From the Guidelines
Most people with Human Papillomavirus (HPV) infection do not exhibit any symptoms, and the infection often clears on its own without treatment. When symptoms do occur, they vary depending on the HPV type. Genital warts, which appear as flesh-colored or gray growths in the genital area, are the most common visible symptom of low-risk HPV types (especially types 6 and 11) 1. These warts may be flat or raised, single or multiple, and sometimes have a cauliflower-like appearance. High-risk HPV types (such as 16 and 18) typically don't cause visible symptoms until they've caused serious health problems like cervical, anal, or throat cancer. Some people might experience itching, burning, tenderness, or bleeding in the genital area if warts are present. HPV can also cause common skin warts on hands and feet, or flat warts on the face or legs, depending on the virus type.
Key Points to Consider
- Most HPV infections are asymptomatic and clear within 1-2 years 1
- Persistent infection with high-risk types of HPV is the most important risk factor for cervical cancer precursors and invasive cervical cancer 1
- Regular screening through Pap tests and HPV testing is crucial for early detection of abnormal cell changes before cancer develops
- HPV vaccination before exposure to the virus provides the best protection against infection and related diseases 1
Recommendations
- HPV vaccination is recommended for 11- and 12-year-old girls and for females aged 13–26 years who did not receive or complete the vaccine series when they were younger 1
- The quadrivalent HPV vaccine can be used in males aged 9–26 years to prevent genital warts 1
- Correct and consistent male condom use can lower the chances of giving or getting genital HPV, but such use is not fully protective because HPV can infect areas that are not covered by a condom 1
From the Research
Human Papillomavirus (HPV) Symptoms
- HPV infection is the most common sexually transmitted infection in the United States, with more than 200 types identified 2
- Most HPV infections are transient and subclinical, but some lead to clinical manifestations ranging from benign papillomas or warts to intraepithelial lesions 2
- Persistent infection with high-risk mucosal types, especially HPV-16 and HPV-18, can cause anal, cervical, oropharyngeal, penile, vaginal, and vulvar cancers 2
- Genital warts are a common symptom of HPV infection, with an estimated prevalence rate of 15 percent in the US population 3
- Genital warts can manifest clinically as single or multiple lesions that may coalesce or be the same color as surrounding skin, cauliflower-like, flat, papular, or keratotic 4
Risk Factors
- A history of multiple sex partners; initiation of sexual activity at an early age; not using barrier protection; other sexually transmitted infections, including HIV; an immunocompromised state; alcohol use; and smoking have been identified as risk factors for persistent HPV infections 2
- Transmission of genital warts can be effectively prevented with vaccination 4
- Current evidence regarding the effects of condom use on the prevalence of genital warts is conflicting 4
Treatment Options
- Treatment options for genital warts include topical treatments such as podophyllin resin, imiquimod, trichloroacetic acid, and podophyllotoxin, as well as surgical or destructive therapies like carbon dioxide laser, surgical excision, loop excision, cryotherapy, and electrodessication 3
- Podofilox 0.5% solution is the most effective patient-administered therapy, and carbon dioxide laser therapy, surgery, and electrosurgery are the most effective for wart removal at the end of treatment 4
- Treatment of choice depends on the number, size, and location of lesions, as well as patient preferences, cost, convenience, adverse effects, and clinician experience 5