Genital warts

Symptoms Of Genital Warts 

Genital warts may not always cause symptoms, but they can cause discomfort. Here are common symptoms:

• Small, flesh-colored or gray bumps on the genital or anal area

• Warts may appear alone or in clusters (like a cauliflower shape)

• Itching, irritation, or discomfort in the affected area

• Mild pain, especially during sex or while passing urine

• Occasional bleeding from the warts

• Moist texture or soft feel on the surface of the warts.

Causes Of Genital Warts 

• Genital warts are caused by the human papillomavirus (HPV), most commonly types 6 and 11.

• The virus spreads through skin-to-skin contact, often during sexual activity, and enters the body through tiny cuts or breaks in the skin. 

• Once inside, it settles in the lower layers of the skin and causes the infected cells to grow faster than usual, leading to the formation of soft, flesh-colored bumps known as warts.

• After infection, the virus usually stays in the body without symptoms for a while. 

• The incubation period can range from 3 weeks to 8 months, but on average, warts appear about 2 to 3 months after contact. 

• Even without visible warts, a person can still carry and pass on the virus.

  
  

Did You Know?

HPV is the most common sexually transmitted infection worldwide. But here’s the good news: the types that cause genital warts are considered low-risk. Still, protecting yourself through vaccination is one of the smartest steps you can take.

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Risk Factors For Genital Warts 

HPV is the main cause of genital warts, and it spreads easily through skin-to-skin contact. Certain factors can make infection more likely, including:

• Multiple sexual partners: More partners can increase the risk of HPV exposure, leading to genital warts.

• Early sexual activity: Starting sex at a young age increases long-term exposure risk.

• Unprotected sex: Skipping condoms allows HPV to spread through direct skin contact.

• Young age: HPV infection and genital warts are most common in this age group, especially 20–30 years.

• Smoking: It weakens the immune response, making it harder to fight off HPV, which can increase the risk of genital warts.

• Weakened immunity: A low immune response in conditions like HIV infection, organ transplant, etc, raises the risk of persistent HPV infection.

• Existing STIs: Other sexually transmitted infections make it easier for HPV to enter the body.

• Partner with a history of genital warts: You can still be exposed even if they don’t have visible warts.

• Low socioeconomic status: Associated with less access to healthcare, screening, and vaccination.

• Long-term use of oral contraceptives: This slightly increases the risk of HPV persistence in some women.

• Having given birth multiple times: It may raise HPV persistence risk due to cervical changes during pregnancy.

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Diagnosis Of Genital Warts

Genital warts are usually diagnosed through a physical exam, but in some cases, additional tests may be used to rule out other issues or check for related risks. Diagnosis includes:

• Visual examination: Doctors typically diagnose genital warts by looking for soft, flesh-colored growths on the genital or anal area.

• Dermoscopy: It is a non-invasive skin examination technique that uses a magnifying lens and light to view skin structures. It may help differentiate warts from other skin conditions.

• Pap smear (for women): While not used to diagnose genital warts directly, a Pap test may be done to screen for abnormal cervical changes caused by high-risk HPV strains.

• HPV DNA testing: This test detects high-risk HPV types linked to cancer (not the low-risk types that cause warts) but may be recommended alongside a Pap smear for cervical cancer screening.

• Biopsy (if needed): A tissue sample may be taken if the wart looks unusual, is resistant to treatment, or to rule out cancer.
  
  

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Specialist To Visit

A general physician can be your first point of contact for genital warts, offering initial assessment and guiding you to the right specialist if needed. Specialists you may be referred to include:

• Dermatologist

• Gynecologist

• Urologist

• STI specialist

A dermatologist diagnoses, treats, and removes warts affecting the skin and the genital area.

A gynecologist is recommended for women, especially if the warts involve the cervix, vagina, or vulva.

An urologist is recommended for men, especially if warts are on the penis, scrotum, or urinary tract.

You may be referred to an STI specialist for guidance on sexual health, transmission prevention, and partner management.

When to see a doctor?

Consult a doctor if:

• You notice unusual bumps or growths in the genital or anal area

• Warts are painful, itchy, or bleeding

• The warts are spreading or multiplying

• You're pregnant and have genital warts.

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Prevention Of Genital Warts

While genital warts are common, they can often be prevented with simple, proactive steps. These include:

1. Get vaccinated

• The HPV vaccine is safe, effective, and protects against the most common wart-causing types (HPV 6 and 11).
  
  

Dose and Schedule of the vaccine

• Ages 9 to 14 years: 2-dose series; 0 and 6 months 

• Ages 15 to 45 years: 3-dose series; 0, 1-2, 6 months

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2. Use condoms consistently

Using condoms consistently offers strong protection by significantly reducing the risk of HPV transmission, even though some skin contact areas may remain exposed.

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3. Limit sexual partners

• Having fewer partners reduces your chances of being exposed to HPV and reduces the risk of genital warts

4. Avoid smoking

• Smoking weakens the immune system, making it harder for your body to clear HPV infections.
  
