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Genital warts are small lumps that develop around the genital region and/or around the anus (back passage).
They look like solid blisters or small cauliflowers. They can appear in hands and feet too but these are different types of warts and they are usually harmless. The culprit is a virus called the human papillomavirus (HPV). Although there are over 100 types of this virus, most genital warts are caused by types 6 or 11. Warts that appear on hands and feet are caused by different types of HPV.
How do I get them?
Human papilloma virus infection is a sexually transmitted infection. It is one of the most commonly acquired sexually transmitted infections in Singapore and worldwide. As the name suggests, it is passed on by sexual contact, and close skin to skin contact. Be aware that not only penetrative sex can pass on the infection. Non-penetrative acts such as sharing sex toys and oral sex can also pass on the infection.
You do not get genital warts immediately after being infected with HPV. It can take week or months for them to appear. In fact, most of the time, people with HPV infection do not develop warts. You can still carry the virus and pass on to others. You can also get warts around the anus even if you have not had anal sex.
Where are they?
Genital warts in women usually appear just outside the vagina (an area called vulva). Less commonly, they can develop inside the vagina or on the cervix. In men, they usually develop on the outer skin of the penis. They can sometimes appear on the scrotum as well (the outer skin covering the testes). Both men and women can get warts around the anus.
Do I need to see a doctor?
The answer is yes.
You should consult a doctor if you develop a lump that looks like a blister or a small cauliflower around your genital or anus. Most of the time, your doctor can diagnose a genital wart by its appearance. They may need to examine your genital region thoroughly and examine the inside of your vagina and anus to look for warts. However, sometimes, the warts may not have a typical appearance and therefore the diagnosis is uncertain. Your doctor will need to remove the lump to send to the laboratory for further confirmation.
If you develop genital warts, you will also need other important tests. Up to 1 in 4 people with genital warts also have other sexually transmitted infections. Although you may not have symptoms, it is strongly advisable to have thorough tests done to check for other infections so you can be treated appropriately.
The types of HPV virus that cause genital warts do not increase your risk of cervical cancer. However, you may have more than one type of HPV infection at the same time, including the types that increase cervical cancer risk. Therefore it is important that every woman has cervical screening tests at the usual recommended times.
It is also important to get your current sexual partner(s) checked by a doctor for any warts or sexually transmitted infection.
How do I get rid of the warts?
There are several treatment options. It usually takes time to clear the warts completely, sometimes up to weeks or months. There is also a chance that warts can return after a course of treatment. It is important to consult a doctor so you can be assessed properly and the best treatment can be given. Your doctor will also need to follow you up closely. Over the counter wart treatment medication should be avoided.
Genital warts can sometimes disappear by themselves over a period of few months. They are not life threatening, but can be unsightly and can cause social embarrassment. Therefore, you should really get them treated properly.
There are some topical treatment (medication you apply on the skin surface) available for genital warts. When put on to warts, they will destroy the wart tissues. However, most of them are not suitable for pregnant women. Sexual contact should be avoided after applying the medication because they can cause irritation to your partner. Topical treatment can be effective if used correctly.
Physical treatment (using equipment) is another treatment option. Warts can be removed with a technique called freezing or cryotherapy. Liquid nitrogen is sprayed on or applied to the warts. Liquid nitrogen is very cold. When applied on to the warts, it can destroy the wart tissues. Warts can also be removed by laser machine that produces the correct laser to destroy the warts by burning. Another technique is called electrocautery, basically using a machine that burns the warts away. Sometimes, warts are removed by a small operation under local anaesthesia.
To clear the warts completely, you may need several treatment sessions, days or weeks apart. Your doctor will follow you up closely to see the progression, and to check for new warts. Remember that warts can come back even after treatment.
How do I decide on the treatment?
Each treatment has pros and cons. It depends on a number of things such as where the warts are, how many warts are present and what you are comfortable with. You need to discuss with your doctor so the best treatment can be recommended.
How do I prevent it?
Male or female condoms may prevent HPV from being passed on to sexual partners who are not infected. They may not prevent you from getting genital warts because the skin surfaces that are not covered by condom can be infected. However, it is strongly advisable to use condoms when you have sex while on treatment, and for at least a further three months after the warts disappear.
There is also a vaccine available for men and women to protect them against HPV.
Also, condoms help to protect against other sexually transmitted infections such as HIV and chlamydia.