Genital warts or pointed condylomas are the symptom of a disease with the human papillomavirus (HPV). Among other things, this is suspected of causing cervical cancer. Genital warts belong to the group of venereal diseases.
What are genital warts (HPV)?
Genital warts are brownish-gray, small to large and flat warts in the genital and anal areas. They develop due to genital transmission of the human papillomavirus and can therefore occur not only in the genital area, but also in other parts of the body that come into close contact with the genitals. The incubation period is from a few days to several years, and usually genital warts heal completely. However, in severe infestations, they can break open and cause bleeding. In addition, pain rarely occurs, so the genital warts can go undetected for a long time – sometimes they do not form at all despite HPV infection.
Causes
The cause of genital warts is infection with the human papillomavirus. These are suspected of causing cancers such as cervical cancer, penile carcinoma, or cancers of the mouth and throat – but genital warts are caused by a low-risk type. They are caused by contact or smear infection with the virus during sexual intercourse or other sexual activity. However, for infection to occur, other conducive factors must also be present. For example, if there are minimal injuries to the mucous membranes, which can quickly occur unnoticed, the viruses nest through them. Moisture or a generally weakened immune system, for example due to a current cold, also ensure that genital warts can develop, as the HPV settles in more easily.
Symptoms, complaints and signs
The majority of human papillomavirus infections are completely asymptomatic, so affected individuals do not experience any symptoms of their disease despite being infected with the genital wart pathogen. Nevertheless, they are virus carriers and can be infectious accordingly. In some cases, developing genital warts are also so small and low-growing that they are not noticeable. Also, genital warts that grow in places that are difficult to see (for example, intrarectally) can only be detected to a limited extent. Individual genital warts usually do not cause pain or other irritation. Sometimes, however, the growths can cause small bleedings or release secretions. This also depends on where they grow and to what extent the affected areas of the body are subjected to mechanical stress. Grown genital warts are well visible as darker elevations from a certain size. These can be different colors and form in the genital, rectal or oral area. They multiply at different rates and in some cases lead to a regular overgrowth of the affected area. Several small warts may combine to form larger ones. Individual warts may show steady growth. Genital warts in particular can lead to tearing or eczema – but this is only to be feared if the disease progresses without treatment. While approximately 90 percent of all infections are caused by low-risk types of HPV, which only lead to treatable genital wart formation, degeneration is possible in the remaining infections. Tumor formation may occur – also depending on the location – due to tissue overgrowth and damage. Untreated infections and larger wart accumulations can degenerate and sometimes lead to the so-called Buschke-Löwenstein tumors. These are dangerous degenerations.
Course
The course of the genital wart disease is as follows: Following infection with the human papillomavirus is the incubation period. On average, it takes several days or weeks for the first symptoms to appear. More rarely, they appear after a few days or even after several years. Initially, a few warts form in the affected area. These tend to form beds and the genital warts spread further:
They are interconnected and cover an increasingly larger area of the skin. In some cases, the genital warts subsequently heal on their own; in severe cases, they form large tumor clusters that can bleed significantly.
Complications
Genital warts can be surgically removed by a physician. Various procedures (laser, cryotherapy, and electrotherapy are available for this purpose.Depending on the procedure, the doctor may injure blood vessels, which subsequently leads to bleeding. Genital warts can also be treated with drugs in self-therapy. In this case, tinctures from the active ingredient group Podophyllotoxin or Imiquimod are applied to the warts, which can lead to very unpleasant skin irritations. It is therefore essential to make sure that only the warts are coated and the surrounding skin is carefully covered. The medication must not be used during pregnancy, as it can trigger complications during the further course of pregnancy. The patient can use trichloroacetic acid, which can remove about 20 percent of the genital warts. In about 30 percent of all affected patients, the genital warts cannot be treated with the above-mentioned means. In addition, not all affected persons notice the infection with the HP virus, so that a therapy is omitted. In such cases, the genital warts begin to proliferate and, in the most unfavorable course, lead to the formation of a malignant tumor. If proliferating genital warts occur during pregnancy and are not treated or do not respond to therapy, the birth canal may be displaced. Vaginal delivery is then no longer possible and the doctor will have to perform a cesarean section.
When should you see a doctor?
If the genital warts are cosmetically bothersome, a doctor should be seen at the first opportunity. Inflammation, bleeding and severe itching are good reasons to consult a medical professional immediately. A visit to the family doctor or dermatologist is also recommended if the warts spread rapidly. If the pointed condylomas “attach” to other skin diseases (such as neurodermatitis), a dermatologist must be consulted. The same applies if the growths appear overnight on other parts of the body or suddenly cause pain, itching and other symptoms. Medical clarification is also advisable if there is an acute risk of infection for others. Children and people over the age of 45 are particularly susceptible to genital warts. These should, like patients with neurodermatitis or a past HPV infection, talk to a doctor and have the skin changes clarified. The medical professional can remove the growth quickly and without pain, and inform the affected person about the sexual and hygienic problems that genital warts pose.