  

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5. Get screened regularly (especially women)

• Routine cervical screening can detect early changes caused by HPV and help prevent complications.

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6. Boost your immunity 

• A healthy lifestyle is the key to enhancing your immunity. Do it with good sleep, balanced nutrition, and stress management to fight off infections naturally.
  
  

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Treatment Of Genital Warts

While genital warts may go away on their own, treatment can help remove them faster, ease discomfort, and reduce the risk of spreading the virus. It includes: 

1. Topical treatments

These are prescription creams, gels, or solutions applied directly to the wart-affected area. They work by either destroying the wart tissue or helping the immune system fight the virus over time. Some examples include:

• Imiquimod

• Podophyllotoxin
  
  

2. In-clinic procedures

Doctors may recommend these if warts are large, stubborn, or keep coming back:

• Cryotherapy: This involves applying liquid nitrogen to the wart, which freezes and destroys the affected tissue. It may cause mild stinging or blistering and usually needs a few sessions for full removal.

• Electrocautery: The wart is burned off using a small electrical current through a heated probe. It’s usually done under local anesthesia and is effective for not-so-large, stubborn warts.

• Laser therapy: A focused beam of light is used to vaporize wart tissue, especially useful for large or hard-to-reach warts. This is typically reserved for cases that don’t respond to other treatments.

• Surgical removal: Warts are cut out using a scalpel in a minor surgical procedure. It offers immediate results and is often used when other methods have failed or when rapid removal is needed.

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Home-care For Genital Warts

Home care tips

• Keep the affected area clean and dry

• Avoid touching, scratching, or picking at the warts

• Wear loose, breathable cotton underwear

• Avoid shaving over the wart-affected area

• Maintain a healthy diet and stay hydrated

• Get enough sleep and manage stress to support immunity

• Refrain from sexual contact while warts are present.
  
  

Certain home remedies may support healing and help with the symptoms. However, it is important to note that these natural options are not a replacement for conventional treatment. Always consult your doctor before trying them.

Home remedies that can help include:

Sinecatechins: A plant-based ointment derived from green tea, shown in multiple clinical trials to clear genital warts with low recurrence rates. 

How to use it?

Apply topically to affected areas daily, as directed by your doctor.

Garlic extract: Garlic has antiviral properties and may also help suppress HPV activity. 

How to use it?

Use in supplement form or apply diluted garlic oil topically with care, after consulting with a practitioner first.

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Thuja occidentalis (white cedar): A homeopathic remedy traditionally believed to support the immune system, though scientific evidence is limited.

How to use it?

Typically used in diluted tinctures or ointments; follow guidance from a trained homeopath.

Tea tree oil: Known for antiviral and antimicrobial effects. It may be irritating to sensitive genital skin, not recommended without supervision.

How to use it?

Always dilute before use; avoid applying directly to sensitive inner skin areas without expert advice

Dietary supplements: Some studies suggest that vitamin B12, L-methylfolate, ferritin, and vitamin D may play a supportive role in managing HPV infections and potentially improving outcomes.

How to use it?

Take as per the recommended daily values or under the guidance of a professional.

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Complications Of Genital Warts

While genital warts are generally benign, they can lead to various physical, emotional, and sexual health complications. These can include:

• Recurring warts: Even after treatment, many people experience recurrence within 3–6 months.

• Local irritation or ulcers: Some warts can cause bleeding, pain, or ulceration, which may lead to infection.

• Urethral obstruction: Large warts near the urethra can block urine flow.

• Potential progression: Though rare, genital warts could evolve into high-grade lesions or cancers, especially in immunocompromised individuals.

• Transmission to partners or newborns: Warts can spread to sexual partners and, rarely, to infants during childbirth.

• Emotional distress: Feelings of shame, low self-esteem, or anxiety are common.

• Sexual dysfunction: Pain, reduced libido, and psychological stress can affect sexual life.

Living With Genital Warts

Living with genital warts can be emotionally and physically challenging, but the right care and support can help you manage them effectively.

1. Stick to the treatment

• Take prescribed medications consistently to help control outbreaks

• Attend regular screenings, especially if you're at risk for complications like cervical or anal cancer

• Follow your doctor’s treatment plan and avoid self-treatment

2. Practice safe sex

• Use condoms to reduce the risk of spreading the virus

• Communicate openly with partners about your condition

• Avoid sexual activity during outbreaks.

3. Take care of your mental health

• Seek counseling to cope with stress and stigma if needed

• Talk to trusted friends or a therapist to ease feelings of isolation

• Practice self-care and engage in activities that can lower your stress.
  
  

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4. Focus on hygiene

• Keep the affected area clean and dry

• Wear loose, breathable clothing to avoid irritation.

5. Upgrade your immunity

• Eat a balanced diet and consider supplements if recommended

• Get adequate sleep and exercise regularly

• Quit smoking as it weakens your immunity

• Manage stress to help your immune system function better.