Genital Warts (Human Papillomavirus)
Genital Warts (Human Papillomavirus)
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This topic provides information about the human papillomavirus (HPV), which causes genitaland can also cause . If you are looking for information about cervical cell changes or , see:
What is human papillomavirus (HPV)?
Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs). It is a that can be spread through skin-to-skin genital contact. There are many different types of HPV. Some types cause genital and are called low-risk. And some types can lead to cervical, anal, or and are called high-risk. There is no known cure for that can protect against some types of the .
What are genital warts?
Genitalare skin growths in the groin, genital, or anal areas. They can be different sizes and shapes. Some look like flat white patches, and others are bumpy, like tiny bunches of cauliflower. Sometimes you can't see the at all.
What causes HPV and genital warts?
HPV is a. Certain types of the virus cause genital warts and some types cause abnormal cervical cell changes and .
HPV and genitalcan be spread through sex or skin-to-skin genital contact with someone who has the .
What are the symptoms?
Most people infected with HPV don't have symptoms. But if they do, the symptoms may be so mild that they may not know they are infected. The symptoms may include pain, itching, and bleeding, or you may develop visible genital.
If you have symptoms, they will probably occur 2 to 3 months after infection. But you can have symptoms from 3 weeks to many years after infection.
Visible genitalappear only during active infection. But it is possible to spread the even if you can't see the .
How are HPV and genital warts diagnosed?
A doctor can often tell if you have genitalby looking closely at your genital and anal areas. He or she may ask you questions about your symptoms and your risk factors. Risk factors are things that make you more likely to get an infection.
Sometimes the doctor takes a sample of tissue from thefor testing.
For women, if you have an abnormal, your doctor can do an HPV test that looks for high-risk types of the .
How are they treated?
There is no cure for HPV, but the symptoms can be treated.
Talk to your doctor about whether you should treat visible genital. They usually go away with no treatment, but they may also spread. Most people decide to treat them because of the symptoms or because of how the look. But if you don't have symptoms and are not worried about how the look, you can wait and see if the go away.
If you do decide to treat genital, talk to your doctor about the best treatment for you. There are prescription medicines that you or your doctor can put on the . Or your doctor can remove them with , surgery, or by freezing them off.
Even if you treat visibleor your go away without treatment, the HPV infection can stay in your body's cells. It is possible to spread genital to your partner even if you have no signs of them.
Can HPV and genital warts be prevented?
The best way to keep from getting genital wartsâ€”or any other STIâ€”is to not haveor any skin-to-skin genital contact. If you do have , practice safer sex.
- Use latex condoms. Latex condoms may help reduce the risk of spreading genital , but they do not protect the entire genital area against skin-to-skin .
- Before you have with someone, talk to them about STIs. Find out whether he or she is at risk for them. Remember that a person can be infected without knowing it.
- If you have symptoms of an STI, don't have .
- Do not have with anyone who has symptoms or who may have been exposed to an STI.
- Having several sex partners increases your risk for infection.
Health Tools help you make wise health decisions or take action to improve your health.
HPV infection is caused by a . More than 100 types of HPV have been found. Some types cause genital and some can lead to cervical cancer. Types 6 and 11 cause most genital . Other types such as 16 and 18 are high-risk and can cause abnormal cell changes on the .
How the infection is spread (transmission)
HPV is spread by direct.
- The can be spread to or from the genitals, anus, mouth, or throat during sexual activities. But in the mouth or throat are extremely rare. Latex condoms can lower your risk of getting genital .
- After the infection occurs, it may spread to other areas of the genitals or to the anal area.
- You can spread the even if you do not have any symptoms of infection or any visible .
- There is a small chance that a pregnant woman can pass the to her baby.
- Children can get genital from sexual abuse.
Human papillomavirus (HPV) infection
Infection with the cervix that can cause an abnormal .(HPV) usually does not cause any symptoms and does not always produce visible genital . Some types of HPV cause cell changes to the
When symptoms do develop, they usually occur 2 to 3 months after infection. But symptoms have been known to occur from 3 weeks to many years after infection.
