Genital warts, also known as venereal warts or condylomata acuminata, are caused by the human papilloma virus (HPV). Papilloma viruses cause small growths (warts) on the skin and mucous membranes. Infection of the genital and anal regions with HPV can cause warts (anogenital condyloma) on the penis, vulva, urethra, vagina, cervix, and around the anus (perianal).
More than 80 types of HPV are known to exist and quite a few of these types cause genital warts, e.g. HPV types 6 and 11. Other HPV types cause common warts on the hands, feet, or elsewhere on the body. Other types (HPV types 16 and 18) can cause cancer of the cervix, the external genital skin, or the anus. Therefore, female partners of affected persons are recommended to see their gynecologist for occult infection. The HPV types that cause genital warts, however, very rarely cause cancer. Although genital warts are usually sexually transmitted, they can infrequently be seen in infants who have been delivered vaginally to mothers with HPV in their genital tracts.
Lesions on the external genitalia are easily recognized. On the penis, genital warts tend to be drier and more limited than on the female genitalia or around the anus of either sex.
They grow best in the moist genital area. They are raised, rough, flesh-colored “warty” appearing tumors that may occur singly or in clusters. Left untreated, warts around the anus and vulva may rapidly enlarge, taking on a “cauliflower-like” appearance. Keeping the infected area dry may be a problem because the warts are usually damp.
In women, HPV can invade the vagina and cervix. These warts are flat and not easily visible without special procedures. Because HPV can lead to premalignant changes in the cervix (cervical dysplasia), it is important that this condition be diagnosed and treated. Regular Pap smears are important for detecting HPV.
Genital warts are particularly a problem in pregnant women and in persons whose immunity has been lowered by cancer, AIDS, organ transplantation, immune suppressive medications, or certain other medications. Only a small percentage of people infected with HPV will develop genital warts. Many persons are “carriers” of HPV and may never develop warts but may still be able to pass HPV to their sexual partners. Although the incubation period from contacting HPV until development of warts may be several months, some people may not develop warts for years after contact with HPV.
Infection with HPV is very common, although the majority of people have no symptoms (asymptomatic). In several studies done on college women, nearly half were positive for HPV; although only 1 to 2% had visible warts and less than 10% had ever had any visible genital warts. The incidence of genital warts appears to be increasing rapidly, although this may be a result of increased diagnostic ability and awareness.
Risk factors for genital warts include multiple sexual partners, unknown partners, early onset of sexual activity, tobacco use, nutritional status, hormonal conditions, age, stress and concurrent viral infections (such as flu, HIV, Epstein-Barr and herpes).
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