Treatment and therapy
The first priority in the treatment of genital warts is to inform the patient about the type of virus that causes the genital warts. If it is a low-risk type, there is no danger – however, there are also carcinogenic forms that become very dangerous, especially for women, and can trigger cervical cancer. The focus is then on screening for rapid detection in the event of an emergency. The low-risk type, however, is seamlessly treated further. First, there is the option of surgically removing the genital warts, for example surgically or by methods such as cauterization or icing. This is followed by treatment with medication. The warts are usually rubbed with the medication so that it can act directly. First of all, cytostatics, which are also used in cancer, are considered to stop the growth of the genital warts – 5-fluorouracil is considered to be the standard drug. In addition, drugs such as interferon are prescribed to stimulate local immune defenses and encourage the body to produce its own immune cells to kill the genital warts from within. Interferons, in particular, have a tumor-inhibiting effect and offer protection against possible cancers, which is why they are also used for the high-risk type of human papillomavirus.
Outlook and prognosis
Genital warts generally have a good prognosis outlook despite their high risk of infection. Warts caused by the papillomavirus can spread rapidly within a short period of time. Without medical care, there is a risk of a steady increase in the benign skin lesions. In addition, they can lead to complications of the menstrual cycle or within an existing pregnancy. In addition, there is a high probability that future sexual partners will be infected with the virus as well as the warts. The particular difficulty lies in the detection of the genital warts. Often the skin changes remain undetected, since they do not trigger any further symptoms in many affected persons and settle in areas of the body that are difficult to access as well as difficult to see.After a diagnosis and medical treatment, in most cases the patient is free of symptoms. In a medical procedure, the warts are completely removed. This is followed by drug treatment to kill the papilloma virus. Within a few weeks, the affected person can be discharged from treatment. Despite the good chance of cure, the warts may reappear at any time. In very rare cases, isolated genital warts mutate into malignant tumors. The otherwise favorable prognosis worsens in these patients and is tied to the stage of the disease at the start of treatment. There is a risk of fatal disease progression.
Prevention
Genital warts are best prevented by safe contraception and caution in the choice of sexual partners. Contraception must understand from methods such as the condom or femidom if you do not know each other or do not live monogamously, because only they can prevent direct contact between the two people. However, in order to prevent genital warts, one should be informed about the sexual behavior and possible infections of the partner beforehand. People who have not yet had sexual intercourse can get a preventive vaccination against HPV. However, the vaccine is still new and no reliable statements can be made about the duration of effect. In addition, there have been unexplained sudden deaths in young women after vaccination, but so far these have not been clearly linked to the vaccine.
Follow-up
Follow-up care for condylomata consists of check-ups that follow previous surgeries. The follow-up examinations are necessary after therapy of warts close-meshed. This is due to the fact that the different virus strains (and accordingly the warts) can form recurrences. These are not necessarily where genital warts were also seen and treated. In addition, warts are also possible in the rectum or within the vagina, which can cause them to spread again. An HPV infection is therefore only considered treated if no further warts have been found for many months. During follow-up examinations, the doctor in charge will therefore closely examine susceptible areas in order to detect even the smallest warts already and prevent them from spreading again by means of treatment. If creams or suppositories are used for treatment, no further action is necessary after this treatment is completed. This is different if the genital warts have been surgically removed. Wound treatment is sometimes still necessary for weeks. Since the areas in question are often the genital region, hygiene is particularly important. In addition, the wounds should not be touched and should be kept dry. If necessary, covers and bandages can be used. In addition, the life partner should be urgently examined and treated if necessary to exclude a new infection with HPV.
What you can do yourself
In addition to medical treatment, the patient can also fight the genital warts with various home and alternative remedies. However, their effectiveness often varies. Among the most effective home remedies for genital warts is tea tree oil. It has proven to be effective in combating the annoying warts. However, it is important to always use tea tree oil that is skin-friendly. It can be purchased at a pharmacy. Tea tree oil reactivates the affected immune system, which in turn leads to the death of the responsible germs. Most users tolerate tea tree oil well, because it consists exclusively of natural substances. However, at the beginning of the treatment, it is recommended to use tea tree oil with restraint, so that in case of negative reactions, it does not aggravate the symptoms. Another proven natural remedy for skin diseases such as genital warts is aloe vera. It is offered both in the form of a gel and in liquid form. Alternatively, the fresh juice from an aloe vera plant can be used. The natural remedy is administered in the morning and in the evening before going to bed. In the process, the patient spreads the aloe vera on the affected areas. Hemorrhoid ointment is also suitable for the treatment of genital warts. It is actually used to combat hemorrhoids, but its ingredients also combat swelling and itching in the genital region. The application takes place two to four times a day.
