Genital warts

Genital warts are one of the most common sexually transmissible infections (STIs). They are caused by the human papilloma virus (HPV). There are over 100 strains of HPV, but only some affect the genitals and not all cause visible warts. Genital warts can appear around the genitals and anus or, sometimes, inside the vagina, rectum or urethra.

Appearance

Genital warts appear as painless growths and may be:

• Flat or raised
• Single or multiple
• Clustered together with a cauliflower-like appearance.

Sometimes warts are not visible

In many cases, the warts are a ‘subclinical’ infection. This means that you may be carrying the human papilloma virus (HPV) on your skin, even though you do not have any visible warts. This commonly happens with women and often cell changes caused by the virus are only detected when they have a Pap test.

Spread by direct contact

Genital warts are spread by direct skin-to-skin contact during vaginal or anal sex. Infection may occur after direct contact with a visible wart or contact with genital skin where the virus is present.

Genital wart treatment

Treatment aims to remove the visible wart/s, but not the virus. Always consult your doctor about any treatments.

Treatment options include:

• Cryotherapy – the warts are frozen off with liquid nitrogen or dry ice. Several treatments may be required.
• Podophyllotoxin – this lotion can be applied at home. It is most effective on multiple warts that are easily accessible. Pregnant women should not use podophyllotoxin.
• Imiquimod cream – this is applied once a day, three times a week for up to three months. This treatment is not recommended for use in pregnancy.
• Laser or diathermy treatment – this is used for larger numbers of warts or when other treatment options have not been effective. Laser or diathermy treatment is administered in hospital under general anaesthetic.

Genital warts can reappear

After treatment for warts, remember:

• The virus may persist on the skin even though the visible wart has gone. This means that warts may reappear.
• If the wart reappears, it does not necessarily mean that you have caught the infection again.
• In most cases, the wart will eventually disappear for good. This is due to the body’s natural immune response clearing the virus from the body.

HPV and cervical cancer

Human papilloma virus can infect the cervix and cause cell changes that may increase the risk of cervical cancer. There are only a few strains of HPV believed to cause cell changes that may progress to cervical cancer if undetected. The types of HPV that cause visible genital warts do not progress to cervical cancer.

The value of Pap tests

Pap tests, or smears, are a screening tool used to detect cell changes on the cervix that may or may not lead to cervical cancer. Australian women are recommended to have Pap tests every two years.

Most cell changes found on the cervix will resolve naturally without treatment. However, some higher level cell changes require closer monitoring and may need treatment to remove these cells. Your doctor will advise you about this if necessary.

Preventing the spread of genital warts

You can help reduce the risk of spreading genital warts by using condoms during anal or vaginal sex.

Condoms for men can be bought from supermarkets, pharmacists and other outlets. Female condoms are available through Family Planning Victoria and may be available from selected shops. Latex-free condoms are also available from some outlets. Male condoms and lubricant are available free from the Melbourne Sexual Health Centre along with female condoms on request.

Using a condom reduces your risk of genital warts, but condoms only protect the area of skin that they cover. This is because condoms do not cover all the genital skin that is exposed during sexual contact.

Remember that transmission of genital warts can occur when a wart is present, but may also occur even if there are no genital symptoms.

The human papilloma virus (HPV) vaccine

The HPV vaccine prevents infection with certain strains of HPV associated with the development of cervical cancer and genital warts. Two types of HPV vaccine are currently available from your doctor. Both vaccines protect against the two HPV types (16 and 18) that are associated with cervical cancer and one also protects against two HPV strains types (6 and 11) that cause most genital warts.

In Australia, school-age girls are offered vaccination and some women and men are also eligible for this vaccine after discussing it with their doctor.

If you are in a regular sexual relationship

The benefits of condoms are less clear if you are in a regular sexual relationship, especially if you and your partner both have warts. You should discuss this issue with your doctor or with a nurse at an STI clinic.

Where to get help

• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
• Your doctor
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Victoria AIDS Council/Gay Men's Health Centre Tel. (03) 9865 6700 or 1800 134 840
• Education and Resource Centre at the Alfred Tel. (03) 9276 6993
• The Centre Clinic, Northcote Tel. (03) 9481 7155
• The Centre Clinic, St Kilda Tel. (03) 9525 5866
• Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100
• The Action Centre (for young people less than 25 years) Tel. 1800 013 952 or (03) 9654 4766
• Sexual Health Clinic Ballarat Tel. (03) 5338 4540
• Bendigo Community Health Tel. (03) 5434 4330
• Geelong Sexual Health Clinic Tel. (03) 5221 4735
• STD Clinic Wodonga Tel. (03) 6051 7535
• STD/AIDS Clinic Traralgon Tel. (03) 5173 8111

Things to remember

• Genital warts are caused by the human papilloma virus (HPV).
• People with HPV can spread the infection, even if they do not have visible warts.
• Warts may reappear after treatment, but most disappear for good eventually.

You might also be interested in:

• Genital herpes.
  
• Infections - bacterial and viral.
  
• Pap tests for all women.
  
• Sexually transmissible infections - avoid the risk.
  
• Sexually transmissible infections - overview.
  
• Sexually transmissible infections - signs and symptoms.
  
• Vulval conditions.
  

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This page has been produced in consultation with and approved by:

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Melbourne Sexual Health Centre

Last reviewed: July 2011

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.

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<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Genital_warts?open">Genital warts - Better Health Channel</a><br/>
Genital warts are one of the most common sexually transmissible infections (STIs). They are caused by the human papilloma virus (HPV). Some strains of HPV infect the cervix and can increase the risk of changes to cells on the cervix that may lead to cervical cancer. Pap tests (smears) can pick up cell changes caused by HPV in the cervix. Treatment removes the visible wart but not the virus.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

For the latest updates and more information, visit www.betterhealth.vic.gov.au

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