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. 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) in an area of your skin, even though you do not have any visible warts. This commonly happens with women and often the virus is 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. It is also possible that contact with an area of skin with a subclinical infection may result in infection.
Treatment
Treatment removes the visible wart 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.
- Podophyllin paint – this caustic plant extract must be applied by a doctor. It must be washed off four hours after it is applied and should only be used once or twice a week. It should never be used during pregnancy.
Genital warts can reappear
After treatment for warts, you should remember:
- The virus may persist in the skin even though the visible wart has gone. This means that the wart 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 increase the risk of cervical cancer. This is rare as there are only a few strains of HPV that are believed to 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 cellular changes on the cervix that may or may not lead to cervical cancer. The Pap test is not a check for 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:
- Treating warts as soon as they appear
- 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. So their ability to provide reliable protection against warts is not certain. 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 symptoms are present, but may also occur even if there are no genital symptoms.
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 606 024 – 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
- The Annexe Sexual Health Clinic Ballarat Tel. (03) 5320 7500
- BBV/STI Clinic Bendigo 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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