What are Genital Warts / HPV?
Genital Warts, or Condylomata Acuminata, are sexually transmitted infections characterised by single/multiple fleshy growths on the anogenital skin. They are caused by human papillomaviruses, of which more than 100 types are known. Genital Warts are mostly caused by HPV types 6 and 11.
Where do genital warts typically appear?
Genital Warts can occur on the cervix, vagina and vulva in females, and on the penis and urethra (urinary canal) in males. They may also occur around the anus and in the anal canal in both males and females.
Warts on other sites like hands, fingers and feet are not sexually transmitted and are caused by varieties of HPV different from those causing genital warts.
How do genital warts spread?
Genital Warts are spread by unprotected sexual intercourse and intimate skin-to-skin contact with an infected partner. Autotransmisstion from hands and fingers to anogenital region is also possible.
Incubation Period of Genital Warts / HPV
Genital Warts / HPV can incubate for months or years before exhibiting symptoms.
Symptoms of Genital Warts / HPV
- Condylomata Acuminata: papular, flat, exophytic, filiform, cauliflower-shaped warts
- Fleshy growths on anogenital skin
- Usually multiple warts > 5 to 15, 1-10mm in size
- Itch and discomfort
- Usually painless, unless traumatized
- May be small to large
- Slow growing
Testing for Genital Warts / HPV
- Clinical signs and symptoms
- Characteristic appearance
- Vaginal examination for cervical warts
- 5% acetic acid for mucosal warts
- Skin biopsy
- HPV DNA
Treatment of Genital Warts / HPV
The goal of treatment is to remove visible exophytic warts, not the eradication of HPV. It is important to check for urethral meatal warts, anal warts, and for female genital warts.
1. Topical wart creams
- An immune response modifier that activates an internal defensive response, when applied to skin infected with HPV.
- Applied 3x a week at bedtime, washed-off next morning
- Duration: until clearance or 16 weeks maximum
- Low recurrence rate – 10-15%
- Side effects are skin redness, burning sensation, erosions after 3–4 weeks
- Not approved for use in pregnant women or internally
2. Cryotherapy – Liquid nitrogen
- Causes wart destruction, thrombosis of vessels
- Treatments done weekly to fortnightly intervals, freeze-thaw-freeze cycle
- Open application by spray or cotton swab
- Simple, relatively inexpensive
- Safe during pregnancy
- Side effects are redness and swelling, blister formation, scarring, pigmentary changes
- Highly effective in removing lesions
3. Topical Podophyllin (Podophyllum resin 25%)
- For removal of benign epithelial growths such as venereal warts, common warts, benign papillomas and plantar warts
- Cytotoxic agent which interferes with mitosis in the cells of the basal layer of the epidermis
- Applied directly to the lesions in the clinic and washed off after 4 – 6 hours
- May be applied on a weekly basis
- Side effects include necrosis and scarring
Follow Up of Genital Warts / HPV
- Regular PAP smears for females
- Reassurance. Complete clearance will occur sooner or later.
Prevention of Genital Warts / HPV
HPV Vaccination is the most effective prevention against genital warts.
Cost of Genital Wart Treatment / HPV Treatment
Cryotherapy (Liquid nitrogen spray gun)
Non-genital:
$50 per single lesion
From $200 for multiple lesions (5 or more)
Genital:
$80 per single lesion
From $300 for multiple lesions (5 or more)
1 – 3 sessions may be required to ensure complete removal of lesions.
Additional topical and/or oral medications may be prescribed to supplement the treatment or for wound care.
HPV vaccination will be encouraged for those who have not been vaccinated.
Consultation fees and GST charged separately.
BY APPOINTMENT ONLY
For enquiries, please call 64433101, SMS/Whatspp 96622880 or email info@tanjongpagarclinic.com.
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