HPV and treating genital warts

What is HPV?

Human papillomavirus (HPV) is the name of a group of viruses that includes more than 150 different types that cause infection on the skin surface. Certain types of HPV cause warts on the hands or feet, while others can cause visible genital warts. Sometimes, however, HPV infection causes no warts, and many people with genital HPV do not know they have it.

What do genital warts look like?

Genital warts are growths or bumps that appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin or thigh. They may be raised or flat, single or multiple, small or large. Some cluster together forming a cauliflower-like shape.

Who gets HPV or genital warts?

Evidence suggests that the majority of individuals who have ever been sexually active experience one or more genital HPV infections during their lifetime. Most HPV infections clear spontaneously. The most common effects of HPV infection are genital warts or abnormalities in the cervical smear.

How do you get HPV or genital warts?

Subclinical HPV and genital warts are usually spread by direct, skin-to-skin contact during vaginal or anal sex. It is also possible, but rare, to transmit them to the mouth by oral sex.

Warts on other parts of the body, such as the hands, are caused by different types of HPV. Contact with these warts does not seem to cause genital warts.

Warts may appear within several weeks after sexual relations with an infected person; or they may take months to appear; or they may never appear. This makes it hard to know exactly when or from whom you got the virus.

It is thought most subclinical HPV infections are transmitted through sexual intercourse, although they are generally believed to be less contagious than genital warts.

How are genital warts diagnosed?

You can check yourself and your partner(s) for warts, but remember - warts sometimes can be very difficult to see. Also, sometimes it’s hard to tell the difference between a wart and other bumps and pimples. If you think you have warts or have been exposed to HPV, go to a doctor or clinic. The health care provider will check more closely and may use a magnifying lens to find small warts.

How are genital warts treated?

Treatment is optional. Most genital wart infections will clear up spontaneously sooner or later. However, many people want to have them treated as they can be unsightly and/or uncomfortable. The following are the recommended treatment options available:

  • The goal of treatment should be to remove visible genital warts and relieve annoying symptoms.
  • There are several available treatments, and no one treatment is ideal for all people or all warts.
  • Podophyllotoxin (Condyline™) solution is a patient applied treatment for external genital warts, recommended for men only as it is too difficult for women to self-apply. For men, it is easy to use and safe if instructions are followed. Contraindicated in pregnancy.
  • Imiquimod (Aldara™) cream is a patient applied treatment for external genital and perianal warts. It is easy to use and safe if instructions are followed. If other treatments are unsuitable, Aldara is available by fully subsidised prescription from your doctor through Special Authority application. Not recommended in pregnancy.
  • Cryotherapy (freezing off the wart with liquid nitrogen) by a trained health practitioner.
  • Trichloroacetic acid (TCA) is a chemical applied to the surface of the wart by a trained health practitioner. It is unavailable in some DHBs.
  • Laser therapy (using an intense light to destroy the warts) or surgery (cutting off the warts) has the advantage of getting rid of the warts in a single visit. Laser treatment can be expensive and the health care provider must be well trained in these methods. It is only available in a few centres. Recurrences may occur.

Factors that might influence selection of treatment include size, location and number of warts, changes in the warts, your preference, cost of treatment, convenience, adverse effects, and the health care provider’s expertise.

Whatever the treatment, here are some important points to remember:

  • It is advisable to seek medical advice before starting treatment for genital warts.
  • Ask your doctor for an explanation of the treatment, including the costs and likely benefits.
  • Be sure to understand the follow-up instructions, such as what to do about discomfort and when to seek help.
  • Be patient – treatment often takes several visits and a variety of approaches.
  • If you are pregnant or think you might be, tell your doctor so he or she can choose a treatment that won’t be harmful to you or your baby.
  • Don’t use over the counter treatments which are not specifically for genital warts. These are not meant for sensitive genital skin.
  • It is recommended to avoid sexual contact with the infected area during treatment, to protect the treated area of skin from friction and help it heal.

Want to know more?

Our website is full of useful information on HPV. The links below will take you to the information that is most relevant to you.