Genital warts, caused by the human papillomavirus (HPV), are a common sexually transmitted infection. Accurate diagnosis and effective treatment are key to managing this condition and minimizing its impact on your health and well-being. This guide provides a detailed overview of the diagnosis and treatment options available for genital warts.
Diagnosing Genital Warts
Identifying genital warts typically involves a combination of physical examination and, in some cases, further laboratory tests. A healthcare professional can often diagnose genital warts through a visual inspection during a routine physical exam.
Physical Examination
Often, a simple physical exam is sufficient for a healthcare provider to identify genital warts. The characteristic appearance and location of the warts are usually enough for diagnosis. However, in some instances, to confirm the diagnosis or rule out other conditions, further steps might be necessary.
Pap Tests
For women, regular Pap tests are a crucial part of gynecological health and play a role in the diagnosis and management of genital warts.
Pap test
A medical illustration showing the steps of a Pap test, a key procedure for diagnosing cervical changes and HPV-related conditions such as genital warts. During a Pap test, a speculum is used to gently widen the vaginal canal, allowing a healthcare provider to collect cell samples from the cervix using a brush and spatula. These samples are then preserved in a solution and sent to a lab for microscopic examination to detect any abnormalities.
Pap tests are primarily designed to detect precancerous and cancerous changes in the cervix, many of which are linked to certain types of HPV, the same virus that causes genital warts. While Pap tests are not specifically designed to diagnose genital warts directly, they can identify cellular changes caused by HPV in the cervix, which is important because some types of HPV that cause genital warts are also linked to cervical cancer. Regular Pap tests are recommended for women to monitor cervical health and detect any HPV-related changes early.
HPV Tests
An HPV test is another diagnostic tool that can be used, particularly for women over 30. This test is often performed in conjunction with a Pap test, using the same cervical cell sample. It specifically detects the presence of high-risk HPV strains that are most strongly linked to cervical cancer.
While HPV tests are excellent for identifying high-risk HPV types, they are not routinely used to diagnose genital warts themselves. Diagnosis of genital warts is typically made visually. However, understanding your HPV status can be helpful in managing your overall health and risk, especially as some of the HPV types that cause genital warts are different from those that are high-risk for cancer. For younger women, HPV infections, including those that cause warts, often resolve on their own without treatment, making routine HPV testing less crucial in this age group unless indicated by abnormal Pap test results.
Treatment Options for Genital Warts
If genital warts are not causing discomfort, treatment may not always be necessary. In many cases, the body’s immune system will clear the virus over time. However, if you are experiencing symptoms like itching, pain, or burning, or if you are concerned about transmission, various treatments are available. It’s important to understand that while treatments can remove the warts, they do not eliminate the HPV virus itself, and warts can recur.
Topical Medications
Several prescription medications can be applied directly to the skin to treat genital warts. These topical treatments work in different ways to destroy wart tissue or boost the immune system’s response to the virus.
-
Imiquimod (Zyclara): This cream enhances the body’s immune response to fight the genital warts virus. It is applied topically and should be used as directed by a healthcare provider. It is crucial to avoid sexual contact while the cream is on the skin as it can weaken condoms and diaphragms and may irritate a partner’s skin. Potential side effects can include skin color changes in the treated area, blisters, body aches, cough, rashes, and fatigue.
-
Podophyllin (Podocon-25) and Podofilox (Condylox): Podophyllin is a resin-based medication applied by a healthcare professional in a clinic setting, designed to destroy wart tissue. Podofilox contains the same active compound and is available for at-home application. It is essential to use podofilox strictly as prescribed and to avoid internal use. This medication is not recommended during pregnancy. Common side effects include mild skin irritation, pain, and sores.
-
Trichloroacetic Acid (TCA): This chemical treatment works by burning away genital wart tissue. It can be used to treat both external and internal genital warts. Application should be performed by a healthcare professional. Side effects are similar to podofilox, including mild skin irritation, pain, and sores.
-
Sinecatechins (Veregen): This ointment, derived from green tea extract, is used to treat external genital and anal warts. Possible side effects include skin color changes, itching, burning, and pain in the application area.
It’s crucial to avoid using over-the-counter wart removers intended for common warts on hands and feet on genital warts. These products are not formulated for the sensitive genital area and can cause significant irritation and damage.
Surgical Procedures
Surgical removal may be recommended for larger warts, warts that do not respond to topical medications, or for pregnant women to remove warts that could expose the baby during childbirth. Surgical options include:
-
Cryotherapy (Freezing with Liquid Nitrogen): This method involves freezing the warts with liquid nitrogen. The freezing process causes a blister to form around the wart, and as the skin heals, the wart sloughs off. Multiple treatments may be necessary. Side effects primarily include pain and swelling at the treatment site.
-
Electrocautery: This procedure uses an electric current to burn off the warts. It is effective for wart removal, but patients may experience pain and swelling following the procedure.
-
Surgical Excision: This involves cutting off the warts using surgical instruments. Local anesthesia is used to numb the area, minimizing pain during the procedure. Post-operative pain is possible.
-
Laser Treatments: Laser therapy uses an intense beam of light to destroy wart tissue. It is typically reserved for extensive or difficult-to-treat warts due to its cost and is not usually the first-line treatment. Side effects can include scarring and pain.
It is important to discuss the most appropriate treatment plan with your healthcare provider based on the size, location, and number of warts, as well as your individual health circumstances and preferences. Regular follow-up appointments are recommended to monitor treatment effectiveness and manage any recurrences.
Preparing for Your Appointment
If you suspect you have genital warts, or are experiencing related symptoms, preparing for your healthcare appointment can help ensure you receive the most effective diagnosis and treatment.
What You Can Do Before Your Appointment
- Symptom List: Detail your symptoms, when they started, and how they have changed over time. If you have a sexual partner, note if they are experiencing similar symptoms.
- Sexual History: Be prepared to discuss your sexual history, including any situations that might have increased your risk of exposure to infections, such as unprotected sex or new partners.
- Medical History: List any other medical conditions you have and any medications, vitamins, or supplements you are currently taking.
- Questions to Ask: Prepare a list of questions for your healthcare provider, such as:
- What tests are needed?
- Should I be tested for other STIs?
- What treatment do you recommend?
- How quickly can I expect improvement with treatment?
- Am I contagious, and how can I reduce the risk of transmission?
- Should my partner be tested?
- When is it safe to resume sexual activity?
- Are genital warts likely to recur?
- What are the long-term health risks associated with genital warts?
- How often should I be screened for related health conditions?
- Are there reliable resources or websites for more information?
What to Expect From Your Doctor
Your healthcare provider will likely ask you several questions to understand your situation better, including:
- How severe are your symptoms?
- Do you practice safe sex, and have you consistently done so?
- Have you recently had a new sexual partner?
- Has your partner been tested for STIs?
- Have you received the HPV vaccine, and if so, when?
- Are you pregnant or planning to become pregnant?
Being open and honest with your healthcare provider will help them provide the best possible care and guidance for managing genital warts and maintaining your sexual health.
