Genital Lesions


Questions--and Answers--About Genital Warts and Human Papillomavirus (HPV) Infection

By DAVID S. REITMAN, MD

Your doctor has just told you that you have an infection with human papillomavirus (HPV). Most teens have a lot of questions about warts and HPV. This guide will help answer some of those questions.

How did I get genital warts?

Genital warts are caused by the human papillomavirus. This virus lives in the skin on the penis or vagina and can be spread to another person when the genitals rub against another person's vagina, penis, scrotum, mouth, or anal area. You probably got the infection while having sexual contact with a partner who already had the infection in his/her skin.

Are the warts treatable?

Yes. Your doctor can talk with you about various treatment options. Some of the treatments can be performed during a quick appointment at your doctor's office. Occasionally, a surgeon or dermatologist may be needed to treat severe cases. You might want to ask your doctor about treatments that you can apply in the privacy of your own home. These treatments generally require a prescription from your physician.

Be sure to follow the application instructions carefully. Otherwise, significant swelling, redness, blistering, and bleeding could develop around the affected areas.

What if I don't want to undergo these treatments? Will I have the warts for the rest of my life?

Luckily, the human body is very skilled at clearing HPV infections. Most patients find that their genital warts disappear with time, even if the warts aren't treated. Usually it takes between 1 and 2 years for that to occur. As long as you don't mind waiting, most genital warts do not need to be medically removed. In certain situations (for example, if there are large warts that interfere with routine bodily functions--such as urination or bowel movements) there may be a more urgent indication to remove the warts.

My friend had her genital warts treated and they came back a few weeks later. Will that happen to me?

There is always some chance for a recurrence, regardless of the treatment. This happens because the virus continues to live in the skin or genital areas surrounding the warts for a year or two. Different treatments carry different recurrence risks. Your doctor can talk to you about these risks to help you decide which treatment would work best for you. Ultimately though, your body will clear the infection altogether--and you probably will not have recurrences after that.

Is it true that the same virus that causes genital warts also can give you cancer? Can I do anything to prevent me from getting cancer?

HPV comes in many different forms--called "genotypes." The genotype that causes genital warts typically does not lead to cancer of the cervix, penis, or anus. However, other HPV genotypes can place a person at higher risk for cancer. For this reason, if you have been sexually active for 3 years, you need to have a Pap smear screening test every year. (Pap smears can detect HPV infection and early changes that could lead to cancer.) Talk with your doctor about the need for annual screening for sexually transmitted diseases as well as about when to begin getting annual Pap smears.

My boyfriend had genital warts in the past. Is there anything we can do to prevent me from getting infected?

As with any sexual contact, consistent and correct condom usage will always decrease your risk of obtaining a sexually transmitted disease. Remember, however, that the condom is only effective if it covers the area that is (or was) infected with the warts in the past. If the warts were present along the shaft of the penis, then a condom should decrease risk of transmitting the infection. However, if your partner has warts along his thighs or scrotum, the condom will not be as effective because those areas will still be able to make contact with your skin.