% of people will have a recurrence 3-4 months after resolution of prior warts. If your warts come back again, make sure you get them treated as soon as possible.

9. What precautions should be taken to avoid getting the disease or giving it to another person?

If a wart is present, you can transmit it to your sexual partner or vice-versa. To prevent transmission of the wart virus the male should wear a latex condom during sex. Of course, the most reliable way to prevent the spread of the virus to another person is to avoid all sexual contact, since if a condom breaks during sex, it provides less protection. After the wart has been treated and resolved, we think that the risk of transmission is much lower. People who have warts in places where they aren't noticed, such as inside the penis or on the cervix, may still be able to transmit the virus to sexual partners.

10. What happens with genital warts during pregnancy?

Genital warts often increase in size and number during pregnancy, possibly due to hormonal changes and a decrease in the body's immune system. Rarely, they can be transmitted to the baby during birth who may develop warts in the larynx later in childhood. This is an uncommon complication for which prevention is not available.

Podophyllin must not be used during pregnancy because it is absorbed and can cause fetal damage. If you think you might be pregnant, please tell the clinician treating you.