Genital warts are often diagnosed by appearance. Sometimes a biopsy might be necessary.
In a Pap test, a vaginal speculum holds the vaginal walls apart to show the cervix. Next, a sample of cells from the cervix is collected using a small cone-shaped brush and a tiny plastic spatula (1 and 2). The brush and spatula are rinsed in a liquid-filled vial (3) and the vial goes to a laboratory for testing.
For women, it's important to have regular pelvic exams and Pap tests, which can help detect vaginal and cervical changes caused by genital warts or the early signs of cervical cancer.
During a Pap test, a device called a speculum holds open the vagina. The health care professional can then see the passage between the vagina and uterus, called the cervix. A long-handled tool collects a small sample of cells from the cervix. The cells are examined with a microscope for abnormalities.
Only a few types of genital HPV have been linked to cervical cancer. A sample of cervical cells, taken during a Pap test, can be tested for these cancer-causing HPV strains.
This test is generally reserved for women age 30 and older. It isn't as useful for younger women because for them, HPV usually goes away without treatment.
If your warts aren't causing discomfort, you might not need treatment. But if you have itching, burning and pain, or if you're concerned about spreading the infection, medication or surgery can help you clear an outbreak.
However, warts often return after treatment. There is no treatment for the virus itself.
Genital wart treatments that can be applied directly to your skin include:
Imiquimod (Aldara, Zyclara). This cream appears to boost your immune system's ability to fight genital warts. Avoid sexual contact while the cream is on your skin. It might weaken condoms and diaphragms and irritate your partner's skin.
One possible side effect is skin redness. Other side effects might include blisters, body aches or pain, a cough, rashes, and fatigue.
Podophyllin and podofilox (Condylox). Podophyllin is a plant-based resin that destroys genital wart tissue. A health care professional applies this solution. Podofilox contains the same active compound, but you can apply it at home.
Never apply podofilox internally. Additionally, this medication isn't recommended for use during pregnancy. Side effects can include mild skin irritation, sores or pain.
- Trichloroacetic acid. This chemical treatment burns off genital warts, and can be used for internal warts. Side effects can include mild skin irritation, sores or pain.
- Sinecatechins (Veregen). This cream is used for treatment of external genital warts and warts in or around the anal canal. Side effects, such as reddening of the skin, itching or burning, and pain, are often mild.
Don't try to treat genital warts with over-the-counter wart removers. These medications aren't intended for use in the genital area.
You might need surgery to remove larger warts, warts that don't respond to medications or, if you're pregnant, warts that your baby can be exposed to during delivery. Surgical options include:
- Freezing with liquid nitrogen (cryotherapy). Freezing works by causing a blister to form around your wart. As your skin heals, the lesions slough off, allowing new skin to appear. You might need to repeat the treatment. The main side effects include pain and swelling.
- Electrocautery. This procedure uses an electrical current to burn off warts. You might have some pain and swelling after the procedure.
- Surgical excision. Warts can be cut off during surgery. You'll need local or general anesthesia for this treatment, and you might have pain afterward.
- Laser treatments. This approach, which uses an intense beam of light, can be expensive and is usually reserved for extensive and tough-to-treat warts. Side effects can include scarring and pain.
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Preparing for your appointment
You're likely to start by seeing your health care professional.
What you can do
Make a list of your:
- Symptoms and when they began. Describe your symptoms and note whether your sexual partner has had similar symptoms.
- Sexual history, including all recent exposures to possible sources of infection, particularly if you've had unprotected sex or sex with a new partner.
- Key medical information, including other conditions you're being treated for.
- All medications, vitamins or other supplements you take, including doses.
For genital warts, some basic questions to ask your doctor include:
- What tests do I need?
- Should I also be tested for other sexually transmitted infections?
- What treatment approach do you recommend, if any?
- How soon after I begin treatment can I expect to get better?
- Am I contagious? How can I reduce the risk of passing this infection to others?
- Should my partner be tested for this condition?
- When can I safely have sex again?
- Will my genital warts come back?
- Am I at risk of complications related to genital warts?
- How often should I be screened for other health conditions related to genital warts?
- Are there printed materials I can have? What websites do you recommend?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you questions, including:
- How severe are your symptoms?
- Do you practice safe sex? Have you always done so?
- Have you recently had sex with a new partner?
- Has your partner been tested for sexually transmitted infections?
- Have you had the HPV vaccine? When?
- Are you pregnant or planning to become pregnant?