February 8th, 2009
Genital warts are the result of an infection of human papillomavirus. With the development of a vaccine for HPV, the occurrence of outbreaks should be decreasing over the next few years. There are many strains of HPV. Strain 6 and strain 11, two of the more common strains, account for 90% of genital wart outbreaks. Women infected with HPV are at a higher risk for cervical cancer. Strain 16 and strain 18 are responsible for 70% of the cervical cancer caused by HPV. With these facts in mind, the vaccine for HPV, Gardasil, immunizes against all four of these strains.
We get can get genital warts from sexual contact with someone who is infected. There is a 60% chance of contracting HPV from just one sexual encounter with an infected person. The period of incubation is 1–6 months. In women, genital warts manifest on the vulva, vaginal walls, cervix, and around the anus. Men get them on their penis, scrotum, and around the anus. Genital warts have also developed around the mouth or in the throat of someone who has performed oral sex on an infected person. Recent research shows that HPV is gone in 70% of infected individuals after one year and 91% after two years. This is thanks to a healthy immune system clearing the virus out.
Getting Rid of Genital Warts
Effective immunizations for women exist. They recently developed a vaccine for HPV. It immunizes against the four most common strains of HPV. The vaccine comes in three shots administered over a six-month period. The Center for Disease Control (CDC) recommends that all girls between the ages of 11 and 26 be vaccinated. After immunization, you will still need to get an annual pap smear, as it does not protect against all strains of HPV. Cost for the vaccine is about $125 per dose for a total of $375.
Abstinence or really safe sex is always an option in the avoidance of HPV. Abstinence from all sexual contact will insure you an extremely low risk for infection. But that's no fun. So instead, I encourage you to just be smarter about who you sleep with. If you're in a monogamous relationship, you shouldn't have anything to worry about. If you have multiple partners, you are at higher risk for infection. Women should get a yearly pap smear, and if you are over the age of 30, get tested for HPV. Using condoms won't help much because it doesn't cover all the genital skin.
Topical ointments are available from a doctor. Medications that can be applied to the affected area are available by prescription. These topical ointments include imiquimod (Aldara), podofilox (Condylox), trichloroacetic acid, or 5-fluorouracil cream. Don't use over-the-counter wart removers. They are not intended for the use on the genitals. Don't use these treatments if you are pregnant. They could cause birth defects.
Some really bad warts can be removed surgically. There are three surgical procedures to remove warts: laser surgery, cryosurgery, and electrocautery. Cryosurgery is just a fancy way of saying freeze it off with liquid nitrogen. Electrocautery is another way to say burn it off with a hot iron. I bet that smells terrible. Sometimes surgery is recommended for very large warts or warts that don't respond to other forms of treatment. Not everyone with genital warts is a candidate for surgery.
A direct injection of the anti-viral drug Interferon alfa has been used to treat genital warts. The general consensus on Interferon alfa therapy is that it is effective only half the time in removing the warts. It does not cure the person of HPV. Some patients required a second dose of Interferon. With all that in mind, it is also a very expensive drug. You would be better off sticking with topical ointments.
HPV and Your Immune System
Genital warts are just a symptom of a larger problem: the human papillomavirus. And so far as I know, there is no effective treatment for completely getting rid of the virus. But somehow 91% of infected individuals are free from HPV after two years. How is this possible? The answer is simple: your immune system got rid of it for you. Yes, once again our own bodies have protected us from a potential life-long illness. It may not have been able to do it right away, but it got rid of it eventually. In fact, one of the reasons there isn't a bigger push for a vaccine for men is because most men never show any symptoms of having the infection. And it's because their immune systems are able to suppress the virus. I hope that knowing your immune system is fighting for you will inspire you to begin treating your body better by eating balanced meals, taking vitamins, exercising, and getting good sleep. Also, be more thoughtful about picking your sexual partners. It is never a bad idea to have a discussion about venereal diseases with your potential sexual partners except that it's a total boner-killer.