Wednesday February 15, 2017
Sexually transmitted infections may be an awkward subject to discuss, but trust us when we say: our doctors at London Doctors Clinic have seen it all! There's nothing patients can throw at us that one of our experienced private doctors has not seen before, and are not able to advise on, including today's topic: Genital Warts.
What Are Genital Warts?
Genital warts are the second most common sexually transmitted disease. They can appear on your genitals or around your anus and are caused by a viral skin infection. The virus that is responsible for causing the warts is called the Human Papillomavirus or, in the abbreviated form, HPV. There isn’t just one type of HPV, there are over 30 different types of the HPV virus!
While HPV has been linked to cervical cancer, the two strains that predominantly cause genital warts are not the same as those that cause cervical cancer.
How Do You Catch Genital Warts?
Genital warts are spread through skin-to-skin contact; this may be vaginal, anal or any sexual act whereby there is skin-to-skin contact between an individual carrying warts. Genital warts do not appear straight away after being infected with the virus - it can takes months for the warts to appear. The delay in the appearance of the warts makes it difficult to pin point the individual whom they were contracted from.
Therefore, the only way to prevent the spread of genital warts is through preventing skin-to-skin contact. Even when using a condom, there is still a chance of spreading the virus. Genital warts may be present on the penis or vagina but can also be present on the surrounding skin (so using a condom will not cover this area up and the risk of transmission still exists).
The warts appear as growths, which look like raised bumps. It is possible to have a single wart or a collective group of warts that can appear as a roughened area of skin.
Where Do Genital Warts Appear?
Common sites for warts in women:
- Around the vulva
- On the cervix
- Inside the vagina
- Inside the anus
- Surrounding the anus or vagina
Common sites for warts in men:
- On the penis
- Upper leg areas
- Inside the urethra
- On the scrotum
Often the only practical issue with genital warts is their appearance, since they are more than often painless. However, discomfort can be caused if the wart is in a sensitive location and if it becomes inflamed.
If you or a sexual partner develops genital warts you should visit a sexual health clinic. It is always important to have an STI check up if:
- You have unprotected sex with a new partner
- Your partner or you have had unprotected sex with someone else
- You have any symptoms that you suspect to be an STI
How Are Genital Warts Diagnosed?
Genital warts can be diagnosed through a basic examination. If the warts are found inside you either inside the vagina or anus, the examination may involve a speculum or proctoscope respectively to provide a detailed examination. You can also find out more about HPV tests, here.
Treating Genital Warts
There are a number of different therapies available for treating genital warts:
If you have a cluster of warts you will be prescribed podophyllotoxin, which has a toxic effect on the warts and is in liquid form. The treatment comes with an applicator, so that the correct amount of the liquid is applied. It is applied in cycles and often individuals being treated with podophyllotoxin complain of mild irritation around the application area.
Imiquimod is a cream, which is used to treat larger genital warts. The cream is applied and then left on for around 6-10 hours, after which time the cream is washed off. It can take several weeks for the warts to show any improvement following treatment with imiquimod.
Trichloroacetic acid is used to treat smaller warts and it destroys a protein found in the warts. It is thought that TCA is safe during pregnancy - a benefit of this type of therapy.
It is possible to have the warts physically removed and these can involve having them frozen off using liquid nitrogen (cryotherapy). They can be excised; you will receive local anaesthetic into the area of the warts and then using a scalpel they will be removed.
There are other options for physical removal, such as electrosurgery; this is a follow up therapy for physical excision. It is kept as an option for larger warts that are not responding to topical treatments. You will receive local anaesthetic to the area where the wart is, then a loop made of metal is placed against the wart, and an electrical current supplied. The electrical current passing through the loop burns away the remaining part of the wart, which was not responding to topical treatment and could not be excised in the traditional fashion.
Laser surgery is an approach that is used for larger warts that cannot be treated with other methods due to the locational issues.
With physical removal of the wart, there can be irritation at the time of removal and then it may take between 4-6 weeks for the area to heal completely.
Preventing The Spread of Genital Warts
Whilst genital warts are visible, it is advised that you do not have sexual intercourse to prevent the spread of genital warts to others. It is also advised that, following treatment for genital warts, you avoid sexual intercourse.
These therapies will be prescribed by your doctor - you should not attempt to treat genital warts with over the counter wart treatments. It is difficult to predict whether the warts will return or not following treatment. Some individuals find that they will only have one episode of warts and then they will never come back, however others will suffer from reoccurring warts. If you develop genital warts after they have been treated it is difficult to tell whether this is as a result of a new infection of HPV or the original infection.
So if you're concerned about genital warts, the sooner you get checked out the better! Book in for a GP appointment today for the diagnosis and reassurance you may need! With eight private clinics around central London, we are always here for you should you need to find a GP or doctors surgery.
By George Wall