Understanding Genital Warts -- Diagnosis and Treatment
How Are Genital Warts Diagnosed?
Usually genital warts are diagnosed by an exam. Warts have a characteristic appearance, but your doctor may want to take a biopsy (a small sample of tissue) to determine if the lesion is really a genital wart.
Genital warts are caused by the HPV virus. Tests to determine the subtype of HPV are sometimes recommended since some are low risk for cancer and others are higher risk.
If you are a woman and are diagnosed with warts, make sure to be tested for cervical irregularities by a pelvic exam.
A regular Pap test is very important. If your pap is abnormal, you may also need an exam with a colposcope, a device used to microscopically inspect the vaginal walls and cervix for abnormal areas. Samples taken during Pap tests can screen for the virus and for pre-cancerous lesions that may be caused by the virus.
Untreated warts may resolve on their own, stay the same, or enlarge. Treatment focuses on removing visible warts. However, even after visible warts are removed, the virus may cause outbreaks again in the future. Also, treatments may or may not decrease the risk of passing genital warts to someone else.
Treatment is not always necessary. To decide whether you want to have warts removed, talk with your doctor about the risks and benefits in your individual situation.
IMPORTANT! If you are pregnant or planning to have a baby, you should talk with your doctor about getting treatment to avoid HPV-related complications. It is rare, but possible to pass HPV to your baby. Also, make sure your doctor knows that you are pregnant before he or she prescribes medication for your warts; some drugs may cause birth defects.
Don't attempt to get rid of genital warts with over-the-counter remedies. The genital area is too sensitive for many products and you could damage your skin. Instead, see your doctor, who may provide treatment or prescribe a drug for you to apply to the warts yourself. Medicines that can be applied include podofilox (Condylox) and trichloroacetic acid (TCA), which kill the wart tissue, or Aldara, a cream that stimulates your immune system to fight the virus. Other options include freezing the warts with liquid nitrogen, cauterizing them with heat or a laser, or removing them surgically. Whatever method you and your doctor choose, several treatments may be needed.
How to Prevent Genital Warts
The best way to prevent genital warts is abstinence. Condoms can help lower risk of HPV infection, but they can't fully protect against HPV since there may still be skin to skin contact with an infected area. Condoms are still important in protecting against other sexually transmitted infections. Unfortunately, since many people do not have symptoms, they are unaware they are spreading the virus. If your partner discovers a wart, insist that he or she sees a doctor. Even if you don’t have symptoms, you should see your doctor also.
Two vaccines, Gardasil and Cervarix have been approved by the FDA to help reduce the risk of cervical cancer by immunizing young women aged 11-26 against certain strains of HPV which cause 70% of cervical cancers. Gardasil also provides protection in men and women against HPV strains that cause 90% of genital wart cases. The vaccine was also approved for the prevention of anal cancer.
Ideally, the vaccine should be given prior to becoming sexually active. Both of these vaccines are given in a three-shot series over six months.