Genital warts are among the most common sexually transmitted infections. They are small, wart-like growths in the genital and anal area, and more rarely in the mouth. They are caused by the human papillomaviruses (HPV). There are many different strains of HPV. Some cause genital warts; others are significant for the development of cervical and anal cancers.
HPV infections and genital warts are more common in people with HIV, and HIV-positive people are more often infected with several strains of HPV at once. The genital warts are usually more tenacious and also occur more commonly in the mouth. With an advanced HIV infection, the treatment of genital warts may also be less effective. The risk of anal and cervical cancers is also increased.
People with HIV should therefore be checked for anal cancer once a year, and/or take advantage of early detection cervical screening programs once a year.
In most cases, the body deals with the HPV infection on its own and the viruses disappear again. If not, small, pointed genital warts appear after six weeks to six months. They usually cause no problems at first. If they remain untreated, they can develop into larger growths with a surface that looks like a cauliflower. Genital warts can also cause severe itching and inflammation in the anal area.
In some cases, HPV infections can eventually lead to cancerous tumors. However, these cancers are caused by different strains of HPV than the ones that cause genital warts.
HPV is transmitted easily. The virus is present in flakes of skin that can easily be passed from one partner to the other during sex. HPV then enters the body through very small injuries in the skin or mucous membranes. The risk of infection is increased if you have recently shaved your pubic hair, due to the tiny cuts caused by shaving.
Condoms can only slightly reduce the risk of infection, because HPV is so easily transmitted. Prompt removal of genital warts reduces the risk of infection for others. People with regularly changing sexual partners should be checked for genital warts regularly, so that the warts can be quickly removed if necessary.
You can be vaccinated against some strains of HPV. Vaccination is recommended for girls aged 12 to 17, as at that age they have usually not yet come into contact with the virus. The vaccine is effective against most strains of HPV that cause cervical cancer or genital warts. However it does not provide complete protection.
HPV itself is usually not tested for or recommended, as treatment is not possible as long as there are no symptoms. If genital warts have developed, a specialist doctor (a proctologist or colorectal surgeon) can recognize them by sight or with a finger exam.
To determine whether early signs of cancer are present, a smear test is carried out as part of early detection screening. The cells of the cervix are then examined in the laboratory. HIV specialist practices offer swab tests of the rectum for people with HIV to check for early signs of anal cancer.
There are various treatments available for genital warts. These include creams, freezing (cryosurgery) and laser treatment. Suppositories to strengthen the immune system may also be prescribed. Larger tumors are surgically removed.
Unfortunately, there is no guarantee of success; genital warts often return, as there is no treatment for the virus itself. Following treatment, the success of the treatment should be checked regularly.
Partners should also be checked and, if necessary, treated.
Early stages of cancer and pre-cancerous cells can be removed in various ways, including surgery.