Genital Warts - Symptoms & Treatment

Genital warts may be small, flat, flesh-colored bumps or tiny, cauliflower-like bumps. In men, genital warts can grow on the penis, near the anus, or between the penis and the scrotum. In women, genital warts may grow on the vulva and perineal area, in the vagina and on the cervix. Genital warts vary in size and may even be so small that you can't see them. They can lead to cancer of the cervix in women or cancer of the penis in men.

Also known as venereal warts and condylomata acuminata, these growths are one of the most common sexually transmitted diseases in the United States.

Causes

Genital warts result from infection with one of the more than 60 known strains of human papillomavirus. The virus is transmitted by sexual contact and incubates for 1 to 6 months (the average is 2 months) before warts erupt.

Signs and symptoms

Genital warts are rough-surfaced lumps that appear in warm, moist areas of the genitals, usually one to six months after infection. In women, this may be inside the vagina, on the vaginal walls and on the cervix, as well as on the skin outside of the vagina. In men, they usually appear around the opening of the penis. People who have anal sex and contract HPV are more likely to develop warts around the anus. Genital warts can vary in color, from pink to brown, but generally look like small pink or red growths. They can cluster together and take on a cauliflower-like appearance. Genital warts can spread and grow rapidly, especially in infected pregnant women. Symptoms may include pain, itching, bleeding, and odor. Genital warts increase the risk for developing cervical, penile, or anal cancers.

Diagnostic tests

Dark-field microscopy of wart-cell scrapings shows marked epidermal cell vascularization. This differentiates genital warts from condylomata lata associated with second-stage syphilis.

Another test involves applying 5% acetic acid (white vinegar) to the warts, which turn white if they are papillomas.

Treatment

Many cases of genital warts resolve spontaneously. Frequently used therapies include cryosurgery, application of caustic agents, electrodesiccation, surgical excision, and laser ablation. Topical antimetabolites, such as 5-fluorouracil, have also been used. Topical podophyllin agents may also be used. Topical interferon benefits condylomata acuminata. Vaccine preparations show promise in preventing papillomavirus.

Prevention

Like most STDs, genital warts can be avoided by not having sex or by having sex only with one uninfected partner.

Condoms offer some protection against genital warts, but they can't completely prevent them because the warts can be outside of the area protected by the condom. Spermicidal foams, creams, and jellies have not been proven to protect against HPV and genital warts.

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