GENITAL WARTS

Genital warts is a common STD caused by Human Papilloma Virus. They occur as small pinkish-red irregular lumps either singly or in clusters. Both men and women mostly in the age group of 15 to 40 are equally susceptible for infection. The vulva and the perineum (area between the vaginal opening and the anus) are the areas most affected in women. They also appear on the vagina, cervix and anus. In men, the warts most often appear on the glans, foreskin and urethral opening. They may also appear on the shaft of the penis, scrotum and anus. Genital warts are extremely contagious. The disease is spread by intimate sexual contact: vaginal, oral, and anal sex. The virus is also easily transmitted when the skin or mucous membrane is already injured. People with weak immune systems will have more widespread infections.

Symptoms
The warts appear between one and six months after infection. Symptoms may be slow to appear and are usually painless and if internal they may cause very few symptoms other than slight itching and mild irritation. Symptoms may include discomfort and pain, to bleeding and difficulty in urination (if they occur in the urethra, penis or vagina) and difficulty in swallowing (if they appear in the mouth or throat). HPV can easily be spread unknowingly by infected people.

Adverse effects
Untreated genital warts can eventually spread, grow, and multiply into large clusters. These may cause a variety of health complications depending on where they are located. Genital warts are also closely associated with cancer of the cervix, anus, penis, scrotum, and vagina. Infected pregnant women can pass them on to their newborns, causing many potentially serious health problems for the infant. 

Tests
External warts are usually diagnosed visually. Internally, particularly in women, the urologist or gynecologist will apply a solution of acetic acid (vinegar) to areas where he or she suspects an infection, causing the warts to whiten and making identification easier. A magnifying instrument called a colposcope may be used to diagnose warts in the vagina or on the cervix. A tissue biopsy or Pap smear may be taken to determine if the warts are cancerous. Both infected women and their sex partners should be tested for warts. Female sexual partner of a man with genital warts requires an annual cervical smear test. 

Treatment
Often these warts will disappear without any treatment. There are a wide variety of treatments available for genital wars such as trichloroecetic acid or podophyllin solution which kills the virus. These treatments are applied directly to the infected region and are washed off several hours later. There is a topical cream Aldara for application or interferon which can be directly injected, which is used as a treatment for warts. The warts themselves may require surgical removal by laser, cauterisation, cryotherapy (freezing off external warts with liquid nitrogen) or conventional surgery. These treatments are effective in eliminating the warts but the virus remains. Consequently warts may appear after treatment.