Symptoms that may occur with genitalinclude:
can be different sizes and shapes.
- They may be large, or they may be too small to be seen with the naked eye. They may appear individually or in .
- may look like tiny bunches of cauliflower or like flat, white areas that are very difficult to see.
- In women and men, urethra, or in the rectum or anus. may appear in the groin, on and around the genitals, in the
- In women:
- vulva, , or . may appear around the anus or on the
- Women are often unaware of inside the or on the until a doctor finds them.
- In men:
- scrotum, or around the anus. may occur on the outside of the penis, on the
- Men are often unaware they have genital , even when they can be seen, until the are identified by a doctor.
Symptoms of genital other conditions.may be similar to those of
Based on the type of HPV, you may or may not have visible genital.
- Common HPV types 6 and 11 produce visible warts. These may go away on their own, stay the same, or increase in number.
- Other HPV types, such as 16 and 18, do not produce visible genital Pap test, are linked to precancerous cervical cell changes and cervical cancer. . These types, which may be found with a
HPV infection and cervical cell changes
In women, most precancerous or cancerous cell changes associated with HPV infection occur on the cervix. This is because the cells of the cervix naturally undergo changes in an area called the transformation zone. This process can cause cervical cells to become abnormal when they are infected with HPV.
Infection with high-risk types of HPV increase the chance that a woman with HPV will develop abnormal cervical cell changes. It is important to have regular exams by your doctor. If your doctor finds abnormal cells on a, the cells can be treated to help prevent them from changing to cancer.
HPV infection and anal and penile cancer
It is not clear whether men who are infected with HPV on the penis are more likely to have precancerous or cancerous changes on the penis than men who are not infected. Because HPV does cause cell changes, more research is being done to find out whether HPV increases the risk of penile cancer. In the United States, cancer of the penis is extremely rare.
HPV infection during pregnancy
The presence of HPV and abnormal cell changes does not affect the outcome of the pregnant woman who is infected with the type of HPV that causes genital may have more complicated than a woman who is not pregnant. Genital may increase in size, bleed, or become infected with bacteria. Your doctor may recommend treatment. may be passed on to the newborn, but this is rare.. A
What Increases Your Risk
Things that increase a person's risk for getting a, such as HPV and genital , include:
- Having multiple sex partners.
- Having high-risk partner(s) (partner has multiple sex partners or HPV-infected sex partners).
- Having unprotected sexual (not using latex condoms).
- Having an impaired immune system.
When To Call a Doctor
Call your doctor if you have any of the following symptoms:
- Sores, bumps, rashes, , or on or around your genitals or anus
- Burning, pain, or severe itching while urinating
- For women, an abnormal vaginal discharge that smells bad
- For men, an abnormal discharge from your penis
Call your doctor if you suspect you have been exposed to a sexually transmitted infection (STI).
Avoid sexualuntil you have been examined by a doctor.
A child can get genital sexual abuse.in several ways. Any child who has genital needs to be evaluated by a doctor to find out the cause and to assess for possible
In rare cases, infants may developin the larynx (laryngeal papillomas), which is in the throat, from exposure to HPV during .
A doctor should evaluate any warts or other symptoms that suggest infection with the human papillomavirus (HPV) or another sexually transmitted infection (STI). Avoid sexualuntil you have been examined. If you have an STI, avoid sexual to prevent spreading the .
Sometimes,may go away on their own. If you have genital , your doctor may observe your condition without using medical treatment. This is called . This period may vary from a few days to weeks or possibly months.
The length of the watchful waiting period is based on:
- The severity of your symptoms.
- The progression of the problem if not treated.
- The risks and benefits of waiting.
- Your age and medical history.
