One of the most common sexually transmitted infections, genital warts are caused by certain strains of human papillomavirus (HPV). As we know, there are more than 40 types of HPV strains. While some are categorized as high-risk (type 16 and 18 are behind 70% of cervical cancers in the world), the low-risk ones often manifest as genital warts. These warts usually look like small red or pink bumps and growths in or around the sex organs. They take on a cauliflower-like-shape and typically affect the moist areas of the genitals.

The culprits behind genital warts are HPV strains 6 and 11 and these two strains are responsible for about 90% of genital wart cases. Although genital warts may look worrisome, they are considered low-risk because they do not cause cancer. Genital warts are usually not painful, but itchiness and discomfort may still occur for some people.

How genital warts spread

As with many STDs, genital warts can spread through vaginal, anal and oral sex. What actually happens is HPV enters the skin and causes skin cell multiplications that result in warts. Depending on each individual’s immune system, some HPV infections do not always end up in warts depending on the immune system – some are greater at combating HPV compared to others. People carrying the virus can have no visible warts but can still infect their sexual partners. Genital warts can be tricky in nature because they are often mistaken for harmless moles or skin tags – resulting in people not getting tested and treatment due to ignorance.

Despite the fact that they are not cancer-inducing, genital warts are still contagious. Non-sexual skin-to-skin contact also facilitates the spread of this infection and a person can still have the virus even when the warts are gone because the virus may stay in the skin and form other warts in the future. It is said that every sexually active person will get HPV at some point in their life. Most HPV cases do clear up on their own within a certain period of time, but risk factors for HPV may surge if a person:

• Engages in unprotected sex with multiple partners
• Has had another sexually transmitted infection
• Starts to be sexually active at a tender age
• Has a weaker immune system due to HIV or other particular circumstances
• Smokes

Symptoms of genital warts

Women may develop genital warts on the vulva, along the walls of the vagina, the cervix, the zone between anus and genitals as well as the area around the anal canal. As for men, these warts can emerge on the tip of the penis, scrotum or anus. Since genital warts can also spread through oral sex, they can occur in a person’s throat or mouth who makes contact with an infected person. Telltale signs of genital warts may include:

• Tiny bumps that are red, pink or flesh-colored in or around the genitals
• Cauliflower-like shaped clusters around the genital area since these warts may grow close to one another
• Itchiness and discomfort
• Bleeding during intercourse

Normally, genital warts are diagnosed by visual examinations. You might want to consider going to a healthcare professional to check for warts if you have 1 or more bumps on or around your genitals. Another symptom that cannot be ignored is itchiness and bleeding. If you see symptoms in yourself or your partner, go to a STD clinic to get yourself tested for STDs. Talk to your partner so that they can get tested as well.

Although doctors can tell warts by just viewing them, it is advisable for women to do PAP tests. PAP tests help monitor the vaginal and cervical changes caused by warts. Going for regular PAP tests is also beneficial because it can detect early signs of cervical cancer. Diagnosing HPV in women is much more accurate since there are more reliable methods. In men, however, the one method used to diagnose HPV is only through visual examinations. Learn about the differences in HPV between women and men here.

Treatment for genital warts

It is important to note that even though warts can go away as time passes by, HPV can still lurk in a person’s skin cells and recurrences may happen. Therefore, treating genital warts is essential before a person actually spreads to others.

There are no reliable over-the-counter (OTC) treatments for genital warts. To treat them, a person may have to apply cream or gel that contains certain substances or proceeds with removal procedures that involve surgery. Treatments that can be directly applied on the skin can include:

• Imiquimod (Aldara). This cream might strengthen your immune system to better fight off the viruses. It is best to avoid sexual contact while warts are still present and while this cream is on the skin as this substance might erode condoms and cause skin irritations on your partner’s skin.
• Podophyllin and podofilox. A plant-based resin, podophyllin helps eradicate the tissues of the genital warts. These substances should not be applied on pregnant women.
• Trichloroacetic acid. This substance works by burning off and destroying the protein that glues the warts together.
• On the other hand, removal procedures include:
• Electrocautery. As the name suggests, this method involves the use of electric current to destroy the warts. Swelling and pain are two imminent effects after undergoing this procedure.
• Cryotherapy. This procedure includes freezing the warts by using liquid nitrogen. The way this method works is by allowing new skin to form as lesions go away. Cryotherapy is a removal method that might need to be repeated to get the full benefits.
• Excision. This means cutting off the warts after being anesthetized.
• Laser treatments. This method is utilized for hard-to-rid and extensive warts and can be expensive.

Although not curable, HPV is definitely preventable. Despite being more prevalent in women, HPV vaccinations are recommended for all genders. Shim Clinic is a sexual health clinic in Singapore that carries Gardasil-9, a vaccine that helps prevent HPV. We also provide HIV prevention methods such as HIV PEP and HIV PrEP.