Genital Warts

What Are Genital Warts?

Before we understand what is Genital warts removal or Genital warts treatment, let us discuss what is causes Genital warts.

Genital Warts (also known as condylomata acuminata) are caused by a sexually transmitted infection that causes small (or large), skin-coloured or pink growths on the labia, at the opening of the vagina, in the cervix or around or inside the anus. For men, they can be found mainly on the penis, sometimes inside the urethra or around or inside the anus. Most people with warts do not have any symptoms at all though less commonly, there may be itching, burning or tenderness in the genital area. 

The Causes Of Genital Warts?

Genital warts are caused by the Human Papilloma Virus (HPV). HPV infection is the most common sexually transmitted disease worldwide. Studies have shown that at least 75% of sexually active adults in the US have been infected with at least one type of HPV at some time.

Investigators have identified 200 different types of HPV and more than 40 of which can be transmitted through sexual contact and infect the genital and anal areas. Genital HPV can be divided into low-risk and high-risk types based upon the associated risk of cancer in any body area. The low-risk types HPV 6 and/or HPV 11 are detected in around 90 percent of genital and anal warts, although co-infection with low-risk or high-risk types of HPV are common.

Risk Factors

  • Sexual activity, including skin-to-skin contact (although less common) is the primary risk factor for HPV infection causing genital and anal warts. The risk increases the more number of partners you have had sex with. 
  • A weakened immune system may be associated with larger and more treatment-resistant genital warts as well as increased risk of recurrences and transformation of warts to cancer.
  • Smoking is also associated with increased risk of developing genital and anal warts and this risk may increase as the higher the number of cigarettes smoked per day and the longer the individual has been smoking in their lifetime. It is not clear whether this is causal or correlation.

Male circumcision may reduce the risk for HPV infection.

Complications

  • After the initial appearance of warts, there may be an increase in size and number or regress spontaneously. It is estimated that approximately one-third of anogenital warts regress without treatment within four months.
  • However, HPV infection may persist despite resolution of visible warts and may result in wart recurrence. The reappearance of warts may be a result of mechanical irritation, wounding, a weakened immune system, or inflammation among other reasons.
  • Although the HPV types responsible for most cases of genital warts are low-risk types, co-infection with high-risk HPV types linked to cancers is common
  • A Danish study of 15,155 men and 32,933 women diagnosed with genital and anal warts between 1978 and 2008 found an increased risk for anogenital cancers and head and neck cancers. 
  • Cancer transformation of existing genital warts is rare and is more likely to occur in individuals with a weakened immune system (e.g. on medications to reduce immune system, transplantation, HIV)

Treatment Options

  • There are many ways to treat genital warts – some involve using a medicine and some involving a procedure.
  • Even with treatment, it is possible that the warts can recur within a few weeks or months. This is because treating them does not necessarily eradicate all of the HPV virus causing the warts 
  • There is currently no treatment that will permanently get rid of HPV in all infected cells, but most people will clear the virus and the warts with their own immune systems within two years.

Medical treatments available include:

  • Podophyllin – this is a solution that destroys the wart tissue. It is applied by the doctor using a cotton swab. Once applied, the area should be washed one to four hours after. The treatment is repeated weekly for four to six weeks or until lesions have cleared. Side effects range from mild skin irritation to pain and skin ulcers. This treatment is not used in pregnant women.
  • Imiquamod (Aldara) – this is a cream that triggers the immune system to get rid of the wart(s). The cream is applied directly to the wart (generally at bedtime), then the area is washed with water six to ten hours later. The cream is used three days a week for up to 4 months. Side effects include mild irritation and redness and is not recommended in pregnancy.

Procedures available include:

  • Cryotherapy – This is a chemical used to freeze the wart. It is done at the clinic and usually does not require anaesthesia. The procedure may cause some pain and side effects to include skin irritation, swelling, blistering and ulceration. This treatment can be offered to pregnant women. 
  • Surgical removal may be offered if the above are not suitable.

Speak to our doctors today. Rapid HPV Testing (Next Day Result) is available in all our Women’s clinics in Singapore.

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