Who to see
In general, your family doctor or any of the following health professionals can determine whether you have genital :
Treatment may require a specialist, such as a:
Exams and Tests
A doctor usually can diagnose visible genitalusing your medical history and a . But not all HPV infections cause visible . If you don't have any visible or other symptoms, it may be hard for your doctor to diagnose HPV infection. Your doctor may ask you the following questions:
- Do you think you were exposed to HPV or any sexually transmitted infections (STIs)? How do you know? Did your partner tell you?
- What are your symptoms? If you have discharge from the vagina or penis, it is important to note any smell or color.
- Did you use latex condoms to protect against STIs?
- Which sexual behaviors do you or your partner engage in, including high-risk behaviors such as with multiple partners?
- Have you had an STI in the past? How was it treated?
- Have you ever had an abnormal Pap test (for women)?
After your doctor takes your medical history, you will have a gynecological exam, which usually includes a .
A cervix. Results of the may indicate an HPV infection even though you have no visible .screens for abnormal cells on the
Women over age 30 may get a screening test for HPV at the same time as a HPV test looks for the (genetic information) of the . Women under 30 usually get the HPV test only if they have an abnormal Pap test.footnote 3. This
If your doctor finds areas of abnormal tissue on the(which may be related to HPV infection), he or she may recommend treatment.
After the medical history, you will have a for genital .
Doctors do not recommend a screening test for HPV infection in men.
For men and women
Some experts believe that people who receive anal HIV infection. Ask your doctor whether and how often you should be tested.should have a screening for , especially if they also have
If visibleare present, a diagnosis can usually be made without more testing.
When your doctor finds abnormal tissue but cannot make a definite diagnosis, you may have a biopsy for lab tissue studies.
Testing for the type of HPV that is causingis not useful for diagnosis. This test is not routinely done for diagnosis or treatment of genital .
There is no cure for HPV infection, but abnormal Pap test will be treated differently than the HPV types that cause genital .and cell changes can be treated. HPV infection that causes an
Genitalcaused by the most common types of human papillomavirus (HPV) may go away on their own without treatment. For this and other reasons, experts sometimes have different approaches to treating genital .
- Genital may disappear without treatment. This is the natural course of many genital .
- Destroying large areas of is difficult and may cause scarring.
- Treatment for genital does not eliminate the HPV infection. You may still be able to spread the infection. Latex condoms can help reduce the risk of HPV infection.
- Treatment of genital can be painful, and may return after treatment. that return after being treated usually are not treated again unless you want to be retreated. If you do, you would usually choose a different form of treatment.
Types of treatment
Treatments for genitalinclude medicines, freezing, , or surgery.
The type of medical treatment for genitalwill depend on:
- The number, size, and location of .
- The side effects of treatment.
- The skill of the doctor for each treatment option.
, which varies depending on:
- The cost of medicine.
- Any specialized equipment used.
- The number of treatments needed.
- The problems caused by the urethra). (such as blockage of the
- Your preference.
- If you are pregnant. Some wart medicines should not be used during .
Doctors often recommend medicine applied to(topical drug treatment) as the first choice of treatment. A doctor will apply the medicines that have a high risk of causing damage to the skin around the . You can apply others at home.
Caution: Do not use nonprescription wart removal products to treat genital. These products are not intended to be used in the genital area and may cause serious burning.
Surgery and other treatment
Surgery to remove genitalmay be done when:
- Medicine treatment has failed and the removal of is considered necessary.
- are widespread.
What to think about
Without treatment, external genitalmay remain unchanged, increase in size or number, or go away. Studies show that no one treatment is completely successful. All treatments have advantages and disadvantages. The benefits and effectiveness of each treatment need to be compared with the side effects and cost.
- Treatment of usually requires a series of applications rather than a single treatment.
- in moist areas usually respond better to treatments applied to the area, such as creams or acids.
- on dry skin may respond best to freezing (cryotherapy) or surgical removal.
- Cryotherapy may be done when genital are visible and bothersome and are growing in a small area. Repeat treatments may be needed to remove all wart tissue.
