Genital warts (or called condyloma acuminata) are one of the most common sexually transmitted diseases (STDs) caused by human papillomavirus (HPV). Anyone who is sexually active may potentially get genital warts, even though it can be prevented and treated. Check out more about genital warts now!
What are Genital Warts and their causes?
Genital warts are sexually transmitted infections caused by certain strains of human papillomavirus (HPV). Genital warts are some soft growths on or around the genitals or anal area.
In fact, there are over 100 strains of HPV. Most of them are “high-risk” strains that can cause problems such as cervical cancer and skin warts, although in most cases HPV goes away on its own without causing any health issues because your immune system is able to fight and get rid of the virus. On the other hand, there are around 40 HPV types that affect the genital area, but only a few of the “low-risk” strains (especially HPV-6 and HPV-11) can cause genital warts.
Genital warts are highly contagious through skin-to-skin contact. It can spread to others through sex, touching people’s genitals, or childbirth (infected by mother at birth). Even if you don’t see any noticeable genital warts, there is still a chance that the HPV virus can spread to your partners.
Signs and Symptoms of Genital Warts
The incubation period of HPV is variable. When you get infected with HPV, it may take several weeks or months or up to a year before you develop any warts. It is also possible that you don’t see any warts developed because they are too small to be visible. In general, genital warts usually appear as small, raised and flesh-colored bumps or a cluster of bumps in a cauliflower-like shape in genital areas.
These genital warts usually appear in the following body parts:
- Male: penis, scrotum, thigh areas, and sometimes inside the urethra.
- Female: on the cervix, around the vulva, inside of the vagina.
- Both male and female: groin, inside or around anus, mouth, throat, lips, tongue.
If you see no warts developed, you may still experience the following signs and symptoms:
- Vaginal discharge
- Bleeding during sexual intercourse
Risk factors of Genital Warts
Anyone who is sexually active can get genital warts, though the risk can be increased by the following risk factors of genital warts:
- Age: Genital warts are more common in people under the age of 30.
- Weaken immune system: A compromised immune system may not be able to fight the HPV infection. This can be caused by HIV/AIDs or immunosuppressive drugs after organ transplants.
- Infected by mother during childbirth: A mother who is infected can sometimes spread the virus to her baby during childbirth.
- Unprotected sex: Any unprotected sex, like sex without condoms, increases the risk of genital warts by skin-to-skin contact.
- Multiple partners: Having sex with multiple partners increases the risk of exposure to the virus.
- Unknown sexual history: Since HPV infection can be asymptomatic or warts may not be visible, you can be infected unwittingly if you have sex with a partner who has an uncertain sexual history.
- Smoking: Some studies have found that cigarette smoking can contribute to the development of genital warts.
Complications of Genital Warts
Sometimes, genital warts patients may not be willing to see a doctor as they feel embarrassed about the growths in their genital area. Although complications of genital warts are uncommon, some health issues can still arise if genital warts are untreated, such as:
- Cervical cancer: Genital warts can cause the growth of precancerous cells on the surface of the cervix, leading to cervical cancers.
- Problems during pregnancy: When genital warts grow larger, it can make a pregnant woman harder and painful to urinate and cause bleeding during delivery. Also, warts on the vaginal wall can obstruct the vagina to stretch during childbirth.
Diagnosis of Genital Warts
Since the signs and symptoms of genital warts are quite apparent, diagnosis of genital warts is mainly made by physical examination and sexual history. Other tests such as biopsy and pap smear tests can be taken to properly confirm the diagnosis.
- Biopsy: Physicians can generally diagnose genital warts by their appearance. If the genital warts are hard to identify, a biopsy may be taken for laboratory analysis.
- Pap smear (Pap test): Pap smear is usually done as a part of pelvic examination. First, a speculum is inserted into the vagina to hold it open. A brush is then inserted to collect cells from the cervix. The cells are analyzed under a microscope for abnormalities, such as cervical cancer or precancerous changes. If abnormal results are found, more advanced tests may be performed. The cervical screening can also detect any HPV infection.
