HPV/Genital Warts: Key Q&A

What is human papillomavirus (HPV)?

HPVs are a group of more than 100 viruses, of which 30 are spread through sexual contact. Genital HPV is a common sexually transmitted disease (STD) that can cause warts on the genitals of women and men. Some types of HPV can cause abnormal Pap smears and cervical cancer in women. The HPVs that cause common warts on the hands and feet are different from those that cause genital warts. Genital HPV should not be confused with genital herpes, another STD.

How common is genital HPV?

Genital HPV is the most common STD. The Centers for Disease Control and Prevention (CDC) estimate that 20 million people are currently infected with HPV. About 6.2 million Americans acquire a new genital HPV infection each year. Genital HPV is more common in women than men.

How is genital HPV transmitted?

The virus is spread through skin-to-skin contact. Genital HPV is transmitted through vaginal, anal and oral sex. It can be transmitted even if there are no visible genital warts. In rare cases, infants born to an infected mother may develop warts in their throats or contract the virus during vaginal delivery.

What are the signs and symptoms of HPV?

Most HPV infections have no signs or symptoms, which means that many people are unaware that they are infected. The virus can remain dormant in the body for years without any harm. With genital HPV, people can develop warts in the genital area. Genital warts usually appear as soft, moist, pink or flesh-colored swellings. They can be single warts or appear in clusters, resembling cauliflower.

In women, genital warts can appear on the vulva (the opening of the vagina), in or around the vagina or anus and on the cervix. In men, the warts typically appear on the penis, scrotum and anus. Less often, they will develop on the groin or thighs. The warts are typically painless but may cause some itching or may bleed after being irritated during sex, from clothing or from cleaning and wiping the area.

How is genital HPV diagnosed?

Genital warts are usually first diagnosed by visual inspection of the genitals. They can also be diagnosed with a small biopsy. Most women are diagnosed during a routine gynecological examination. An abnormal Pap smear may also indicate the presence of genital HPV. Women may also receive a test that identifies certain high-risk types of HPV associated with the development of cervical cancer. The test collects cells from the woman's cervix, which are analyzed for viral DNA. It can detect some HPV strains before there is visible evidence of the changes to the cervical cells.

What is the treatment for genital HPV?

There is no cure for HPV; the virus remains in the body forever. The genital warts often disappear on their own without treatment, even while the virus remains active in your body, and can resurface at any time, even after you've had treatment. The most common time for genital warts to return is within 3 months of the treatment. However, there is no way to predict whether a genital wart will continue to grow or disappear. If genital warts are suspected, an examination should be done by a physician to determine the necessary treatment.

Treatment of the genital warts depends on the size and location of the growths. They may be treated at home with certain topical creams or solutions prescribed by a physician.

If the growths are small, the warts may be treated by cryosurgery (freezing), use of an acidic solution, electrocautery (burning) or laser treatment. All of these treatments are administered by a physician in an office or a clinic. Repeated treatments may be necessary to completely remove the genital warts. If the genital warts are larger or do not respond to other treatment, they may need to be removed by surgery.

How can genital HPV be prevented?

Four of the major strains of HPV can be prevented with the HPV vaccine, which is approved for young girls and women (ages 9 to 26). For people not eligible for the vaccine, sexual abstinence can prevent transmission. In addition, safer sex practices can reduce the risk of transmission, but not completely prevent it. Using a latex condom during vaginal, anal or oral sex can reduce the chances of contracting or transmitting the disease. However, condoms are not 100 percent effective due to exposed skin. In addition, dental dams or condoms should be used during oral sex to reduce the transmission of the infection between the genitals and the lining of the mouth. Limiting the number of sex partners and maintaining a monogamous relationship with an uninfected individual also reduces the risk of genital HPV.

Who is at the greatest risk for genital HPV?

Women are infected with genital HPV more than men. Individuals with multiple sex partners or high risk partners have an increased risk of genital HPV, as do those who engage in unprotected sex.

How does genital HPV affect pregnancy?

Genital HPV may cause some complications with pregnancy and delivery. Some warts may grow large enough to create problems with urination or block the birth canal. Larger genital warts can be removed from pregnant women to avoid this complication. There are certain topical creams that cannot be used by pregnant women because they may cause damage to the fetus.

In rare instances, the infection can be passed onto the baby during vaginal delivery. Some infants born to infected mothers may have warts in their throat. These warts have the potential to cause serious problems and can be removed with laser surgery after birth to prevent obstruction of the airway.

Can genital HPV be contracted through objects or clothing?

There has been inconclusive evidence that the virus can be spread through objects, such as toilet seats or clothing. It is transmitted through direct contact with the virus, which may include sharing contaminated sexual toys with partners.

Reviewed by Timothy Yarboro, M.D.

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