Genital Warts and HPV Infection: Teen Version

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KEY POINTS

• Genital warts are soft, fleshy, small growths on the skin. They may be found on the vagina, penis, and scrotum, and in the area around the rectum.
• Treatment may include medicine on the warts or removal of the warts with freezing or surgery. If you have genital warts and plan to get pregnant, get treatment for the warts before you get pregnant.
• Follow the full course of treatment prescribed by your healthcare provider. A vaccine is available to prevent types of HPV infection that can cause genital warts and cancer of the cervix.

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What are genital warts?

Genital warts are soft, fleshy, small growths on the skin. They may be found on the vagina, penis, and scrotum, and in the area around the rectum. Genital warts can be spread to the throat and vocal cords through oral-genital sex.

What is the cause?

Genital warts are a common sexually transmitted disease caused by infection with human papillomavirus (HPV). It is spread by skin-to-skin contact. Genital warts are more contagious and easily spread than other warts. They may spread to other nearby parts of the body and they may be passed from person to person during sexual activity.

There are many types of HPV. Some types cause genital warts, others cause warts on other parts of the body. Some types of HPV can cause cancer of the cervix, vagina, or vulva in women. In men, HPV can cause cancer of the penis. In both men and women, HPV can cause cancer of the anus or mouth.

What are the symptoms?

The warts usually first appear 1 to 6 months after contact with an infected person. However, you can be infected with HPV without seeing any warts. You may have many warts or just 1 wart. In women, warts can grow in the vulva (the folds of skin around the opening of the vagina), on the cervix, inside the vagina or urethra, or around the anus. In men, warts can grow on the tip or shaft of the penis and sometimes on the scrotum, in the urethra (the tube that carries urine out of the body), or around the anus.

You may have no symptoms or you may have:

• Small, flesh-colored, grayish white or pinkish white growths
• Itching
• Large warts or a group of warts that may bleed or be painful during sex
• Women may also have:
  • A bad smell, mild irritation, burning, itching, or pain in the vulva or vagina
  • More vaginal discharge than usual

How are they diagnosed?

Your healthcare provider will ask about your symptoms, activities, sexual and medical history, and examine you. In women, genital warts that are not causing symptoms may be found during a routine pelvic exam and Pap test, which is a screening test done to check for abnormal changes in the cells of the cervix or vagina.

Your provider may put a liquid on the skin to make it easier to see warts. He or she may use a magnifying instrument, or scope, to look closely at your genitals. A biopsy may be taken to help make a diagnosis. A biopsy is the removal of a small sample of tissue for testing.

An HPV-DNA test is available for women age 30 and over to see if the type of HPV causing the warts is the type that may cause cancer.

How are they treated?

There are several ways to treat HPV. Your healthcare provider will discuss your treatment choices with you. Usually the treatment is done in the provider's office. Your healthcare provider may:

• Put medicine on the warts
• Surgically remove the warts
• Freeze the warts with liquid nitrogen (cryotherapy)
• Destroy the warts with a laser

You may need a local anesthetic to numb the area before some of these treatments.

In some cases, your provider may recommend waiting to see if the warts go away on their own. Removal of the warts does not get rid of the virus. You may get more warts after treatment.

If you have genital warts and plan to get pregnant, get treatment for the warts before you get pregnant. If you get genital warts while you are pregnant, it is rare for the HPV to affect the baby. However, warts tend to grow and you may get more of them during the pregnancy. If warts are found during pregnancy, they are usually treated after the baby is born. You may need to have a C-section if your healthcare provider thinks that the warts are so big that they might make it hard to deliver the baby, or might tear and cause too much bleeding. It is rare for the baby to get warts after the delivery.

Because some types of HPV can cause precancerous or cancerous changes in the cervix, it is important for women who have had HPV infection to have regular Pap tests to check for abnormal cells. Cervical cancer is highly preventable with regular Pap tests and follow-up.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Keep your genital area clean and dry.
• Wash your hands well after touching the area where you have warts.
• Don’t scratch the warts.
• Ask your provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
• If you have genital warts and plan to get pregnant, have your warts checked by your provider.

How can I help prevent the spread of genital warts?

Because HPV is the most important risk factor for cervical cancer, try to prevent HPV infection and get treatment if you think you have an infection.

The best way to prevent the spread of HPV is by not having sex.

A vaccine is available to prevent types of HPV infection that can cause genital warts and cancer of the cervix. If you already have HPV, the vaccine will not cure your infection, but it will help prevent infections from several other types of HPV.

The HPV vaccine is approved for females and males age 9 to 26 years old. The vaccine is most effective if it is given before a young man or woman has sex for the first time. The best age to give the vaccine to boys and girls is at 11 to 12 years of age. It is given as a 3-shot series over 6 months as part of a routine immunization schedule. The vaccine may protect against HPV for 5 years. Researchers are doing studies to see if a booster shot is needed after 5 years. The HPV vaccine is usually not given to pregnant women.

Here are some other things you can do to help prevent HPV or its complications:

• Women: Get an exam every year and a Pap test as often as your healthcare provider recommends.
• Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex. Even after your warts are gone, you can infect your partner because the virus is still in your body. Condoms can lower the risk of getting genital warts from another person, but HPV can spread from areas not covered by a condom.
• Have sex with only 1 person who is not having sex with anyone else.
• Avoid sexual contact until the genital warts or HPV is completely treated and healed.
• Don’t smoke. Studies show that smoking increases the risks and problems related to HPV infection.