Genital warts are one of the most common sexually transmitted infections in Australia. They are caused by the human papilloma virus (HPV, “wart virus”). There are about 100 strains of HPV, but most do not affect the genitals.

Infection by the wart virus may result in:

Genital warts
These are growths that appear around the genitals or anus, and sometimes in the vagina, rectum or urethra.

They may be raised or flat, single or multiple, small or large, and may cluster together with a cauliflower-like appearance. They are painless and rarely cause discomfort.

Subclinical infection
No warts are visible but microscopic changes in cells show evidence of the virus.

Transmission
HPV is spread by direct skin contact with a partner during vaginal or anal intercourse. Infection may occur by contact with a visible wart, and possibly also from an area of skin with no visible wart (subclinical infection).

After sex with an infected person, warts may take a few weeks to many months (or even years) to appear.

Diagnosis
Genital warts are diagnosed by looking for them.

Subclinical HPV infection is difficult to diagnose. However, if present on the cervix, it may show up on a Pap smear.

There are no blood tests or swab tests to diagnose genital warts.

Treatment
Treatment removes visible warts, but does not eradicate the wart virus. There are several types of treatment. Each may cause mild irritation, but if you experience significant discomfort or inflammation you should tell your doctor. An alternative treatment may be required.

Cryotherapy
Warts are frozen by applying liquid nitrogen or dry ice once a week. It usually takes several applications before the warts disappear. You may not be able to see the warts yourself, so it is important to continue the treatment until the doctor says the warts have gone.

Podophyllotoxin paint
Podophyllotoxin paint (Condylline) is a plant extract that is easily absorbed through the skin. It should be carefully applied to the warts twice daily for 3 days, followed by a break of 4 days. This treatment may be repeated for several cycles. Podophyllotoxin does not need to be washed off after application, but it should not be applied inside the vagina, urethra or anus.

Podophyllotoxin should not be used by pregnant women.

Genital Warts (or condyloma) is a Sexually Transmitted Disease (STD) caused by the human papilloma virus (HPV). The virus may cause wart-like bumps to form on the penis, in and around the vagina, on the cervix (opening to the womb), around the anus (butt), and rarely on the mouth. The virus is passed between people during anal, vaginal, and sometimes oral sex. These are NOT the same warts commonly found on hands and feet.

How are genital warts spread?

Many people carry the wart virus on their penis, in and around the vagina, or in and around the anus/rectum. Only a small number of these people develop warts that can be seen. It is passed with skin to skin contact during anal or vaginal sex. The wart virus is very common in adults who are sexually active.
How do I know if I have warts?

Not everyone with the genital wart virus will have signs of disease. You may have painless wart-like growths on or in your sex organs or around your anus (butt). The warts may vary in size and be bumpy or flat. Sometimes special tests are needed to detect the wart virus.
Are genital warts serious?

They can be. For most people warts are only a bother, and are treated if you wish. If a woman has warts on the cervix (opening to the womb), they can be a problem. It is rare, but sometimes having warts can cause a woman to have a pap smear that is not normal, (including changes that may lead to cancer). For this reason, women with warts on the cervix should have a pap smear test (part of a pelvic exam) every six months to one year. Men and women who have warts on or inside the anus should have an exam every year.
What can I do if I have genital warts?

Be sure you see a clinician (licensed medical provider).
Keep all your return treatment appointments.
Your sex partner(s) should also be seen and treated.
If you may be pregnant, tell your clinician.
If you have sex, it is always a good idea to use a condom to avoid getting STDs.
However, condom use is not a 100% protection from the wart virus.
How are genital warts treated?

A clinician puts a cold liquid chemical on the warts to remove them.
You may need to come back more than once to finish the wart treatment.
You may need longer treatment if you have HIV. The warts may increase in size and number more quickly. Tell your clinician if you are HIV positive.
Will the warts come back?

Warts may return, even after treatment, this is because the virus stays in your skin once you are infected. You can pass the virus to your sex partners during vaginal or anal sex, even when you don’t have warts you can see.
How can I avoid getting genital warts?

Check yourself often for signs of actual warts; these can be treated. But remember: we treat the wart, not the virus, which stays in the skin.
Use condoms (rubbers) every time you have sex. Condoms reduce your risk for getting warts, but they won’t guarantee protection. Condoms also help to prevent other STDS.
Risk Factors for Cervical Cancer

Early onset of sexual intercourse (< 18 years of age)
Multiple sex partners (3+ lifetime)
Male partners with multiple partners
Sexual partners of men whose previous sex partners developed cervical cancer
Cigarette smoking
History of HPV infection (subtypes 16, 18 - not external)
Protective Factors

Celibacy
Life-long mutual monogamy
Use of condoms and spermicides
No Association with Cervical Cancer

Herpes simplex I or II
Uncircumsized male partner
Jewish ethnicity
Multiple pregnancies
Use of oral contraceptives