Genital warts are inextricably linked to the human papillomavirus (HPV) – a common virus that infects skin and mucous membranes. People with genital warts often feel ashamed, uncomfortable and embarrassed, which sometimes leads to depression. While for HPV there is no treatment, genital warts are easy to treat, but they can come back and can then be treated again.
What are genital warts?
Genital warts are quite simply warts around or on the genitals, caused by the human papillomavirus (HPV). This is an STI (sexually transmitted infection). You can contract and pass on this virus without noticing it, through contact of the genitals, but also through fingers that have been in contact with a genital wart or a used towel or washcloth.
The genital warts can form after you have come into contact with the HPV. Even if you have no symptoms, you can still infect your sexual partner(s) and in rare cases, a mother can infect her child at birth.
The time between infection and development of the genital warts is between three weeks and eight months.
What forms of HPV and genital warts are there?
The highly contagious HPV (human papillomavirus) has 150 types, of which 30 focus on the genitals and are divided into low-risk and high-risk types. High-risk types are those that can cause cervical cancer, and indeed almost all cervical cancer is caused by HPV. The types are classified by numbers, with types 16 and 18 being the highest risk.
The most common low-risk HPV types are 6 and 11. They are not carcinogenic but are the cause of genital warts in 90% of cases. Some genital warts are barely visible. There is no connection between warts elsewhere on the body and genital warts. Warts on the hands cannot cause genital warts.
How can you recognise an HPV infection and genital warts?
Many people have been infected by HPV (80% of women and men) but do not realise it. Most infections are automatically about whether the immune system suppresses the virus, and how this works exactly is not yet fully known. Usually the virus does not cause any symptoms. Possible complaints include bleeding during and after sexual contact, pain and/or a burning sensation in the vagina, and difficulty with bowel movements.
In addition, a low-risk type of HPV infection can be recognised when it results in genital warts. The genital warts look like fleshy, soft skin-coloured, pink-red or grey-white warts. For women, genital warts may appear on the labia, cervix and/or anus. For men, genital warts may appear on the penis and/or the anus, and the urethra.
The presence of genital warts around the anus does not necessarily mean that there has been anal sexual contact. Genital warts are first small and then usually grow in groups. Sometimes there is only one wart. Sometimes the warts can bleed or itch, and they can cause some hindrance during sexual contact or during bowel movements.
Is there anything I can do about HPV infection and genital warts?
You can reduce the risk of HPV infection by using condoms during sexual contact. Although condoms are not 100% safe (because if the warts are higher on the penis than the condom reaches, there may still be contamination), it appears that using a condom reduces the risk of contamination.
Immunity plays a major role in the virus. When your immunity is strong, the infection will be less likely to strike and if the virus is dormant, it can always remain dormant due to good levels of immunity. A healthy lifestyle is important for good immunity, and that also includes good hygiene. Always wash your hands after going to the toilet, and use washcloths and towels only for yourself. Try to live as healthily and regularly as possible with a varied diet. Get enough sleep, avoid stress and exercise regularly. Moderate your alcohol consumption or do not consume any alcohol at all, and most importantly, do not smoke, as this causes your immune system to work less well because it damages the cells. Cervical cancer is more common in women who smoke.
What are the treatments for HPV and genital warts?
Genital warts usually disappear by themselves after a long time. However, they can be removed if they cause discomfort and inconvenience. Removing the genital warts does not mean that the HPV is no longer present. The warts can also come back and can be treated again.
There are no medicines against HPV. However, there is the aforementioned prevention against certain types. In the case of genital warts, the following creams and ointments can be applied by yourself:
- Podophyllotoxin cream;
- Imiquimod cream 5%;
- Fluorouracil cream;
- Cidofovir cream 1%;
- Sinecatechins ointment.
Some substances should not be used during pregnancy. Before treatment, read the package leaflet on how to apply the product. Wash your hands well after applying the cream or ointment. The products often have to be used for a longer period of time, but are more likely to be stopped when the genital warts are gone.
Other treatments of genital warts include:
Where the warts are frozen by a doctor using liquid nitrogen. It is possible that more than one treatment is required.
- Chemical cauterisation with trichloroacetic or bichloroacetic acid:
Where the doctor applies a medicine to break the cells.
In which the warts are burned away with a special device.
- Surgical removal:
Which usually happens under anaesthesia.
- Laser treatment:
In which the genital wart is evaporated.
If you have genital warts, it is advisable to have safe sex with new partners or when changing partners. This also applies if your sexual partner(s) has / have genital warts. Be aware that condoms do not provide 100% coverage. If you have a regular partner, the use of a condom is in fact unnecessary because the virus is exchanged between partners and when HPV is detected (by the presence of genital warts), the transfer has probably already taken place.
The fact that you, your partner or both have an HPV infection with or without genital warts does not necessarily mean that there is an issue of infidelity. The virus may have been dormant and present for a long time. Good immunity by living hygienically and healthily (see above under “Is there anything I can do about HPV infection and genital warts?”) can keep the infection at bay. If having an HPV infection and/or genital warts affect the quality of your life, for example if it generates feelings of anxiety and shame or depression, then talk about it with a confidant or consult a doctor.
Additional risks and side effects of HPV infection and genital warts
HPV is contagious and can result in genital warts, some of which can get very big and start to inflame. This can occur in healthy people, although it is rare. It is seen more often in people who have a weakened immune system due to, for example, HIV or a treatment that suppresses the immune system (for example after a transplant). The tumours are not malignant, but they do penetrate the tissues and have to be surgically removed. Genital warts at the outlet of the urethra can cause trouble urinating and also have to be removed.
High-risk HPV types can develop into cancer after a number of years, the most common being cervical cancer but there is also cancer of the labia, anus, penis, oral cavity, throat and oesophagus.
How can you prevent HPV infection and genital warts?
An HPV infection and therefore genital warts cannot be completely prevented, but you can reduce the risk by having safe sex when you have multiple partners or when you have a new partner, and also by limiting your partners. It is almost impossible to know when you have contracted the virus, therefore it makes little sense to warn former partners. However, you can alert your new partner(s).
Women can be tested for HPV (smear), while men are not (yet) tested. There are vaccines for both groups. See: “Prevention by the government” about vaccinations and smears.
In addition, good immunity can prevent HPV infection and genital warts (see above: “Is there anything I can do about HPV infection and genital warts?”).
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