How To Remove Genital Wart?

Introduction 

Definition and overview of genital warts 

Genital warts also known as Condylomata acuminate. Genital warts, a common sexually transmitted infection (STI), are small, rough lumps that can develop around the penis, vagina, or anus. Genital warts may present as papillomatous plaques or flat lesions, either singular or in multiple forms, and can grow in size and/or number. Their colour ranges from flesh-toned to white, pink, or brown.¹ Genital HPV is primarily transmitted through sexual contact, although vertical transmission and autoinoculation have been reported in some cases.² The occurrence is most frequent among younger age groups and the elderly population.³ Advancing age, weakened immune system, diabetes mellitus, and HIV are risk factors for the disease.³

Strains of human papillomavirus (HPV) are the cause of genital warts

While genital warts are not life-threatening, they can cause discomfort, emotional distress, and potential complications if left untreated. This article provides a comprehensive guide on how to remove genital warts, including preventive measures, treatment options, and aftercare.

Diagnosis

Diagnosing genital warts generally involves a physical examination where the provider looks for distinctive growths or lesions. Acetic acid might be applied to reveal warts that are not easily visible. Additionally, a biopsy may be conducted to confirm the diagnosis and exclude other conditions.

The Pap test, or Pap smear, is a screening procedure used to detect abnormal changes in the cells of the cervix and vagina. For women with genital warts, this test helps identify any changes or potential issues related to HPV infection, which can affect these areas. During a Pap test, a sample of cervical cells can be analysed to detect cancer-causing HPV strains.

Treatment Options

Treatment aims to remove the wart but does not completely remove the HPV virus.³ 

Based on the size and extent of the wart, a topical treatment should be the initial recommendation for patients.²

Topical Treatments

Podophyllin and podophyllotoxin: Podophyllotoxin acts by inhibiting the proliferation of human skin keratinocytes.⁴ Topical application of podophyllin solution has been considered as the first choice of drug for the removal of genital warts. Podophyllotoxin is available in various forms: 0.15% cream, 3% cream, 5% solution, and 5% gel.⁴ Podophyllotoxin is not to be used while pregnant or breastfeeding.

The treatment involves applying it topically twice daily at home for three consecutive days, followed by a four-day break. Podophyllotoxin should be applied with caution. Side effects are itching, burning, tenderness, erythema and erosion.⁴ The treatment of genital warts aims to remove the warty tissue rather than eliminate the virus. Treatment options are divided into three categories: topical agents, systemic agents, and surgical therapies.¹

Imiquimod 5% cream

In the late 1990s, the FDA approved 5% imiquimod cream for the immunotherapeutic treatment of external anogenital warts. The recommended regimen involves applying the cream once daily, three times a week, until the warts are completely cleared or for up to 16 weeks.⁵ Erythema is one of the reported side effects.

Sinecatechins- Green tea (leaves of Camellia sinensis, Theaceae)

Sinecatechins are not recommended for use on internal warts or during pregnancy.⁴ Sinecatechins (Polyphenon E) ointment is used for small clusters of warts, less than 30 cm² in size.⁵

Home remedies for genital warts

Although these methods have not been scientifically proven to remove warts some people may consider these natural remedies.

• Tea tree oil
• Apple cider vinegar

Procedural Treatments

Cryotherapy (freezing warts)

Cryotherapy is a highly effective treatment for genital warts, significantly reducing the HPV virus concentration and eliminating the factor that promotes cancer development.⁶ This method can be used during pregnancy. It is recommended to freeze each genital wart individually, with the procedure repeated every 7 days. A maximum of 7 treatments is permitted.

Side effects of this treatment method include exudation, swelling, and pain.⁶

Electrosurgery: this method involves burning warts with electricity

Chemical cautery or chemical ablation: This wart removal method involves trichloroacetic acid ( TCA) with a concentration of 70-100% which cauterises, burns, and dissolves them.^3,7 Pain, bleeding, and burning sensation are some of its common side effects.

Laser therapy

In CO2 laser therapy, a concentrated beam of infrared light energy is used to heat and ultimately vaporize the genital warts being treated.³

It is the preferred treatment for pregnant women with extensive lesions or those unresponsive to TCA.⁷

Surgical excision

The area around the warts is numbed with local anaesthetic and warts can be surgically removed. If warts are large or resistant to other treatments, surgical excision may be employed to physically cut them. This option often leaves a scar and requires stitching.

Preventive Measures

HPV vaccination

The HPV vaccine is recommended to protect against new infections and diseases linked to the virus, including specific cancers.⁸ The HPV vaccine is recommended for administration during early adolescence, as it is most effective when given before any exposure to HPV through sexual activity.³

Safe sex practices 

Consistent and correct use of condoms can reduce the risk of HPV transmission. Also, having fewer sexual partners can reduce the risk of contracting HPV.

Regular medical check-ups

Regular checkups and screening can help detect STIs early, allowing time for timely treatments and reducing the risk of transmission.

Summary

Genital warts can be distressing, but understanding the condition and knowing the options for treatment can help manage the infection effectively. Whether opting for at-home remedies or seeking medical treatment, it is crucial to discuss any concerns with a healthcare provider to determine the best course of action. Additionally, preventive measures, including vaccination and practising safe sex, can significantly reduce the risk of HPV infection and its associated complications. By staying informed and proactive, you can take control of your sexual health and well-being.

Frequently asked questions 

How do I know if I have genital warts?

Genital warts appear as small fleshed-coloured growths in the genital area. They can be raised or flat and may occur as single warts or in clusters. If you suspect you have genital warts, it is important to consult a healthcare provider for a proper diagnosis.

Are genital warts contagious? 

Yes, they are highly contagious and can be transmitted through skin-to-skin contact during sexual activity even if the infected person does not display visible warts or symptoms.

What are the side effects of treatment for genital warts?

Side effects vary based on the treatment method. Common side effects can include local irritation, redness, pain, or a burning sensation at the treatment site. Cryotherapy may cause blistering or scabbing. Always discuss potential side effects with your healthcare provider before beginning treatment.