- The success of surgery is related to the number of . The success rate is higher and additional treatments are less likely to be needed when surgery is done on fewer and smaller . But surgery is less likely to be needed for a few small areas of . Surgery may require .
- Small areas of can be quickly treated with removal methods, such as cryotherapy or surgical excision.
- Self-applied medicines may be used for larger areas of that need longer or repeated treatments.
A biopsy of that do not go away on their own or after treatment is often done to rule out precancerous or cancerous conditions.
Several choices of treatment for pregnant women have been found to be effective and safe, including trichloroacetic acid (TCA), cryotherapy, and surgery.
You can reduce your risk of becoming infected with the human papillomavirus (HPV) or another sexually transmitted infection (STI). You also can reduce the risk of spreading HPV to your sex partner(s).
Practice safer sex
Preventing a sexually transmitted infection (STI) is easier than treating an infection after it occurs.
- Talk with your partner about STIs before beginning a sexual relationship. Find out whether he or she is at risk for an STI. Remember that it is possible to be infected with an STI without knowing it. Some STIs, such as HIV infection, may be in your blood for 3 to 6 months before they can be detected.
- Be responsible.
- Avoid sexual if you have symptoms of an STI or are being treated for an STI.
- Avoid sexual with anyone who has symptoms of an STI or who may have been exposed to an STI.
- Having several sex partners increases your risk of getting an STI.
Male condom use
Latex condom use can reduce the risk of becoming infected with HPV. You can reduce the risk of infection if you use a condom every time you have . Condoms must be put on before beginning any sexual .
Female condom use
If you are age 26 or younger, you can get the HPV shot. The HPV vaccine can protect against genital warts. It is recommended that girls and boys age 11 or 12 get the , but the vaccine can be given from age 9 to 26. Children ages 9 to 14 years get the vaccine in a series of two shots over 6 months. Children age 15 years and older should get the vaccine as a three-dose series. For the vaccine to work best, all shots in the series must be given.
The footnote 4 But it may protect a woman against types of the HPV virus other than the one causing her infection.is not useful for treating women who already are infected with HPV.
Home treatments may not cure HPV infection and genital warts. But a doctor may prescribe medicine that you can use at home, such as podofilox lotion or gel or imiquimod cream.
Caution: Do not use nonprescription wart removal products to treat genital. These products are not intended for the genital area and may cause serious burning.
You can use at-home care to feel more comfortable.
- Take . Fill a tub with a few inches of warm water and sit in it for 10 or 15 minutes every day.
- Squeeze warm water from a bottle over your genital area to provide comfort and cleansing.
- Keep the clean and dry in between baths. You may want to let the sores air dry. This may feel better than a towel.
It is important to remember that most infections are minor, without serious complications. Some cases of HPV infection and genital warts disappear without treatment, although human papillomavirus (HPV) may still be present in your body's cells.
Medicine may be used to destroy bothersome genital, relieve your symptoms, and reduce the amount of area affected by , particularly when the are:
- Visible, bothersome, and growing in a small area.
- A cosmetic concern and you want them removed. vulva, may be removed because they are unsightly. Some treatments that remove genital are more likely to leave scars. So cosmetic concerns about scarring may help guide the choice of treatment. that are growing around the anus or on external genitals, such as on the penis or
Topical medicine often is the first treatment. For safety, a doctor will apply the topical medicines that could damage the skin around the. You can apply other medicines at home. If warts return after one course of treatment with topical medicine, they are treated again only if there are clear reasons for retreatment.
Medicines are not used to treat abnormal cell changes found on a For more information on treating abnormal cell changes caused by high-risk HPV, see the topic Abnormal Pap Test..
Treatment applied at home
The following medicines can be applied to the affected area (topical treatment) at home:
- Imiquimod (such as Aldara)
- Podofilox lotion or gel (such as Condylox)
- Sinecatechins (such as Veregen)
Do not use these.