Treatments of Genital Warts
Genital warts generally go away on their own over time and do not require treatment. However, if you want to minimize their appearance or relieve its signs and symptoms like pain and itching, treatments can be beneficial. Nevertheless, even if there are no symptoms or visible signs of warts, the virus is still infectious.
Genital warts are mainly treated by medication and surgery, depending on the number of warts, location of warts, and physical health condition, etc. Always discuss with your doctor all the treatment options, and never treat genital warts by yourself without consulting a doctor or pharmacist officially.
- Medication: Some topical medicines may be prescribed. Podophyllin is used to stop genital warts from growing, while imiquimod can be used to boost the immune system for fighting the HPV virus.
- Surgery: When the warts are too large or do not respond to topical medications, some procedures may need to be performed to remove warts, including:
- Cryosurgery: It freezes off warts with liquid nitrogen and requires repeated treatments.
- Excision: Your physician may physically cut out warts with special tools.
- Electrocautery: It uses electric currents to burn off warts.
- Laser treatment: It destroys warts with laser light.
- Other treatment: When the previous treatments fail, injections of the drug interferon might be used.
The major objective of genital warts treatment is to remove visible warts instead of getting rid of the HPV virus. There is no treatment to kill the virus, meaning the infection can recur and the virus can spread through sex.
HPV test in Hong Kong
HPV test is only used to check for high-risk strains of HPV causing cancer. If you want to test for genital warts, a pap smear would be sufficient. It is also recommended to perform both tests at the same time for a more comprehensive result. You can find out more information about STD testings at our HK STD Testing Guide.
HPV vaccine in Hong Kong
To prevent genital warts or other HPV infections (e.g. cervical cancer), the most effective way is to get vaccinated. There are 3 types of HPV vaccines in Hong Kong: Gardasil, Gardasil 9 and Cervarix.
Cervarix only covers 2 of the most high-risk HPV virus strains to prevent cervical cancer but not genital warts. Gardasil and Gardasil 9, on the other hand, directed at 4 and 9 common HPV types respectively, including those causing both genital warts and cervical cancer.
Gardasil 9 is the more recommended vaccine as it protects against more HPV strains than Gardasil. It is recommended for all males and females aged 9 – 45, which is more effective before the person has any sexual contact. The doses of administration are usually 2 or 3, depending on age.
By now, Gardasil 9 has been included in the Hong Kong Childhood Immunisation Programme (HKCIP), which offers 2 doses of HPV vaccine for all eligible female students at primary 5 and 6. You can find out more at our HK HPV Vaccination Guide.
Prevention of Genital Warts
Besides vaccination, the following approaches can lower the risk of getting genital warts and spreading the HPV virus:
- Have protected sex, such as using condoms or dental dam.
- Avoid having sex with someone with unknown or active sexual history.
- Limit your number of sex partners.
Genital warts bumps are usually small, raised, flesh-colored in genital areas. It can also be a cluster of bumps in a cauliflower-like shape. You can find them on the penis, scrotum, thigh, cervix, vagina, vulva and groin.
This article was medically reviewed by Dr. Vera Chung 鍾楊醫生. Dr. Chung is a female urologist practicing at the Hong Kong Urology Clinic. She qualified in 2003 from the University of Hong Kong and was trained as a urologist in Queen Elizabeth Hospital and obtained the Fellowship of Royal College of Surgeons of Edinburgh in 2011. Dr. Chung was promoted to associate consultant in Pamela Youde Nethersole Eastern Hospital in 2012. From 2013 to 2015 she has completed a two-year European Board of Urology (EBU) Fellowship in endourology and laparoscopy at Nuffield Department of Surgical Sciences, University of Oxford. In Oxford, Dr. Chung also consolidated her training in the management of continence and prolapse problems in the Department of Gynecology.
This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.