Condyloma acuminatum

Genital warts (or condyloma, or condylomata acuminata) is a very contagious sexually transmitted disease. Caused by some variants of the Human papillomavirus, typically HPV 6 and HPV 11, it is spread during oral, genital, or anal sex with an infected partner. About two-thirds of people who have a single sexual contact with a partner with genital warts will develop warts, usually within three months of contact. more...

In women the warts occur on the outside and inside of the vagina, on the opening (cervix) to the womb (uterus), or around the anus. While genital warts are approximately as prevalent in men, the symptoms of the disease may be less obvious. When present, they usually are seen on the tip of the penis. They also may be found on the shaft of the penis, on the scrotum, or around the anus. Rarely, genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.

Genital warts often occur in clusters and can be very tiny or can spread into large masses in the genital or anal area.

Treatment

Genital warts often disappear even without treatment. In other cases, they eventually may develop a fleshy, small raised growth that looks like cauliflower. There is no way to predict whether the warts will grow or disappear. Therefore, if you suspect you have genital warts, you should be examined and treated, if necessary.

Depending on factors such as the size and location of the genital warts, a doctor will offer you one of several ways to treat them.

• Imiquimod, (Aldara®) a topical immune response cream which you can apply to the affected area
• A 20 percent podophyllin anti-mitotic solution, which you can apply to the affected area and later wash off
• A 0.5 percent podofilox solution, applied to the affected area but shouldn’t be washed off
• A 5 percent 5-fluorouracil cream
• Trichloroacetic acid (TCA)
• pulsed dye laser
• liquid nitrogen cryosurgery

If you are pregnant, you should not use podophyllin or podofilox because they are absorbed by the skin and may cause birth defects in your baby. In addition, you should not use 5-fluorouracil cream if you are expecting.

If you have small warts, the doctor can remove them by freezing (cryosurgery), burning (electrocautery), or laser treatment. Occasionally, the doctor will have to use surgery to remove large warts that have not responded to other treatment.

Some doctors use the antiviral drug Alpha Interferon, which they inject directly into the warts, to treat warts that have returned after removal by traditional means. The drug is expensive, however, and does not reduce the rate that the genital warts return.

Although treatments can get rid of the warts, they do not get rid of the HPV virus, so warts can recur after treatment. However, the body's immune system typically clears the virus anywhere from 6 months to a year. There is even some suggestion that effective treatment of the wart may aid the body's immune response. An effective HPV vaccine is currently undergoing a phase III FDA trial and appears nearly 100% effective against the most common types.

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