What is it?
HPV is known by many names including venereal, anogenital, or genital warts, and condylomata acuminata. It is a viral infection of skin causing the growth of skin-colored, cauliflower-like masses of various sizes and shapes as shown by the arrows in this picture. (A tampon string is in place as she was menstruating at the time this photo was taken.) It has become very common over the last two decades infecting anywhere from 3% to 28% of the population.
Common Signs & Symptoms
Several weeks to months after being exposed to a sexual partner with HPV, these painless growths occur on damp or moist surfaces in either sex. Common locations include those pictured as well as around the anus. They often begin as tiny red spots and can grow quickly into cauliflower-like masses. Infection of a woman’s cervix with certain strains of this virus can lead to cervical cancer. It is crucial, therefore, for all women who have this disease to have regular pap smears. (Actually, all women who are sexually active need to have regular pap smears to look for cervical problems.)
HPV of the penis
HPV on the cervix
(looking into the vagina through a speculum)
How’s it Diagnosed?
Diagnosis is made when a physician sees the classic-shaped growths. If there is any question, a sample of the abnormal tissue (biopsy) can be taken and sent to the lab for microscopic analysis. Cervical HPV is diagnosed by taking a small sample of cervical cells with a popsicle-like stick (pap smear) and preparing this specimen on a slide for microscopic analysis.
How’s it Treated?
Like most viral infections, there is no cure for Human Papillomavirus. Treatment consists of destroying the infected cells, but it often comes back due to infection of normal-appearing nearby skin. If left untreated, genital warts may go away on their own. One study showed that nearly 1/3 of all patients had spontaneous resolution of the growths.
For those not wanting to wait to see if they disappear on their own (e.g., most people), destruction of the abnormal cells can be done via a number of methods such as freezing the growths with liquid nitrogen, destroying the tissue with laser surgery, using a blistering agent (such as podophyllin - made from rain forest beetles), or burning them off with a potent acid (e.g., trichloracetic acid). A doctor trained in one of these techniques should be seen to prevent damaging the normal surrounding tissue.
A novel approach is to enhance ones own immune system to fight off the genital warts. One such “immune-enhancer” is a cream called imiquimod (Aldara). Imiquimod is currently available by a doctor’s prescription only, but unlike the other treatments that require a health professional to apply, Aldara is applied by the patient themselves, in the privacy of their own home. The patient puts a small amount of the cream on the warts three times a week. Aldara is for the treatment of visible warts on the genitals and perianal area. It is not for treatment of cervical or intravaginal warts. Cervical or intravaginal warts are usually treated with freezing or by surgically removing the infected area.
How do I avoid Getting It (Prevention)?
Abstinence, and correct condom use may prevent transmission of this virus from one person to the next. A vaccine called Gardasil can prevent the types of genital warts that cause cervical cancer. More details on this vaccine are here.
It is crucial that all infected skin be covered to prevent skin to skin transmission. Since multiple areas of skin touch during intimate encounters, condom use is not terribly effective.
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