Genital Warts (HPV) Overview

Genital warts, sometimes referred to as condyloma acuminata, are flesh-colored or gray growths found in the genital area and anal region of both men and women. They represent the most common sexually-transmitted disease caused by a virus. The warts are caused by the human papillomavirus (HPV). Infection with genital warts may not be obvious.

Genital warts affect both men and women and can occur at any age.

• Most patients with genital warts are between the ages of 17-33 years. Genital warts are highly contagious. There is a 60% risk of getting the infection from a single sexual contact with someone who has genital warts.

• In children younger than three years, genital warts are thought to be transmitted by nonsexual methods such as direct manual contact. Nevertheless, the presence of genital warts in children should raise the suspicion for sexual abuse.

Genital Warts Causes (HPV)

• Genital warts are caused by the human papillomavirus (HPV). Over 100 types of HPVs have been identified; about 40 of these types have the potential to infect the genital area.
  
  
  • About 90% of genital warts are caused by two specific types of the virus (HPV-6 and -11), and these HPV types are considered "low risk," having a low cancer-causing potential. Other HPV types have been strongly associated with premalignant changes and cervical cancers in women. HPV-16 is responsible for about 50% of cervical cancers, and types 16, 18, 31, and 45 together account for 80% of cancers.
    
    
  • Common warts are not the same as genital warts and are caused by different HPV types that infect the skin.
    
    
• The viral particles are able to penetrate the skin and mucosal surfaces through microscopic abrasions in the genital area, which occur during sexual activity. Once cells are invaded by HPV, a latency (quiet) period of months to years may occur.
  
  
  • Generally, two-thirds of people who have sexual contact with a partner who has genital warts develop them within three months.
    
    
  • Genital warts are indirectly associated with use of birth control pills due to increased sexual contact without the use of barrier protection, multiple sex partners, and having sex at an early age.

Genital Warts Symptoms (HPV)

Although genital warts are painless, they may be bothersome because of their location, size, or due to itching.

• The size may range from less than one millimeter across to several square centimeters when many warts join together.
  
• Men and women with genital warts will often complain of painless bumps, itching, and discharge.
  
• Rarely, bleeding or urinary obstruction may be the initial problem when the wart involves the urethral opening (the opening where urine exits the body.)
  
• Warts in more than one area are common.
  
• There may be a history of previous or concurrent sexually transmitted diseases (STDs).
  
• Specific descriptions
  
  
  • In men, genital warts can infect the urethra, penis, scrotum, and rectal area. The warts can appear as soft, raised masses with a surface that can be smooth (on the penile shaft) or rough with many fingerlike projections (anal warts). Others may appear pearly, cauliflower-like, or rough with a slightly dark surface. Most lesions are raised, but some may be flat with only slight elevation above the skin surface. Infection with HPV may be dormant or undetectable, with some lesions hidden by hair or in the inner aspect of the uncircumcised foreskin in males.
    
  • In women, genital warts have a similar appearance and usually occur in the moist areas of the labia minora and vaginal opening. Lesions visible on the outer genitals warrant a thorough examination of the vaginal canal, cervix, and anorectal area. Most vaginal warts occur without symptoms. Rarely, women may experience bleeding after sexual intercourse, itching, or vaginal discharge.
    

When to Seek Medical Care

If you have genital warts, see your doctor and discuss treatment options.

Bleeding warts that cannot be controlled with direct pressure should be seen by a doctor. Warts that obstruct the urethral opening and don't allow you to urinate are an emergency and should be treated as soon as possible.