What are genital warts?
In the category of condylomata acuminata, genital warts play a prestigious role: it is a group of sexually transmitted infectious diseases - probably the most widespread venereal diseases - that manifest as rough growths located on the surface of the skin or on the mucous membranes of the area genital.
Causes
Genital warts reflect a viral infection supported by the HPV papilloma virus (belonging to type 6 or 11), the same pathogen involved in the formation of warts in the feet and other anatomical sites. Genital warts are highly contagious lesions, which are transmitted through sexual contact; however, even in the case of sexual intercourse with infected people, some individuals do not become infected, probably due to a highly effective immune system. Not surprisingly, many affected patients are immunocompromised or debilitated, therefore people with a low effectiveness of the immune system.
Symptoms and complications
Genital warts can affect anyone, both men and women; when symptomatic, the genital lesions - after an incubation period varying from one to six months - appear as rough eruptions, more or less evident, circumscribed to the genital area. In humans, warty growths infect, in particular, the glans, the urethral meatus, the frenulum, the shaft of the penis and the balano-preputial groove; in women, on the other hand, genital warts appear more frequently at the level of the vulva, vagina and cervix. Fortunately, warty growths involve pain, irritation, itching and localized burning, of variable intensity, generally weak. Most often, genital warts are so small that they are not visible to the naked eye; other variants, on the other hand, can grow, aggregating and forming small groups of sharp condylomata, which are decidedly more annoying.
Genital warts can also spread orally, in the case of oral sexual contact with infected partners or carriers.
Among the possible complications, the possible repercussions during pregnancy should not be forgotten: in a pregnant woman, the genital warts can magnify, even to create important urinary disorders; moreover, the formation of verrucous lesions in the genital area of women in labor can weaken the elasticity of vaginal tissues, an indispensable factor for a faster birth. Only rarely, the child born to a mother suffering from genital warts can contract warty lesions inside the oral cavity: for this last possibility - however extremely remote - the child will undergo a surgical operation aimed at preventing the obstruction of the airways.
Genital warts and tumor degeneration?
Genital warts are benign neoplastic microlesions that, only rarely, turn into tumors; it is right not to alarm: the probability of malignant degeneration is very low, even if some subjects seem to be predisposed to it, especially AIDS patients and patients with a history of organ transplantation and cancer. It should be emphasized, again, that the possibility of a possible malignant progression of genital warts is heavily conditioned by the type or types of viruses involved in the infection; for example, an underlying co-infection with papilloma virus type 16 or 18 significantly increases the risk of malignant transformation.
To give an example, just think of cervical cancer, which reflects an infection linked to the HPV virus: for this reason, the screening programs recommend performing the PAP test every three years starting at 25 years of age.
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We have seen that genital warts do not always have appreciable symptoms; for this reason, often the affected patient does not realize the infection, and the diagnosis is discovered causally.
The detection of genital HPV infections is essentially clinical; subsequently, we proceed with the analysis of a sample (biopsy) to ascertain whether or not the diagnosis. Often, genital warts are difficult to diagnose immediately, so the doctor can directly apply an acetic acid solution in situ to whiten them and make them more noticeable.
For women who have not performed it in the previous three years, the pap test is recommended, useful to highlight the early signs of cervical cancer degeneration. A more modern test, the HPV test for serotypes with greater malignant potential, can replace the pap test, but only from 30/35 years.
If one of these two tests has a positive outcome, a diagnostic procedure known as colposcopy is indicated to confirm or deny the possible presence of a tumor process affecting the cervix.
Treatment and drugs
Genital warts can disappear spontaneously, without the need for any treatment: young women often have an iron immune system, therefore able to defeat the virus without drugs. Other patients, often immunologically compromised, are not able to eradicate the pathogen by themselves, therefore, in similar circumstances, the administration of drugs is indispensable. Furthermore, the risk of recurrences should be taken into consideration: in order to avoid the reappearance of genital warts, it is recommended to put into practice some simple tricks:
- Scrupulous personal and intimate hygiene
- Avoid applying perfumed intimate creams
- Use mild, never aggressive detergents
- Prefer not too tight clothing
- Avoid synthetic underwear, prefer cotton underwear
- Use a condom, especially in relationships with different partners at risk
However, genital warts can be frozen (literally) with cryotherapy, cold therapy which consists of using swabs soaked in liquid nitrogen to ward off the genital wart: treatment with the cold allows the wart to be removed avoiding the bleeding. Also laser therapy, electrocoagulation and surgical excision are alternative therapeutic techniques, recommended for genital warts that are particularly annoying and resistant to medical treatment (for drug therapy: read the article on drugs for the treatment of genital warts).
It is also recommended to subject the sexual partner (even if asymptomatic) to the pharmacological treatment for genital warts, in order to avoid the rebound effect.
