Genital warts are one of the most common sexually transmitted infections  and are caused by some types of human papillomavirus (HPV).

Genital warts, also known as anogenital warts or condylomata acuminata are raised lesions that develop on the skin and mucous membranes after infection with some types of HPV, a virus transmitted through contact during sexual activity.

Signs and symptoms of genital warts

Genital warts appear clustered as a few small, raised lesions, but their appearance varies.

They can be flesh-colored, light and pearly, or dark purple, gray, or brown. There may be many or only one. They may be small and difficult to see or they may enlarge and combine into masses. They can be rounded bumps or flat plaques; they may be smooth or rough. They are generally painless but may itch or become irritated.

In men, genital warts may be found on the scrotum, on the shaft of the penis, and in and around the tip of the penis. In women, genital warts may be found on the vulva, in the vagina, and on the cervix.

Human Papillomavirus

There are more than 100 types of HPV and more than 40 types infect the genitals. Types 6 and 11 cause most genital warts. Others cause warts found on the hands and feet. Many people infected with HPV have no symptoms but can still transmit the infection to others. There is no treatment for the virus, but the infection can go away on its own. Most people are infected with HPV at some time during their lives.

Who Is at Risk

People who have unprotected sex or multiple partners or who start having sex at a younger age; people between 16 and 25 years old; and those who are infected with other sexually transmitted infections (STIs) are at increased risk.

Diagnosis

Genital warts are often diagnosed by appearance. Sometimes a biopsy might be necessary.

1. Pap test

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For women, it's important to have regular pelvic exams and Pap tests, which can help detect vaginal and cervical changes caused by genital warts or the early signs of cervical cancer.

During a Pap test, your doctor uses a device called a speculum to hold open your vagina and see the passage between your vagina and your uterus (cervix). He or she will then use a long-handled tool to collect a small sample of cells from the cervix. The cells are examined with a microscope for abnormalities.

2. HPV Test

Only a few types of genital HPV have been linked to cervical cancer. A sample of cervical cells, taken during a Pap test can be tested for these cancer-causing HPV strains.

This test is generally reserved for women ages 30 and older. It isn't as useful for younger women because for them, HPV usually goes away without treatment

Treatment

If your warts aren't causing discomfort, you might not need treatment. But if you have itching, burning and pain, or if you're concerned about spreading the infection, your doctor can help you clear an outbreak with medications or surgery.

However, warts often return after treatment. There is no treatment for the virus itself. The medications that are used include:

Genital wart treatments that can be applied directly to your skin include:

• Imiquimod (Aldara, Zyclara). This cream appears to boost your immune system's ability to fight genital warts. Avoid sexual contact while the cream is on your skin. It might weaken condoms and diaphragms and irritate your partner's skin.

  One possible side effect is skin redness. Other side effects might include blisters, body aches or pain, a cough, rashes, and fatigue.

• Podophyllin and podofilox (Condylox). Podophyllin is a plant-based resin that destroys genital wart tissue. Your doctor applies this solution. Podofilox contains the same active compound, but you can apply it at home.

  Never apply podofilox internally. Additionally, this medication isn't recommended for use during pregnancy. Side effects can include mild skin irritation, sores or pain.

• Trichloroacetic acid. This chemical treatment burns off genital warts, and can be used for internal warts. Side effects can include mild skin irritation, sores or pain.

Don't try to treat genital warts with over-the-counter wart removers. These medications aren't intended for use in the genital area.

Surgery

You might need surgery to remove larger warts, warts that don't respond to medications or, if you're pregnant, warts that your baby can be exposed to during delivery. Surgical options include:

• Freezing with liquid nitrogen (cryotherapy). Freezing works by causing a blister to form around your wart. As your skin heals, the lesions slough off, allowing new skin to appear. You might need to repeat the treatment. The main side effects include pain and swelling.
• Electrocautery. This procedure uses an electrical current to burn off warts. You might have some pain and swelling after the procedure.
• Surgical excision. Your doctor might use special tools to cut off warts. You'll need local or general anesthesia for this treatment, and you might have pain afterward.
• Laser treatments. This approach, which uses an intense beam of light, can be expensive and is usually reserved for extensive and tough-to-treat warts. Side effects can include scarring and pain.