Human papillomavirus, also known as HPV, is the virus that causes all warts. There are several different strains/types of the HPV virus. Some cause genital warts that affect the vagina, vulva, cervix, penis, scrotum, and rectum/anus and are considered sexually transmitted diseases (STDs). A few strains of human papillomavirus are also known to increase the risk of certain types of cancer, especially cervical cancer, but less often can cause cancer of the anus, penis, throat, and vagina/vulva. HPV is very contagious and can be easily transmitted from person to person. You can get HPV from touching warts, from touching surfaces that a person with a wart has also touched, and from sexual contact, including oral sex, anal sex, and hand-to-genital contact, with anyone who is infected with HPV. It is important to remember that HPV is the cause of all warts, but the strains of HPV that cause warts on the other parts of the body such as the hands, feet, face, arms, and legs are not associated with increased cancer risk. Not all strains of HPV cause warts to develop, and the strains associated with increased cancer risk do not cause warts. In fact, there may not be any symptoms at all. So, it is important to be screened regularly for STDs if you are sexually active and have any form of unprotected sex. HPV can also be detected during routine pap tests, so it is important to visit the doctor as recommended for regular check-ups.
Treatment for HPV depends on the type/strain of human papillomavirus that you have, and the location. There is no cure for human papillomavirus, but there are medication and surgical treatments to remove warts/genital warts. Sometimes, the immune system can fight the virus enough that warts may go away on their own, but once infected, the virus never leaves the body. If are a female with HPV but have no symptoms, your healthcare provider will recommend more frequent Pap tests to check for any abnormal cells that can progress into cancer. If abnormal cells are detected, a procedure called colposcopy will be done to take a closer look at your cervix and perform a biopsy to check for cancer. Often, a small surgery called a LEEP procedure will be done to remove abnormal or cancerous cells. When cancer develops due to HPV, additional surgeries may be done, and chemotherapy will be given to fight the cancer. Chemotherapy drugs are specialized and sometimes complicated regimens, and will not be discussed here.
Salicylic Acid is an over-the-counter (OTC) topical treatment. It is an active ingredient in liquid and gel solutions applied to warts, and in patches that stick to the skin and cover the wart. It works by breaking down and sloughing off skin, layer, by layer, until the wart is gone, and healthy skin tissue replaces it. Salicylic acid has many uses for other skin conditions, including acne. The concentration used for wart removal is much higher than for other skin conditions, so it is important that you use salicylic acid-containing products specific for wart removal, only on warts. It can be damaging to the skin otherwise. Salicylic acid is recommended only for common warts on the body, not for use on genital warts.
Imiquimod is a topical cream applied directly to the wart, used for both common and genital warts, that is available as a prescription. It works by activating immune system cells in the skin to fight HPV and help eliminate the wart.
Podophyllotoxin is available as a prescription topical gel or solution, and as an active ingredient in some over-the-counter wart removers. It disrupts the metabolism/reproduction of skin cells and kills the skin tissue contained in the wart. It is not recommended for the treatment of internal genital warts (those inside the vagina or anus).
It is important to remember that these topical treatments will take several applications to work, from a few days to weeks. Also, remember that these treatments do not cure HPV, so warts may come back, either in the same or a different location.
Liquid nitrogen is used topically on warts to “freeze” them off. This deadens the skin cells, and the wart usually will fall off after one or two applications.
In some cases, your healthcare provider may use an acid solution or cauterization to “burn” off warts, or a simple surgical procedure or laser surgery to remove them.
Side effects of wart removal medications are minimal because they are topical treatments and there is little absorption into the rest of the body. The most common side effects are pain, irritation, itching, redness, dryness, or swelling of the skin where the treatment was applied.
HPV can be prevented by avoiding skin-to-skin contact with others who have warts or known HPV infection. You should always use a condom during sexual intercourse to avoid infection from HPV or other STDs. However, condoms do not cover all areas of the skin that may contract HPV during intercourse. It is recommended to wear sandals or shower shoes in public shower facilities to avoid HPV infection of the feet, particularly plantar warts. Unfortunately, since many cases of HPV infection are not symptomatic, it can be difficult to avoid contracting it. Fortunately, there is an HPV vaccine available to help with HPV prevention. While the HPV vaccine does not offer protection from all strains of HPV, it does significantly decrease the chance of getting the strains of human papillomavirus that are most strongly associated with cervical and other HPV-related cancers. HPV is known to be the cause of 99% of all cervical cancer cases.
The HPV vaccine is given in two to three doses/shots, 6-12 months apart, and is recommended for girls aged 9-14 years old, prior to the age of sexual activity. It may also be given to boys of the same age, and to adults up to 45 years of age. If you have genital warts, your doctor may recommend getting the vaccine to prevent contracting other strains of HPV. The vaccine is also recommended in adults who have suppressed immune systems due to HIV or another illness/medication. The vaccine is considered safe and very effective for many years post-vaccination. Common side effects associated with the HPV vaccine are irritation, pain, swelling, and redness at the injection site, fever, nausea and vomiting, headache, tiredness, and muscle and joint pain. These usually only last a couple of days after vaccination.