Genital Wart (Condyloma)

What is Genital Wart (Condyloma)?

Genital warts are benign skin growths that look like a lump, usually the size of a pinhead. They are reddish, brownish or grayish white in color. Condylomas colonize the genital or anal area and are among the most common sexually transmitted diseases. Genital warts usually occur in large numbers and are close together. In this case, doctors talk about wart beds. The formations do not normally cause any discomfort, but they can cause itching in sensitive skin areas.

As with almost all types of warts, condylomas are caused by human papillomaviruses, or HPV for short. They enter the body mainly through unprotected sexual contact. HPV types 6 and 11 are most commonly found in genital warts. Unlike types 16 and 18, experts estimate that the risk of cervical cancer is very low with these papillomaviruses. Viruses nest in the upper layers of the skin, but do not necessarily lead to a wart. However, if there are also favorable factors, such as a weak immune system, they can cause the skin to proliferate and warts to form.

The doctor usually recognizes genital warts by their characteristic appearance. It examines not only the affected part of the body but also the anus, rectum, vagina and cervix, as structures can spread there unnoticed.

Condylomas have different treatment strategies depending on where they are located and to what extent they occur. Patients usually have to apply special solutions or creams for several weeks. Especially stubborn warts can also be surgically removed.

Causes and Risk Factors of Genital Warts (Condyloma)

Genital warts are caused by the human papillomavirus, or HPV. Viruses primarily infect the skin through unprotected sexual intercourse. They can penetrate the upper layer of skin or mucous membranes and nest there through minor injuries to the penis, vagina, anus or rectum.

Rarely, HPV can also be transmitted through sharing towels or bathing with an infected person. If a mother has contracted pathogens, she can transmit the viruses to the newborn during birth.

There are numerous types of HPV. Types 6 and 11 usually cause genital warts. Types 16 or 18 are also very rarely found in skin growths. These two HPV types are considered the main risk factors for cervical cancer. However, experts think that the likelihood of a genital wart developing into a malignant tumor is very low. For example, eczema, discharge and thin tears in the skin or mucous membranes caused by a fungal infection in the genital area can promote virus transmission. Genital warts are more likely to develop when the immune system is weakened, as this is when viruses can multiply particularly quickly. People with HIV/AIDS or taking medications that suppress the immune system (immunosuppressants) may experience condylomas more often.

Genital Wart (Condyloma) Symptoms

Genital warts are benign skin growths. They are usually the size of a pinhead, but can sometimes be even larger. Condylomas are reddish, brownish or grayish white. They usually appear in large numbers and stand close together. Doctors talk about wart beds. In women, genital warts usually grow on the labia, the entrance to the vagina, the cervix and sometimes the urethra. In men, the foreskin, glans, anus, urethral inlet and rectum are mainly affected. Usually, this type of wart does not cause pain or other discomfort. However, itching, burning and increased discharge sometimes occur.

The psychological stress on those affected causes much bigger problems. People with genital warts in the genital area often feel ashamed and guilty. They also limit their sex life for fear of infecting their partners.

How is Genital Wart (Condyloma) Diagnosed?

If genital warts are suspected, the doctor will examine the anus and genital area. If he finds characteristic skin areas, he examines them more closely. If necessary, the doctor will take a small tissue sample (biopsy) under local anesthesia and examine it under a microscope.

If genital warts are on the mucous membranes of the intimate area, diagnosis can be more difficult. For this reason, internal condylomas often remain unnoticed for a long time. A colonoscopy can be performed if genital warts are present in the rectum. If they affect the urethra, urethral endoscopy may be considered.

Since human papillomavirus is sexually transmitted, the infected person's sexual partner should also be tested.

How is Genital Wart (Condyloma) Treated?

External genital warts can usually be treated by the person affected. For this purpose, the doctor may prescribe a solution or cream containing the active ingredient podophyllotoxin. Or prescribe a cream containing substances such as imiquimod with epigallocatechin gallate.

Podophyllotoxin inhibits cell division and causes the infected cells in genital warts to die. Epigallocatechin gallate is a green tea medicine. It also causes regression of condylomas through various mechanisms of action - but only if used in very high concentrations. Imiquimod activates the skin's defense system, causing the body's own immune cells to attack wart pathogens more intensively.

Patients should take these medicines regularly for several weeks. If skin irritation occurs, the doctor may - depending on the severity - discontinue treatment for a few days until the skin calms down again.

For some patients, such as internal genital warts, self-treatment is out of the question. The doctor then removes the condylomas using different methods, depending on where they are and how extensive they are. For example, if small genital warts appear on the mucous membrane of the vagina, urethral opening or anal canal, the doctor may use trichloroacetic acid. This acid kills genital warts. To do this, the doctor applies the substance to the skin growths with a cotton swab and repeats the treatment at weekly intervals.

Alternatively, you can freeze genital warts by applying liquid nitrogen to the affected areas with a cotton swab. Since both procedures can cause pain, the doctor may use local anesthesia beforehand, depending on the location, number and size of the skin growths.

What should be considered during pregnancy?

Since podophyllotoxin inhibits cell division, pregnant women should not use medicines containing this active ingredient. If the expectant mother has genital warts, they must be treated by a doctor. The doctor chooses an appropriate therapy.

Why do genital warts often reappear?

Genital warts can recur (relapse) even if they disappear after treatment. This is possible with all the therapy methods mentioned. Therefore, regardless of whether the person concerned treats condylomas or the doctor removes the warts. The reason for this: Viruses cannot always be completely eliminated by treatment. In addition, cells located near condylomas may already be infected with the virus. Despite this, the skin in these areas does not look conspicuous from the outside. In special cases, it may therefore be advisable to treat the surrounding skin with ointment in addition to the visible genital warts or to carry out a comprehensive follow-up treatment after surgical removal of the skin formations.

How to Prevent Genital Warts (Condyloma)?

Human papillomavirus (HPV) is transmitted primarily through direct skin contact or smear infection through unprotected sex. Condoms can therefore reduce the risk of genital warts if they are on the vagina or penis. However, condoms offer no protection if skin growths have formed elsewhere in the genital area.

If one partner is already infected, the other should avoid direct skin contact with affected areas. Separate bath and hand towels are also recommended.

Depending on the vaccine, the HPV vaccine can protect against infection with various types of human papillomaviruses. Its primary aim is to prevent cervical cancer.