Genital warts appear on the skin anywhere in the genital area as white or flesh-coloured, smooth, small bumps, or larger, fleshy, cauliflower-like lumps in both men and women.
They are caused by the Human Papilloma Virus (HPV), a diverse group of viruses which variously infect the skin and mucous membranes of the body.
While the majority of the over 200 subtypes do not cause clinically significant disease, about 30 of them infect the genital area. Of these, a few cause warts and in some cases can lead to cancer of the cervix, vulva, anus and penis.
How do I get the disease?
The HPV virus that causes warts are transmitted through genital skin contact, or through transfer of genital fluids. You do not need penetrative sexual contact to acquire the infection. Condoms and other barrier methods provide only limited protection against HPV. In rare cases, there can be transmission through childbirth.
How do I know I am infected for HPV? How can it be detected?
Generally, HPV viruses as a group do not cause symptoms and the majority are unaware that they are infected with HPV. Nevertheless, a small group present with genital warts which are small bumps or larger fleshy, cauliflower-like lumps on the skin or mucous membranes in the genital area. They usually appear about 1 to 3 months after initial infection.
The most severe disease that HPV can cause is cervix cancer and hence, women are advised to go for pap smears with their doctors regularly.
For Men-who-have-sex-with-Men (MSM), it is recommended that they do the Anal Pap as well.
How can HPV be treated or removed?
There is no specific treatment for HPV as the infection is usually self limiting. In general, the body’s immunity usually clears the infection after some time. Notwithstanding, some people have lingering infection, especially in people who’s immunity is impaired, e.g. due to concurrent infection with HIV.
For genital warts that HPV causes, treatment depends on how severe and extensive the warts are.
The most common and effective treatments are:
- Resin applications
- Cryotherapy with liquid nitrogen which “freezes” the wart and destroys them.
- Electrocautery/surgical excision removes the wart surgically.
The majority of genital warts recur even after adequate treatment and repeat treatments may be needed to completely eradicate the problem.
HPV and Cervical cancer
High risk HPV viruses (especially types 16 and 18) can induce changes in the cervical cells and this can lead to cancer of the cervix. This is why all sexually active women are advised to get themselves screened for HPV and also to go for a regular Pap smear test.
Pap smear is a screening test for cervical cancer. It involves opening the vagina to take a small sample of cells from the cervix (opening of the uterus/womb) with a swab and examining those cells under a microscope. If there are any abnormal changes in these cells, the patient will be referred for further examination and treatment to eradicate the problem.
These high risk subtypes of HPV also cause changes in the anal/rectal mucosa that predisposes men and women who engage in anal intercourse to cancer.
In these men or women, Anal Pap, which is available all DTAP clinics.
Prevention of HPV, Cervical Cancer and Genital Warts
There are currently 2 vaccines available in Singapore to prevent cervical cancer and genital warts caused by the major high risk subtypes of HPV. Gardasil protects against 4 high risk subtypes and is effective for genital warts and cervical cancer prevention.
The other vaccine, Cervarix protects against the 2 high risk subtypes which cause cervical cancer.
It is however, not used for prevention against genital warts.
All our Doctors are trained and certified in the treatment of Warts and HPV vaccination.
Feel free to visit our clinics anytime if you think you are suffering from Genital Warts.