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HOW TO TREAT GENITAL WART

Genital warts are one of the most common kinds of sexually transmitted infections. Nearly all sexually active people will get infected with at least one type of human papillomavirus (HPV), the virus that causes genital warts, at some time during their lives. Women are somewhat more likely than men to have genital warts.

As the name would suggest, genital warts affect the moist tissues of the genital area. Genital warts may seem like small, flesh-colored bumps or have a cauliflower-like appearance. In many situations, the warts are too small to be visible.

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Like warts that show up elsewhere on your body, genital warts are caused by the human papillomavirus (HPV). Some strains of genital HPV can cause genital warts, while others can cause cancer. Vaccines can assist protect against certain strains of genital HPV.

Symptoms

Female genital warts

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Male genital warts

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In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, the anal canal, and the cervix. In men, they may appear on the tip or shaft of the penis, the scrotum, or the anus. Genital warts can also starts in the mouth or throat of a person who has had oral sexual contact with an infected person.

The signs and symptoms of genital warts may include:

  • Small, flesh-colored or gray swellings in your genital area
  • Several warts close together that take on a cauliflower-like shape
  • Itching or discomfort in your genital area
  • Bleeding during intercourse

Genital warts may be so small and flat that they can not be seen with the naked eye. Sometimes, however, genital warts may multiply into large clusters.Causes

The human papillomavirus (HPV) causes warts. There are more than 40 different strains of HPV that specifically affect the genital area. Genital HPV is spread through sexual contact. In most cases, your immune system kills genital HPV and you never develop signs or symptoms of the infection.

Risk factors

The Centers for Disease Control and Prevention suggest that nearly all sexually active people will become infected with at least one type of HPV at some point during their lives. Factors that can increase your risk of becoming infected are inclusive of:

  • Having unprotected sex with multiple partners
  • Having had another sexually transmitted infection
  • Having sex with a partner whose sexual history you do not know
  • Getting sexually active at a young age

Complications

Genital wart complications include:

  • Cervical cancer has been closely associated with genital HPV infection. Certain types of HPV also are associated with cancer of the vulva, cancer of the anus, cancer of the penis, and cancer of the mouth and throat. Human papillomavirus infection doesn’t always result to cancer, but it’s still important for women to have regular Pap tests, particularly if you’ve been infected with higher risk types of HPV.
  • Problems during pregnancy.Genital warts may create problems during pregnancy. Warts could enlarge, making it difficult to urinate. Warts on the vaginal wall may lower the ability of vaginal tissues to stretch during childbirth. Large warts on the vulva or in the vagina can bleed when stretched during delivery.

Rarely, a baby born to a mother with genital warts may have warts in his or her throat. The baby may require surgery to make sure his or her airway isn’t blocked.

Prevention

Using a condom every time you have sex can greatly reduce your risk of contracting genital warts. Although condom use can reduce your risk, it is not 100 percent effective. You can still get genital warts infection.

Vaccination

A vaccine known as Gardasil protects against four strains of HPV that cause cancer, and is used to prevent genital warts. In 2014, the U.S. Food and Drug Administration approved a vaccine called Gardasil 9, which protects against nine strains of HPV.

Another vaccine, called Cervarix, guards against cervical cancer but not genital warts.

The national Advisory Committee on Immunization Practices recommends routine HPV vaccination for girls and boys ages 11 and 12. If not fully vaccinated at that age, it’s advised that girls and women through age 26 and boys and men through age 21 receive the vaccine. However, men may get the HPV vaccine through age 26 if desired.

These vaccines are most effective if administered to children before they become sexually active. Research has indicated that people under 21 and age 21 to 30 who get the HPV vaccine can reduce their risk of getting genital warts by up to 50 percent.

Side effects from the vaccines are usually mild and include soreness at the injection site (the upper arm), headaches, low-grade fever or flu-like symptoms. Sometimes dizziness or fainting happens after the injection, especially in adolescents.

Diagnosis

Because it’s often hard to detect genital warts, your doctor may apply a mild acetic acid solution to your genitals to whiten any warts. Then, he or she may observe them through a special magnifying instrument, a colposcope.

For women, it’s vital to have regular pelvic exams and Pap tests, which can assist detect vaginal and cervical changes caused by genital warts or the early signs of cervical cancer — a possible complication of genital HPV infection.

During a Pap test, your doctor will make use of a device called a speculum to hold open your vagina. He or she will then use a long-handled tool to collect a small sample of cells from your cervix — the passage between your vagina and your uterus. The cells are examined with a microscope for abnormalities.

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HPV test

Only a few types of genital HPV have been associated with cervical cancer. A sample of cervical cells, taken during a Pap test, can be tested for these cancer-causing HPV strains.

This test is generally kept for women ages 30 and older. It isn’t as useful for younger women because their immune systems usually can kill even cancer-causing varieties of genital HPV without treatment.

Treatment

If your warts aren’t causing discomfort, you may not require treatment. But if your symptoms include itching, burning and pain, or if visible warts are causing emotional distress, your doctor can assist you clear an outbreak with medications or surgery. However, the lesions are likely to come back after treatment. There is no treatment for the virus itself.

Medications

Genital wart treatments that can be applied directly to your skin include:

  • Imiquimod (Aldara, Zyclara).This cream appears to boost your immune system’s ability to fight genital warts. Avoid sexual contact while the cream is on your skin. It may weaken condoms and diaphragms and may irritate your partner’s skin.

One possible side effect is redness of the skin. Other side effects may include blisters, body aches or pain, cough, rashes, and fatigue.

  • Podophyllin and podofilox (Condylox).Podophyllin is a plant-based resin that destroys genital wart tissue. Your doctor will apply this solution. Podofilox contains the same active compound, but can be safely applied by you at home.

Your doctor may want to give the first application of podofilox, and will recommend precautionary steps to keep the medication from irritating surrounding skin. Never apply podofilox internally. Additionally, this medication isn’t recommended for use during pregnancy. Side effects can include mild skin irritation, sores or pain.

  • Trichloroacetic acid (TCA).This chemical treatment burns off genital warts, and can be used for internal warts. Side effects can be mild skin irritation, sores or pain.
  • Sinecatechins (Veregen).This cream is used for treatment of external genital warts and warts in or around the anal canal. Side effects are often mild and could include reddening of the skin, itching or burning, and pain.

Don’t try to treat genital warts with over-the-counter wart removers. These medications aren’t intended for use in the moist tissues of the genital area. Using over-the-counter medications for this purpose can cause even more pain and irritation.

Surgery

You may require surgery to remove larger warts, warts that don’t respond to medications or — if you’re pregnant — warts that your baby may be exposed to during delivery. Surgical options include:

  • Freezing with liquid nitrogen (cryotherapy).Freezing works by causing a blister to form around your wart. As your skin heals, the lesions slough off, letting new skin to appear. You may require repeated cryotherapy treatments. The main side effects include pain and swelling.
  • This procedure uses an electrical current to burn off warts. You may have some pain and swelling after the procedure.
  • Surgical excision.Your doctor may equally use special tools to cut off warts. You’ll find local or general anesthesia for this treatment, and you may have some pain afterward.
  • Laser treatments.This approach, that uses an intense beam of light, can be expensive and is usually reserved for very extensive and tough-to-treat warts. Side effects can include scarring and pain.

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