Genital Warts
Genital warts are skin-colored or pink bumps and swellings in the genital area caused by human papillomavirus (HPV) infection. They are sexually transmitted; the diagnosis is made by physical examination and, if needed, HPV testing, and treatment is planned with topical agents, cryotherapy, laser, or surgical methods.
Prof. Dr. Melahat Atasever
Obstetrics & Gynecology · Ankara
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Genital warts are bumps and swellings in the genital area that develop when low-risk HPV types are transmitted through skin and mucosal contact; they are more common in sexually active people aged 18-40. Treatment is carried out with topical medication, cryotherapy (freezing), laser, or surgical methods depending on lesion size, and regular follow-up is recommended because of the possibility of recurrence.
Genital Warts: Diagnosis and Treatment of HPV-Related Lesions
Genital warts are small, usually skin-colored or pink bumps or swellings that form in the genital area as a result of human papillomavirus (HPV) infection. They are sexually transmitted and can occur in both women and men.
- Relationship to HPV: The most common cause of genital warts is the low-risk types of HPV. The virus spreads through skin and mucosal contact.
- Who is affected? They are seen more often in sexually active people between the ages of 18 and 40. The risk increases in those with weakened immune systems and in those who have unprotected sexual intercourse.
Key features:
- They can cause itching, irritation, or a burning sensation.
- They may appear as a single lesion or as multiple lesions.
- In some cases they can progress without causing any symptoms.
What Are the Symptoms of Genital Warts?
Genital warts usually appear as skin-colored or pink bumps and swellings. Some people may experience itching, irritation, burning, or a feeling of discomfort.
- In women: They can appear as small lesions on the vulva, inside the vagina, or on the cervix.
- In men: They emerge as bumps and protrusions on or around the penis and scrotum.
- Other features: Lesions may occur singly or in clusters, and can sometimes progress without symptoms.
What Causes Genital Warts?
The principal cause of genital warts is infection with human papillomavirus (HPV). The virus is transmitted primarily through sexual contact and produces lesions in the genital area.
- HPV infection: Low-risk HPV types are the most common cause of genital warts.
- Sexual transmission: Unprotected sexual intercourse increases the risk of transmission.
- Weakened immunity: In people with low immunity the virus multiplies more easily and symptoms become more pronounced.
Types of Genital Warts
Genital warts occur in different forms depending on their appearance and pattern of spread:
- Flat warts: Small, smooth lesions close to the skin surface.
- Raised warts: Found in clusters as small bumps or nodules.
- Single and confluent lesions: Lesions that occur alone or merge together into a grouped appearance.
How Are Genital Warts Diagnosed?
The diagnosis of genital warts is mostly made with simple, safe, and quick methods. The doctor assesses the appearance of the lesion and, if needed, confirms the diagnosis with additional tests.
1. Physical Examination
- The doctor visually inspects the lesions in the genital area.
- The location, number, size, and type of the lesions are assessed.
- In some cases lesions may go unnoticed; examination with lighting and magnification may be needed.
2. HPV Tests
- These identify the types of human papillomavirus (HPV) responsible for genital warts.
- Detecting high-risk HPV types in particular is done to assess cancer risk.
- HPV testing is usually performed on a smear or a cervical cell sample.
3. Biopsy and Laboratory Studies
- A tissue sample is taken from suspicious, resistant, or unusual lesions.
- Laboratory examination establishes the correct diagnosis of the lesion and identifies the HPV type.
- A biopsy is usually performed under local anesthesia and yields results quickly.
4. Additional Evaluations
- In recurrent or widespread lesions, blood tests and immune system tests may be carried out.
- The diagnostic process is shaped with pregnancy, immune status, and any accompanying conditions in mind.
Treatment Options for Genital Warts
Treatment of genital warts is determined by the number, location, and size of the lesions. The aim is both to remove the warts and to prevent the virus from spreading.
1. Topical Treatments
- Local applications shrink or destroy the warts.
- With regular application, most small lesions can be treated.
2. Cryotherapy (Freezing)
- Lesions are destroyed by freezing with liquid nitrogen.
- It is a quick and safe method.
3. Laser Treatment
- Suitable for resistant warts or those covering larger areas.
- It offers the advantages of rapid healing and minimal scarring.
4. Surgical Methods
- Used for large or deep lesions.
- The procedure can be performed under local anesthesia and produces rapid results.
5. Follow-Up After Treatment
- Because recurrence is possible, regular check-ups are important.
- Informing the sexual partner and, if necessary, arranging their treatment is recommended.
Genital Warts and Pregnancy
Genital warts require special precautions during pregnancy. Because of immune system changes in pregnancy, existing lesions can grow or new warts can form.
- Risks in pregnancy: Lesion growth, discomfort, and, rarely, bleeding can occur.
- Transmission during birth: Genital warts can rarely be passed to the baby and can lead to wart formation in the respiratory tract.
- Treatment options and safety: Some treatment methods are limited during pregnancy; safe methods are chosen under a doctor’s supervision.
Frequently Asked Questions
What are genital warts?
They are bumps or swellings in the genital area caused by the HPV virus.
Are genital warts contagious?
Yes, they are transmitted mostly through sexual contact.
Does the HPV vaccine protect against genital warts?
It provides a high level of protection and is recommended especially before the start of sexual activity.
What happens if genital warts are left untreated?
The lesions can grow, increase in number, and, rarely, complications can develop.
Do genital warts go away on their own?
Some small lesions may clear with the immune system, but treatment is usually needed.
Do genital warts recur?
Yes, they can come back after treatment; regular follow-up is important.
Do genital warts cause itching?
Some people experience mild itching, irritation, or burning.
Do genital warts look different in men and women?
In women they appear on the vulva and in the vagina, in men on the penis and scrotum, in varying forms.
Do genital warts cause cancer?
Low-risk HPV types produce warts; high-risk types are associated with cervical cancer.
Is treatment of genital warts painful?
Depending on the treatment method and lesion size, mild discomfort may be felt.
Should the sexual partner also be treated?
Yes, to prevent transmission it is recommended that the partner be examined and, if necessary, treated.
Can recurrence of genital warts be prevented?
The risk of recurrence can be reduced with the HPV vaccine, protective measures, and regular check-ups.
How long do genital warts take to clear?
Treatment duration varies with lesion type; it can take from a few weeks to a few months.
How are genital warts diagnosed?
The diagnosis is made by physical examination and, if needed, HPV testing.
Can genital warts be transmitted during childbirth?
Although rare, there is a risk of transmission to the baby's respiratory tract.
At which ages are genital warts most common?
They are usually seen in sexually active people between the ages of 18 and 40.
When should follow-up take place after treatment of genital warts?
Check-ups at 1-3 month intervals are recommended after treatment, with monitoring for recurrence.
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