Exams and Tests
Diagnosis is often based on findings from the history and appearance of the genital warts.
- Sometimes, lesions are only visible with an enhancing technique called acetowhitening. This technique involves the application of 5% acetic acid solution to the area of suspicion for about 5-10 minutes. Infected areas will turn white.
- Magnification of the area (colposcopy) using a scope may be necessary to see the lesions. In females, a colposcope may be used to look for lesions in the vaginal canal and on the cervix.
- A routine Pap smear should always be done in order to look for evidence of HPV infection and abnormal cells on the cervix.
- A biopsy can be performed if the lesion appears unusual or recurs after treatment.
- Special laboratory tests can also be used to confirm the presence of HPV infection
Genital Warts Treatment (HPV)
Self-Care at Home
Because genital warts essentially have no symptoms other than their appearance, there is little need for home treatment. It is important, however, to recognize that the warts exist.
- Take the necessary precautions to prevent trauma to the area, which can result in bleeding.
- Be careful to prevent transmission to a sexual partner.
- Because the warts themselves are infectious, avoid touching them. Do not pick or squeeze the warts.
Medical Treatment
No single treatment is effective in eliminating warts and preventing them from coming back. Genital warts may go away on their own in about 10%-20% of people over a period of three to four months.
- 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. The laser physically destroys the HPV-induced lesion. Disadvantages include high cost, increased healing time, scarring, and potentially infectious viral particles in the air caused by the laser plume.
- 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
Medications
Several medications exist for treating genital warts and can be used as an alternative to other treatments.
- podophyllum resin (Pod-Ben-25, Podofin) - Topically applied by a doctor
- podofilox (Condylox) - Can be topically applied at home, higher cure rates than Podophyllum resin, useful for prevention
- trichloroacetic acid - Topically applied, response is often incomplete and recurrence is higher, may cause pain and burning
- 5-Fluorouracil (Efudex) - Applied as a cream, long treatment time, can cause burning and irritation, many side effects
- Interferon alpha-n3 (Alferon N) - Used as an injection for warts that do not respond to other therapies, many side effects
- imiquimod (Aldara) - New treatment, applied as a cream, local skin irritation is a common side effect
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