Next Steps

Follow-up

Complete the necessary treatment as outlined by your doctor. Women with genital warts should see their doctor for a routine Pap smear and investigation for HPV infection of the vaginal canal and cervix. If the genital warts are not successfully treated with the initial therapy, follow-up with your doctor or a dermatologist to discuss options for alternative treatment.

Prevention

In 2006, an HPV vaccine (Gardasil) was approved by the FDA for use in girls and women aged 9-26. This vaccine has been shown to be safe and 100% effective in preventing infection with the four most common HPV types (6, 11, 16, and 18) in women who have had no previous exposure to the virus. However, it is less effective in women who have already been infected with HPV, and it does not protect against all types of HPV infection. Studies are underway to determine whether the vaccine is safe and effective in older women and in males.

Because no treatment is 100% effective, it is important to prevent the spread of HPV, which causes genital warts and some cancers whenever possible. Transmission of genital warts can be decreased if you use condoms and refrain from sexual activity until therapy is completed.

Outlook

• In many cases, genital warts fail to respond to treatment or come back even after an initial good response.
  
• Reappearance of abnormal cells on the cervix of women is not altered by treatment of their sexual partners.
  
• Recurrence rates of genital warts are greater than 50% after one year and have been attributed to the following factors:
  
  
  • Recurrent infection from a sexual partner
    
  • Potentially long incubation time of HPV
    
  • Persistence of the virus in the surrounding skin, in the hair follicle, or in sites that are missed by the treatment used
    
  • Deep lesions or lesions that cannot be detected
    
    
• Genital warts often appear or increase in number during pregnancy. Dormant infections may also become activated. The presence of genital warts may make vaginal delivery difficult if they are in the cervix or vagina and warts in these locations tend to bleed easily. The warts often disappear on their own after pregnancy. The real danger, however, is that newborns may become infected during passage through an infected birth canal. HPV can cause a very serious condition in children called recurrent respiratory papillomatosis (RRP). This is a life-threatening disease of the respiratory tract. The papillomas or warts appear and spread quickly, sometimes dangerously blocking the child's airway.