Genital Warts

Genital warts are growths on the genitals or anal area in both males and females caused by the Human Papilloma Virus (HPV).

There are many different types of HPV, known as sub-types.

• Sub-types 6 and 11 cause warts on the external genitalia
• Sub-types 16, 18, 31, 33, 55 and 56 can predispose to pre-cancer or cancerous lesions on the Cervix.
• Genital Warts affect both men and women equally.
• They are typically appearing as cauliflower-like growths on the skin and cervix ranging in size from 1-10 mm

Transmission
Warts are spread by direct contact with affected surfaces, with the virus passing through cracks in damaged skin. Sexual intercourse is not required but vaginal and anal intercourses do transmit the wart virus. Evidence indicating oral transmission is limited.

Testing

• Physical Examination and direct visualization
• Cervical Cytology: Pap smear or Pap test
• Anoscopy & Urethroscopy if lesions are extensive
• Meta-analysis for HPV typing

Treatment

• Imiquimod – Self applied 3 times a week for up to 16 weeks, should be washed after 6-8hrs.
• Podophyllin – Applied to the wart and must be washed off in 1-4 hrs. Not indicated in pregnancy, fetal loss is reported.
• Destruction - Curettage, Sclerotherapy & Trichloro acetic acid
• Cryotherapy - Liquid Nitrogen, CO2 and local anesthetic for pain
• Laser Therapy- for extensive warts