Imiquimod and podofilox are typically the most effective medicine options that can be applied at home. Read the instructions carefully before using these medicines.
Treatment applied by a doctor
Treatment by a doctor can:
- Treat areas that you cannot reach easily.
- Treat a large area.
- Remove the quickly.
- Be expensive.
- Be painful.
- Have side effects.
Medicines applied by a doctor include:
- Trichloroacetic acid (TCA) or bichloroacetic acid (BCA).
- Intralesional (injected into wart lesion) interferon.
Treatment during pregnancy
Treatment for pregnant women includes trichloroacetic acid (TCA), cryotherapy, laser therapy, loop electrosurgical excision procedure (LEEP), and surgical removal by electrocautery or excision.
What to think about
Avoid sexual contact in the treated area until the area is completely healed.
Some medicine may be more expensive than others.
biopsied to rule out precancerous or cancerous conditions.on the vulva or penis that do not go away on their own or after treatment often are
Removing genital warts does not cure an HPV infection.may go away with topical treatment, but they may return, because HPV may still be in the body's cells.
Even if genitalhave been removed or destroyed:
- You may still be able to infect sex partners with HPV.
- You should continue to use latex condoms during sexual intercourse if you have multiple sex partners.
You may have surgery to remove genitalif they are widespread and medicine or freezing (cryotherapy) fails to remove them.
If you have a high-risk type of HPV that causes an abnormal For more information about surgical methods to treat abnormal cell changes, see the topic Abnormal Pap Test., your doctor may recommend certain types of surgery.
Surgical methods that may be used include:
- Cryotherapy (cryosurgery).
- Surgical excision.
- Laser surgery.
- Loop electrosurgical excision procedure (LEEP).
Surgical treatment for pregnant women
Surgical choices for pregnant women with genitalinclude electrocautery, surgical excision, loop electrosurgical excision (LEEP), and laser surgery.
What to think about
The success of surgery is related to the number ofpresent. The success rate is higher and additional treatments are less likely to be required when surgery is done on fewer and smaller . But surgery is less likely to be needed for a few small areas of .
Surgery may be more expensive than some other treatment choices.
- Bonnez W (2015). Papillomaviruses. In JE Bennett et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 8th ed., vol. 1, pp. 1794â€“1806. Philadelphia: Saunders.
- International Collaboration of Epidemiological Studies of (2007). and hormonal contraceptives: Collaborative reanalysis of individual data for 16,573 women with and 35,509 women without from 24 epidemiological studies. Lancet, 370(9599): 1609â€“1621.
- U.S. Department of Health and Human Services (2007). : HPV information for Clinicians. Available online: http://www.cdc.gov/std/hpv/hpv-clinicians-brochure.htm.
- Hildesheim A, et al. (2007). Effect of 16/18 L1 viruslike particle vaccine among young women with preexisting infection. JAMA, 298(7): 743â€“753.
Other Works Consulted
- American Academy of Pediatrics (2015). Human papillomaviruses. In DW Kimberlin et al., eds., Red Book: 2015 Report of the Committee on Infectious Diseases, 30th ed., pp. 578â€“583. Elk Grove Village, IL: American Academy of Pediatrics.
- Centers for Disease Control and Prevention (2011). Recommendations on the use of quadrivalent human papillomavirus vaccine in males: Advisory Committee on Immunization Practices (ACIP). MMWR, 60(50): 1705â€“1708. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6050a3.htm?s_cid=mm6050a3_e.
- Gillison ML, et al. (2012). Prevalence of oral HPV infection in the United States, 2009â€“2010. JAMA, 307(7): 693â€“703.
ByHealthwise StaffPrimary Medical Reviewer Sarah A. Marshall, MD - Family Medicine Kathleen Romito, MD - Family Medicine E. Gregory Thompson, MD - Internal Medicine Adam Husney, MD - Family Medicine Kevin C. Kiley, MD - Obstetrics and Gynecology
Current as ofNovember 27, 2017
Current as of:
November 27, 2017