Genital Warts

Genital warts are a 'viral infection' under the umbrella term of sexually transmitted infections (STIs) and is the second most common STI in the UK, according to the NHS. Being a viral infection, once contracted, genital warts are incurable, however, you may find bouts infrequent and/or very manageable.

Not to be confused with other lumps and bumps that can be present on and around the genitalia naturally, warts are new flesh growths that are often painless, but cause embarrassment and worry for many. They can vary in colour and size, most will typically be a close variation to your own skin tone and can either be clusters or stalk like tags, and are common amongst late teens for women and early twenties for men.

Being extremely contagious, you are able to contract the virus even if no symptoms are present and despite the name, genital warts can appear in the mouth and groin, as well as the penis, vagina and anus, depending on where and how you have contracted the STI.

• Common places for men include the penis, scrotum, around and/or inside the anus, inside the urethra, groin and thighs.
• Common places for women include inside the vagina, outside the vagina (the vulva), around and/or inside the anus, the cervix and thighs.

The cause of genital warts is the human papilloma virus, more commonly referred to in its abbreviated format; 'HPV'. Whilst there are nearly 200 strains of the virus, genital warts are generally only associated with types 6 and 11.

It is said that the vast majority of sexually active adults are likely to contract HPV at some point in their lives, as many strains are symptomless, yet highly contagious. You could have the virus for years without knowing and it often passes through your system over time without trouble.

Due to its largely elusive nature, HPV is easily transmitted through sexual contact, even if no symptoms have appeared, mostly frequently through unprotected vaginal or anal sex. Saying this, even wearing condoms doesn't offer full protection, as sexual contact (dry humping for example), oral sex (although rare) and sharing sex toys can transfer the virus.

Symptoms of genital warts can be difficult to distinguish, as you can contract HPV and not experience or notice any warts for weeks, months or even years after the initial infection. In fact, the vast majority of people with the virus will not have the type 6 or 11 strain that causes any symptoms including warts at all. If you do experience warts, they could be one or all of the following:

• One single growth
• Multiple single growths
• One cluster of growths
• Multiple clusters

The growth will be fleshy in colour, although this can vary slightly depending on the individual, with some resembling skin tags rather than the stereotypical wart. The NHS has stated that clusters of warts often resemble a cauliflower, and we happen to strongly agree. Warts are largely painless for most, however, for a minority of people, you may find that there are additional symptoms:

• Itchy
• Sore
• Inflamed
• Can bleed

Whilst genital warts are generally just unsightly and fairly infrequent, they can cause distress, so many use medication to clear the condition quicker.

HPV cannot be treated if there are no symptoms, however, if you have warts, there are a number of treatments available for you. These will depend on the location of your warts.

Creams and ointments

For more information and further details about any of these three treatments, click on the relevant links below.

• Condyline podophyllotoxin cream is applied daily for the first three days, then weekly to stop the warts from returning. This cream is good for those with short bouts where the warts are manageable, or when used quickly after they have appeared.
• Aldara imiquimod cream can be applied for a few months, making it a good option for those who experience frequent bouts. A thin layer is applied directly to the wart(s) three times a week, so it doesn't disrupt intercourse.
• Warticon podophyllotoxin cream is similar to Condyline and may also go by the name 'Wartec'. It can be applied for a minimum of four weeks, three days of the week.

Condyline, Aldara and Warticon are also known as 'topical creams' and work quickly and effectively, reducing discomfort caused by symptoms within days.

It's important to note that the effectiveness of barrier contraception can be compromised when using certain creams and ointments, however, it is best practice to avoid having sex altogether until the warts have completely cleared. Others will not be of use to pregnant women also.

Freezing and surgery

Other methods involve freezing the warts off or minor surgery to cut the warts away.

• Cryotherapy using liquid nitrogen to freeze off the warts that takes a maximum of 3 weeks to heal
• Excision is the name for a surgical procedure that cuts away the warts, especially clusters, which also takes about 3 weeks to heal
• Laser surgery is used for large genital warts and/or those warts that are difficult to access, especially with topical creams and ointments
• Electrosurgery is also used for large and/or unattainable warts with a excision to remove the bulk with an electric current used to burn away the remainder.

Freezing is usually preferred over surgery as it is less invasive and unknown to experience genital warts that are large and unmanageable.

Avoiding certain substances

When you have warts present, they can become inflamed and itchy, especially when provoked with certain substances. Medical professionals advise to avoid perfumed lotions, bath products and soaps that may irritate tender skin even further, prolonging the healing process.

During STI testing at GUM or sexual health clinics, you will not be tested for genital warts unless you have any symptoms present that can be analysed. The good news is HPV will most likely appear in the form of abnormal cells after a cervical screening test (smear test) for women over 25 - which is available and highly recommended as certain HPV types are also the leading cause of cervical cancer. However, there is no such equivalent test for men.

As well as attending your yearly smear test for females, there are other prevention tactics both sexes can use to significantly decrease the chances of contracting HPV and genital warts.

Condoms

Condoms are currently the most effective option when avoiding most STIs, including genital warts, however, this particular virus can infect outside the genitalia (on the thigh, mouth and anus for example), so you can still contract HPV, even when using condoms (male or female) correctly.

Saying this, they are still the safest option and can reduce the chances a tremendous amount compared to going without, not to mention male condoms being easily obtainable from pharmacies, beauty stores and supermarket.

There is a female version of the condom that can be inserted into the vagina just before sex, however, as with male condoms, this doesn't offer full protection against genital warts but does significantly improve your chances.

You can also order dental dams, usually at sexual health clinics or GUM clinics, which can offer protection during oral sex by placing the latex square over the vagina.

HPV vaccine

Over recent years, the HPV vaccine has been made available for all girls aged 12-13 years. Whilst the vaccine cannot protect against all strains of HPV, it does protect against genital warts types, 6 and 11, and also types 16 and 18; the two kinds linked with over 70% of cervical cancers in the UK, according to NHS statistics.

The vaccine isn't currently offered to men, older teenagers and women, or if you've already had sex as effectiveness in these sectors hasn't been proven.

Not having sex

Others may decide to become or remain celibate until they are sure about their partner's health. This can be a religious or personal choice with the knock-on effect being avoiding STIs completely, or something you consciously do for health reasons.

Outbreaks of genital herpes can be successfully treated using effective medication. Aldara cream, Condyline solution and Warticon (Wartec) cream are easy to apply and can alleviate uncomfortable symptoms and clear genital warts quickly. These treatments can be purchased from OnlineClinic after completing a quick, confidential online consultation. For more information, please visit the Aldara, Condyline and Warticon (Wartec) product pages.