Genital Warts

Diagnosis

Genital warts are often diagnosed during a routine physical examination by a healthcare professional. In some cases, a small tissue sample may be taken and analyzed in a laboratory. This procedure, known as a biopsy, helps confirm the diagnosis and rule out other conditions.

Regular screening is particularly important for women, as certain strains of the human papillomavirus (HPV) that cause genital warts are linked to cervical cancer.

Pap tests and HPV testing are key diagnostic tools used to detect early changes in the cervix or the presence of cancer-causing HPV strains.

Pap test
During a Pap test, a device called a speculum is used to hold open the vagina so that the cervix can be examined. A long-handled tool is used to collect a small sample of cells from the cervix. These cells are then checked under a microscope for abnormal or precancerous changes.

HPV test
An HPV test detects high-risk types of HPV that can lead to cervical cancer. The test is often done using the same cell sample taken during a Pap test. It is most commonly recommended for women aged 30 and older, as younger women often clear HPV infections naturally without treatment.

Your healthcare provider may also recommend testing for other sexually transmitted infections (STIs), since genital warts can occur alongside other infections.

Treatment

If genital warts are not causing discomfort, treatment may not be necessary. However, medical treatment can help reduce symptoms such as itching, burning, or pain and may also decrease the risk of spreading the infection.

Although treatment removes visible warts, it does not eliminate the HPV virus from the body, and warts may return.

Medications
Topical treatments prescribed for genital warts include:

• Imiquimod (Zyclara): A cream that boosts the immune system to fight off the virus. Avoid sexual contact while using it, as it may weaken condoms and irritate your partner’s skin. Possible side effects include skin color changes, blisters, fatigue, body aches, cough, or rashes.

• Podophyllin (Podocon-25) and Podofilox (Condylox): Plant-based treatments that destroy wart tissue. Podophyllin is applied by a healthcare provider, while podofilox can be used at home. These should never be used internally or during pregnancy. Side effects may include skin irritation and soreness.

• Trichloroacetic acid (TCA): A chemical solution that burns off warts and can be used for internal lesions as well. Side effects can include mild pain and irritation.

• Sinecatechins (Veregen): An ointment made from green tea extract, used for warts on or around the genitals and anus. Side effects may include itching, redness, and changes in skin color.

Over-the-counter wart removers should never be used on genital areas, as they are not designed for sensitive skin and can cause severe irritation or injury.

Surgical options
For larger warts or those that don’t respond to medication, surgical removal may be recommended. Pregnant women with large genital warts may also need surgery to prevent complications during delivery.

Common surgical treatments include:

• Cryotherapy: Freezing warts with liquid nitrogen to destroy affected tissue. Multiple sessions may be needed. Side effects include pain and swelling.

• Electrocautery: Using electric current to burn off warts. Mild pain and swelling may occur afterward.

• Surgical excision: Physically cutting off warts under anesthesia. This may cause temporary pain after the procedure.

• Laser treatment: Using focused light to remove extensive or hard-to-treat warts. This option can be expensive and may cause scarring or discomfort.

Regular follow-up with your healthcare provider is essential to monitor for recurrence and manage symptoms effectively.