Genital warts

Overview: What are genital warts?

Genital warts are benign changes to the skin that mainly form on the female and male genitals. The culprits are special types of human papillomavirus (HPV). They are considered to be particularly contagious and are mainly transmitted during sex. Genital warts therefore fall into the group of sexually transmitted diseases (STDs). Genital warts are also called genital warts, pointed condylomas or condylomata acuminata.

A few weeks after infection with the human papillomavirus, skin changes appear on the labia, in the vagina, on the external female genital organs (vulva), on the penis, scrotum, foreskin or anus. Viruses can also colonize the cervix or urethra. Genital warts can look very different: Flat, pointed, stalked or even cauliflower-like. They can also vary in color – from whitish, reddish to grey-brownish.

Genital warts – frequency and age

Genital warts are not uncommon in western industrialized countries. Doctors estimate that around one to two percent of all sexually active men and women have genital warts. Many people are unaware of the viral disease because it often causes hardly any symptoms. Young adults are most frequently infected, which is not surprising as most of them are particularly sexually active at this age. Genital warts are more common between the ages of 15 and 30.

Genital warts: Causes are human papillomaviruses

Genital warts are caused by certain human papillomaviruses, HPV for short. They are transmitted during sex. There are more than 100 different types of HP viruses, which can cause a wide variety of diseases in different parts of the body – even cancer (typically cervical cancer, but also vaginal cancer, cancer of the labia, penis or anus and in the nasopharynx). HPV types 6 and 11 are most frequently responsible for genital warts.

Human papillomaviruses are aggressive and dangerous in different ways when it comes to causing cancer. Experts also classify human papillomaviruses according to this:

How can you become infected with HPV?

Human papillomaviruses infect the skin and mucous membranes. They stimulate the division of surface cells, causing warts to develop in the form of thickened skin. The viruses are very easily transmitted from one person to another on contact with infected mucous membranes. The pathogens penetrate the skin and mucous membranes through the smallest of injuries. Most people become infected with HPV during sexual intercourse. And those who have sex frequently are naturally also at a higher risk of infection with the virus. Smoking and the use of hormonal contraceptives (e.g. the pill) can also promote HPV infection. Babies can become infected with genital warts during birth if the expectant mother has contracted the disease. HPV is very rarely transmitted via contaminated objects, for example shared towels or washcloths.

Symptoms: Genital warts often go unnoticed

In most cases, genital warts develop in the genital region: labia, vagina, anus, foreskin, penis or scrotum. They can also appear in other parts of the body, such as the anal canal, rectum, urethra or cervix. The symptoms also depend on the location of the infection. Genital warts can go unnoticed for a long time because they are barely visible at first and do not immediately trigger symptoms.

The following signs are an indication of genital warts:

• Four weeks to eight months (on average three months) after the HPV infection, the skin changes in the affected areas: Flat, individual or small nodules arranged like a bed appear.
• Itching, burning, oozing
• Minor bleeding
• Genital warts are rarely painful.

Without treatment, genital warts may continue to grow and change in size, shape and color. Visually, genital warts can look like a cauliflower or cockscomb. They can be reddish, gray-brownish or whitish in color. In addition, genital warts sometimes spread further in skin folds that are in close contact with each other.

Genital warts – diagnosis with us

Always consult a doctor promptly if you notice skin changes in the genital area or suffer from symptoms. This is not only in your own interest, but you must also think for others. Because without adequate treatment, you can quickly infect others.

We can often diagnose genital warts based on their visual appearance. At first, however, pointed condylomas are often still small and difficult to recognize: They can be made more visible by carefully applying acetic acid to the affected areas: The warts then turn white.

Sometimes we take a tissue sample (biopsy) from the altered skin area. A pathologist then examines the tissue under a microscope in the laboratory. Benign and malignant cells can thus be precisely distinguished.

If you have genital warts, all sexual partners should also be examined. You must also undergo treatment, otherwise you will infect each other again and again.

Genital warts: prevention, early detection, prognosis

You can prevent genital warts to a certain extent. Because they are mainly transmitted during sex, appropriate protective measures help. Some tips:

HPV vaccination

There are two different HPV vaccines in Switzerland: one protects against the nine most common HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58; since the beginning of 2019, it has replaced the previous vaccine, which was only used against four HPV types. The second vaccine protects against the high-risk types HPV 16 and 18 (i.e. not against genital warts). The Federal Commission on Vaccination recommends the HPV vaccination as a basic vaccination for all girls and boys between the ages of 11 and 14 and as a booster vaccination for young women aged 15 to 19. The HPV vaccination is recommended as a supplementary vaccination for young women aged between 20 and 26 and for boys and men aged between 11 and 26. Vaccination is free of charge as part of the cantonal vaccination programs.

Condoms

Condoms reduce the risk of HPV infection, but do not offer 100% protection. Even brief skin contact with genital warts outside the areas protected by the condom is enough to become infected. Condoms not only protect against unwanted pregnancy, but also against many other sexually transmitted diseases. So safe sex is never wrong!

There is no special program for the early detection of genital warts. However, condylomas that are discovered in good time are also easier to treat. Always consult your doctor if you notice any signs of genital warts (or any other sexually transmitted disease). Not only do you protect yourself from complications, but you may also prevent your sexual partner from becoming infected.

Genital warts – progression and prognosis

If you have the genital warts adequately treated, the course and prognosis are usually good. This prevents the genital warts from continuing to grow and spread. However, condylomas occasionally reappear despite treatment. It is not uncommon for genital warts to disappear on their own without treatment.

Very rarely, genital warts develop into a malignant tumor. This can happen, for example, if you have not only been infected with the low-risk types HPV 6 and HPV 11, but also with high-risk HPV types. Examples are the more aggressive variants HPV 16 and HPV 18.

Genital warts during pregnancy – a problem?

Genital warts during pregnancy can also cause problems if they become very large. However, this is very rarely the case. Babies can rarely become infected with the virus during birth. In the case of very extensive condylomas, it is sometimes not possible to give birth in the normal way. The alternative is then a caesarean section. Pregnant women with genital warts should therefore undergo treatment before giving birth, which also makes spontaneous delivery possible.

Genital warts: treatment depending on the spread

Which therapy is suitable for genital warts depends on the location and spread of the skin lesions. However, it is important that you overcome any shame you may feel and take the first step towards seeing a doctor. Don’t treat your genital warts yourself for a long time, but seek professional help straight away. There are a number of treatment options and preventive measures that you can use to fight the human papillomavirus (HPV). Although many therapies require a prescription, you can carry them out yourself at home.