Condylomas, genital warts

Condylomas or condylomata acuminata, genital warts are one of the most common sexually transmitted diseases. As the name says, they spread on the skin and mucous tissues of the genitals. They can appear as pink or skin colored flattened lumps, and as cauliflower growths. They can be barely visible or make entire wreaths and plates of growths.

Although they can be treated with medication or surgically, the genital warts are a serious health problem. A virus that causes them – HPV, is associated with the cervix carcinoma, but also other genital region carcinomas. Discussions are common on the subject of vulnerability of women to the HPV virus, but almost 30 types of this virus can lead to carcinoma of the anus and penis in men. These types of carcinoma are rare, but the risk is 17 times higher then with the presence of the HPV infection.

How to recognize condylomas – genital warts?

  • Small flattened growths at the genital region.
  • Cauliflower whitish or pinkish changes
  • Brown and rugged plates, often in the perianal region.
  • Itch and discomfort on the mucous tissue.
  • Advent of a bloody trace during an intercourse.

Also, they don’t have to cause any symptoms or problems. They can be so small and flattened that they are barely visible to the naked eye. Pregnancy or immunodeficiency can be the triggers for concealed infections.

Causes of genital warts

Just like wart on other parts of the body, the warts are also caused by HPV virus. There are more then a hundred types of this virus but only some cause genital problems. These types are very contagious and are sexually transmitted. Change in the mucous tissue of the mouth and throat after oral sex is possible but very rare. About 2/3 of the persons who have sexual contact with the infected, get the virus. Warts appear in the following month or even up to 2 years. This means that the incubation period of the virus is anywhere from 15 days to 18 months. Condoms unfortunately do not offer a complete protection, because there is a part of the skin which is not protected from contact.

Tests and diagnosis

Tests can be very complicated. In women, acetic acid test is used, where warts are colored white. The same test can be used in men, however the test reliability is small. Sometimes even healthy skin can have whitish areas. For women, the Pap test is mandatory, because it gives the earliest data on the cervix carcinoma. Colposcopy examination is mandatory, too.

Treating condylomas or genital warts

  • Imiquimod (Aldara) cream activates the immune system. It is necessary to avoid sexual contact during its use. Small wounds often appear while it is applied, and it needs to be supervised by a doctor.
  • Podophyllotoxin (Condylox) – can be applied at home. Medical advice is needed because of skin irritation. Relapses are common (skin changes reappear after six to eight months).
  • Trichloroacetic acid can burn the wart. It is applied only by a skilled physician.
  • Cryosurgery forms a bubble with which the wart falls off.
  • Electrocauterization burns the nipple to a controlled depth. Invasive anesthesia or in cream form is mandatory.
  • Surgical excision is used only for large changes. Laser treatment is equally successful as electrocauterization. A somewhat longer period of tissue healing is required.

There is no treatment for asymptotic HPV infections (when there are no warts).

Preventing genital warts

  • Use a condom. HPV is spread by skin to skin contact but by using condoms in every sexual contact you decrease the risk of infection.
  • Avoid sexual contact when visible warts are present, until they are removed.
  • Think about vaccination. A vaccine known as Gardasil protects from two types of HPV viruses which cause around 70% of carcinomas in the genital area and two types that cause 90% of genital warts. Vaccination of girls between the age of 11 and 12 and also between the age of 13 and 26 is advised.
  • Inform the partner about the infection in order to prevent constant reinfection. After the treatment immunity is not acquired.

Genital warts can be treated in every patient. However, after treatment immunity is not acquired. Some people require more interventions due to constant occurrence of new warts but that doesn’t meant that this person will not be treated.

Spec. Dr. Svetlana Djurisic, dermatologist