warts anogenital

A virus that can be passed on by close sexual contact causes Anogenital warts. Treatment options include chemicals or physical treatments such as freezing to destroy the warts. If you have anogenital warts, you will usually be advised to have tests to check for other sexually transmitted infections.

Anogenital warts (sometimes just called genital warts) are small lumps that develop on the genitals and/or around the anus (back passage). They are caused by a virus called the human papillomavirus (HPV). The virus is passed on by sexual contact and needs a close skin-to-skin contact to pass on the virus. This means that you do not necessarily need to have penetrative sex to pass on infection even sharing sex toys may also pass on infection. Very rarely, anogenital warts may be passed on from hand warts. They may also rarely be passed on to a baby when a woman gives birth.

After being infected it takes weeks or months to develop warts. Most people infected with HPV do not develop warts, they remain as carrier of the virus without realising it, and may pass on the virus to others who then develop warts. People who have been treated with warts may also transmit the virus to others. It is not necessary to have anal sex to develop warts.

It is one of the most common sexually transmitted infections in India; with most of the infected persons are carriers with no visible warts. The main region where warts develop, in men, is usually on the outer skin of the penis. In women, it develops on the vulva, just outside the vagina. Warts may also develop on the skin around the anus, both in men and in women. Sometimes warts develop inside the vagina, on the cervix, on the scrotum, inside the urethra (the tube that drains urine from the bladder to the outside) or inside the anus. Rarely, they occur in the mouth or nose.

The appearance of the wart is usually small, skin-coloured, lumps on the skin (similar to the common warts that many people have on their hands). They are soft and non-hairy on skin that is warm, moist, and firm when they develop on dry and hairy skin.

People who develop warts cause no physical discomfort. They sometimes cause irritation and soreness, especially if they occur around the anus. Bleeding and pain could result from warts in anal region during intercourse. Though they are benign but look unsightly and distress some people.

Diagnosis of warts warrant thorough examination by a doctor or a nurse, this includes examination of genitalia and back passage.  No tests are required to diagnose this condition, but tests and swabs are advised to diagnose other sexually transmitted diseases.

The treatment of this condition is taken over several weeks and takes six months to clear. Sometimes, quitting smoking resolves warts; no one treatment may be successful. There is also a chance that anogenital warts can return after treatment. This is because the treatments do not clear the HPV virus itself but just treat the warty lumps. Wart treatments , sold over the counter in pharmacies should not be used to treat anogenital warts.

Anogenital warts are not serious, but can be unsightly. Some people prefer to just leave them alone. There is a good chance that they will go without any treatment. In fact, about one third of visible warts disappear by themselves over six months.

The treatment of warts include:

  • A number of chemicals, when put on to warts, will burn or destroy the wart tissue.These chemicals include:
    • Podophyllotoxin is a chemical that comes as a cream or lotion. This may be prescribed for you to put on the warts at home. You should apply it twice daily for three days, followed by four days' rest. This is repeated four to five times depending on the type of podophyllotoxin you are given (so the whole treatment lasts about four to five weeks). It should not be used in  pregnant females, should not  be put on broken skin or open wounds , normal skin around the warts should not be applied, Sexual contact is not recommended soon after the cream/lotion is applied to your skin, as it may cause irritation for your partner and If you apply too much, the cream/lotion may start to have unwanted effects inside your body.
    • Imiquimod cream is an alternative cream which is applied to warts at bedtime and wash it off 6-10 hours later. This is repeated three times per week for up to 16 weeks. It may take some weeks before the treatment works. While using this cream, care is taken to not to use condoms or diaphargms, as they weaken them, one should rely on oral contraception, should not be used in pregnant females, sexual contact shold be avoided, it should not be applied in broken skin
  • Physical treatments include:
    • Freezing warts with liquid nitrogen. This is a common treatment which is called cryotherapy. Liquid nitrogen is sprayed on or applied to the wart. Liquid nitrogen is very cold. The freezing and thawing destroys the wart tissue. To clear the warts fully you may need several treatments, a week or so apart. This treatment may be used if you have a small number of warts.
    • Surgical removal of warts under local anaesthetic. This may be an option if you have just a few warts that can be easily removed in this way.
    • Electrocautery is another techniques that destroy the warts by burning.
    • A laser is sometimes used to destroy the warts by burning.

It is important for Current sexual partner(s) to get themselves checked to see if they have warts or other sexually transmitted diseases. Since, there is an increased risk for wart patients to develop cervical cancer, they should also be screened for it.

Prevention of anogenital warts include:

  • Condoms usage (male or female) may prevent HPV from being passed on to new sexual partners who are not infected. However, they do not completely protect you from getting anogenital warts as the skin that is not covered by a condom can become infected. But condoms do help to protect against other sexually transmitted infections such as chlamydia and HIV. You should also use condoms whilst having oral sex and you should not share sex toys.
  • HPV  vaccine should include the type that covers HPV-6/11/16/18 (Gardasil®)

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