Condyloma Acuminata, otherwise known as genital warts, is a sexually transmitted disease cause by the human papilloma virus (HPV). HPV is very very common – it is estimated that almost three quarters of adults have a strain of HPV. However, most people with HPV will never develop warts, and only a few strains are associated with complications more serious than warts.
A wart is an abnormal proliferation of virally infected cells. Most have a distinctive roughened “cauliflower” surface. They are typically painless unless they become irritated from friction from clothing or sexual intercourse. The warts caused by HPV can be seen on the penis and vagina, but are also commonly seen on the scrotum and anus. Having many warts around the anus can lead to difficulties with defecation.
HPV causes warts because it takes over many aspects of the cell’s metabolism leading to aberrant reproduction and fusion of cells. In many cases these growths are benign and self-limiting, meaning that the body’s immune system will eradicate the infection without medical intervention. However, this process may take years, and some warts (especially those caused by HPV strains 6,11,16, and 18) may eventually develop into squamous cell carcinoma. This process is the leading cause of cervical cancer in women. Fortunately, a vaccine has been created that, when given at an early age, can protect both women and men from these potentially malignant forms of HPV. In fact, HPV is why women get annual PAP smears – this test is used to find changes associated with HPV so that cervical cancer may be caught and treated early. The Gardasil vaccine and annual PAP smears have saved thousands of lives.
Treating existing warts is possible and is usually successful, but can be difficult. There are a multitude of treatment options based on a number of variables including number, size, and location of the warts and other factors such as patient preferences. Some common treatment modalities include simply mechanically removing the wart using clean techniques, using liquid nitrogen to freeze it off, using an electrical current to burn it off, using topical preparations to dissolve the wart, and using chemicals that locally upregulate the immune system to hasten the body’s natural attack on the infected cells.
Unfortunately, none of these treatments are 100% effective every time and many warts will reoccur following treatment. Furthermore, most patients with HPV are infectious even without visible warts. The best way to “treat” genital warts is to avoid getting them in the first place. Practice safe sex practices, limit your number of sexual partners, and use condoms. Make an appointment with your dermatologist if you have a genital wart for evaluation and treatment.