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Genital Warts

Appearance and Cause:

Genital warts, caused by the Human Papilloma Virus (HPV), occur around the anus and on the penis, vagina, vulva, cervix and rarely orally. Genital warts are increasingly common and affect as many as one-third of young women in Canada. These warts, spread by sexual contact, are often flat, tiny and difficult to spot and diagnose. There are approximately sixty different strains of HPV and there is mounting evidence that certain strains of the virus are linked to the development of cervical cancer. At the present time there is no simple, cost effective way to differentiate between viral types, therefore all must be carefully followed even though there are three or four viral thought to be the most problematic.


Most visible warts are detected by your doctor during routine physical examination of the genital organs. Physicians may use the "vinegar test" for hard to visualize warts in which they put mild acetic acid (vinegar) on the penis of men or the cervix and genital areas of women and observe these areas with a magnifying glass.

Sexual partners may also notice the warts. In women, HPV infection of the cervix is detected by the pap test. For this reason all sexually active women are advised to have an annual pap smear and gynaecological exam from age 15 to 40 and then every two to three years until age 60, when women can ask their physician how often they need testing. Because of the link to cervical cancer the frequency of pap smears is increased to two to three times per year if HPV effect is detected on a pap smear.

Removal of warts is recommended as this is when large amounts of the virus is present and the virus is highly contagious at this time. Removal of the warts is thought to reduce the virus load, diminish viral shedding, lessen infectivity and possible stimulate the immune defences. However, it is often not possible to remove every virus particle and attempts to do this are not usually indicated. The development of genital warts may well be the result of a longstanding latent infection of the virus. HPV DNA can remain "dormant" in the genital skin for decades and for some unknown reason, activate at a later date and produce visible warts. So it is highly possible that in a long-term sexual partnership, one of the partners was a carrier of HPV that was contracted many years ago, before the current relationship; then, the virus activated and was transmitted between the two partners.


To prevent the spread of genital wart, experts suggest that "safer sex" be practised and in particular, that condoms be worn for at least several months after wart removal. Although not fool proof in stopping viral spread, they may reduce the chance of infecting sex partners. "Safer sex" includes inquiring about the type of sexual practice and history of previous STD's of your sexual partner. Avoid having sex with an infected partner or multiple partners. Condoms are recommended in all cases when you are having sex. Remember, monogamy still remains the safest way………


There is no single universal treatment for genital warts and a combination approach often works best. Your physician will decide on the best treatment based on your history and clinical symptoms. Some of the common treatment options include:

Cryotherapy or freezing, using liquid nitrogen to remove the warts. Multiple freezing sessions may be needed and there is occasionally some local discomfort although the genital area generally heals easily and quickly.

Trichloroacetic acid treatment may help to remove genital warts. Like liquid nitrogen, multiple treatments may be needed and local discomfort can occur.

Podophyllin, a natural extract of plants such as the Wild Flower May Apple, arrests cell division and is used in a 25-50% solution. Petroleum jelly is put onto the surrounding skin to protect it from the solution, which is precisely painted onto the wart once a week, left on 2-6 hours, then washed off. As treatment proceeds, the solution may be left on for progressively longer periods as directed by your physician, but some blistering may occur and occasionally swelling or inflammation. Podophyllin should not be used in pregnant women because it affects fetal development, nor should it be put on the vagina because it can be absorbed into the blood stream causing nausea and vomiting.

If the warts or virus are present on the cervix, referral to a gynecologist may be indicated for a colposcopy where biopsy or laser treatment may be indicated.

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