Genital warts are usually not a topic of common conversation, and it’s not easy to ask questions to your family doctor, friends and relatives about this. So how do you find out how you can treat genital warts? Where do you look for genital warts removal in Rome and who can suggest you which remedies for genital warts would work? With the help of our doctors, we collected the 12 most common questions patients at our clinic in Rome ask. Here are the answers.
— You don’t need a test for genital warts. The physical examination made by a doctor is usually sufficient to tell you that you have genital warts. Sometimes, when it’s not clear, it can be necessary to take and analyse in a lab a small piece of tissue (biopsy) in order to assess its nature.
— Genital warts (or, better, “anogenital warts”, since they can affect both genital and anal area) are small, skin-colored or flesh-colored growths. Sometimes they are so small to be almost invisible, sometimes they are smooth and flat and sometimes they are so big and rough to resemble the shape of a cauliflower. They form at the opening or inside the vagina, on the penis, around or inside the anus.
In medical jargon they are called “Condylomata acuminata” that means “pointed wart” (mixed word from Latin and Greek: κόνδυλος, “tuber”, ending -ωμα -oma, “disease,” and Latin acuminatum “sharp” or “pointed”). “Condylomata acuminata” are different from “Condylomata lata” that are skin lesions caused by a completely different microorganism, a spirochaetae called Treponema pallidum (responsible for syphilis, another sexually transmitted infection). Anogenital warts are also called “Venereal warts” to distinguish them from common warts, skin warts and plantar warts.
— Genital warts are caused by a virus. It is called Human Papillomavirus (or simply HPV). HPV causes the most common viral sexually transmitted infections (STIs) in the United States (and one of the most common in the world).
It is true, but it is very important to know that not all the HPV are created equal. There are more than 150 different types of HPV (aka “genotypes”), each one identified by a number. At least 35 of these genotypes have a predilection for the genital tract, while others have a propensity to infect different body sites (e.g. HPV 6 and 11 are frequently responsible of genital warts while the common warts or skin warts are often caused by HPV 1 and 2); some are responsible for minor skin lesions others are related to some type of cancer.
— Usually they are not. The majority of people will not experience any discomfort. Some patients refer itching, burning, tenderness, even pain or bleeding, depending on the number of warts and the area involved, but that is not typical. If you are experiencing any of these symptoms this may be a sign of the presence of another STI (Herpes, Chlamydia, Trichomoniasis, etc.). An STI screening would be necessary to diagnose the cause and choose the right treatment.
— Through vaginal, anal or oral sex, but also through other close skin-to-skin contact during sexual activity. Hand-to-genital contact can be sufficient to spread the infection. Even without any evidence of wart, your sexual partner can carry Papillomavirus and transmit it to you during a sexual intercourse. However you cannot get infected with HPV by touching a toilet seat.
— Genital warts may appear a few weeks to a year or more after being exposed to the virus; it is not usually possible to know exactly when or how you became infected. If you have had more than one sexual partner, it is impossible to know which one had HPV. If you have a single sexual partner and you develop genital warts, your partner can have carried HPV without symptoms for a long time. A diagnosis of HPV in a couple does not imply infidelity. Nonetheless if one sex partner has genital warts, both should be screened for other STIs
— If you have genital warts you have an HPV infection. You can also have an HPV infection and not have warts or any discomfort.
If you are a female, you can have a test for HPV alone or together with a Pap-smear.
In the United States, there are no FDA-approved tests clinically available to detect HPV infection of oropharyngeal, anal, or male genital specimens. Even though men play a key role in the transmission of HPV to women, and can develop forms of cancer caused by HPV, we have still limited information on HPV infection in men and on the appropriate diagnostic workup that must be applied to detect HPV infection.
The test that is considered more reliable, though not approved nor recommended, requires swab sampling of the glans, penile shaft, and scrotum. Nonetheless since the genital infection can affect any site, no one knows the optimal sampling site, and false negative results are very common.
— Most HPV infections clear naturally with little or no inconvenience, but some types of HPV may cause persistent infections that put at a higher risk of developing a cancer. Recurrent genital warts may happen when the HPV infection does not clear on its own. However a positive result on an HPV test is not necessarily a cause of concern.
Genital warts left untreated may spread to other areas and increase in size and number. In most cases genital warts do not go away on their own and should be evaluated by a doctor as soon as they appear.
— Genital warts are 90% of the times caused by HPV types that do not typically cause cancer. Other HPV strains are considered “carcinogenic” viruses, i.e. they can cause cancer. For instance, Papillomavirus infection is recognized as the main cause of cervical cancers in women but it has been associated also to penile, vaginal, vulvar, anal and oropharyngeal cancers. It has been estimated that in 2009 alone, 32 000 cases of cancer in USA were attributable to HPV infection. Luckily the transformation to cancer takes several years (more than 10 usually), thus we have many chances to detect and treat early HPV related forms of cancer. Regular visits with a gynecologist for women, consultations with a urologist for men, and visits with a proctologist for both are crucial in detecting early signs of an HPV related cancer.
—Yes. Abstaining from sex with someone with HPV would be the best way to protect yourself, but it’s not easy since most people don’t know to have the virus. Using condoms can help, but they are not as effective as they usually are in other STDs (the virus can infect areas outside the condom).
There are now HPV vaccines that help keep people from getting infected. Of course they work best when are administered before being infected by HPV (ideally before the first sexual intercourse), but can be helpful also later on. There are three different HPV vaccines available. All of them come in shots and require three doses over 6 months. Children can get the vaccine any time from age 9 up to 26 (the sooner the better). Women should not get the vaccine if they are pregnant and should continue to be checked anyway on a routine schedule for cervical cancer with regular Pap-smear starting at 21 years old (no vaccine is perfect!).
— Although not dangerous, genital warts can be sometimes be difficult and costly to remove, thus they can be debilitating to young couples. Warts removal can be performed using various chemical agents (some are self-administered and some can be applied only by a doctor) or, better, through physical destruction (surgery, cryotherapy, laser or cautery) under local anesthesia.
Nonetheless remember that there is a recurrency of 30-70% within 6 months of treatment.
There are over the counter remedies for genital warts sold at the pharmacy, that sometimes are effective in removing genital warts. Usually they have to be applied for several weeks before seeing a result. When you do not get better with these medications or if you have many warts or big warts, it is better to contact a doctor in Rome. You may be tempted to try to cut off warts on your own. Please don’t! Serious consequences like local or general infection can occur.
If you need assistance to evaluate and remove your genital warts or if you need counseling about the HPV vaccine, please do not hesitate to contact our medical center in Rome. One among our gynecologist, urologist or proctologist will be here to help you.