Miami urologist David Robbins, MD has extensive experience in the diagnosis and treatment of Genital Warts (HPV warts).
Genital Warts are skin growths that occur in the genital region and around the anus. They are caused by certain subtypes of the Human Papilloma Virus, known more commonly as HPV.
While there are more than 100 subtypes of HPV, types 6 and 11 are the most common cause of genital warts. Other subtypes can cause warts of different parts of the body such and the feet and hands. Type 16 and 18 are more closely associated with cervical cancer.
According to the CDC, 79 million Americans are currently infected with HPV and 14 million people become infected every year. HPV infection is so common that at some point in life, nearly all sexually active men and women are exposed to a strain of HPV.
Genital warts are passed directly from skin to skin contact during sexual interactions most commonly during vaginal or anal intercourse. HPV does not require fluid transfer for transmission; therefore, condoms are not effective in preventing transmission. HPV can be passed from one individual to another even when one partner does not have any active signs or symptoms of genital warts.
Genital warts can be found on the mouth or genital areas including the penis, scrotum, vagina, vulva, cervix, and rectum. Genital warts typically appear as small raised lesions or bumps in the genital area. They can grow to larger lesions with varying appearances including raised, flat, or cauliflower-like. Genital warts commonly occur after a few weeks or months with an infected individual. Warts can resolve spontaneously, remain the same, or increase in size and number.
In most instances, genital warts are painless and asymptomatic, however, in some people, genital warts can cause bleeding, itching, or even urethral obstruction. Although genital warts can grow on any individual infected with HPV, they grow more rapidly on individuals with diabetes, HIV/AIDS, individuals on chemotherapy, or those taking immunosuppressant medications for an organ transplant.
Genital warts can be diagnosed by their common appearance on the skin, however, only your health care provider can accurately diagnose genital warts. Remember that all small bumps in the genital region are not necessarily genital warts. Bumps may represent benign skin tags, penile papules, and other non-HPV lesions. Dr. Robbins will often send a small biopsy on the initial presentation of a patient with a suspicious genital lesion to confirm the diagnosis of an HPV-related genital wart.
Regular condom use can help prevent the transmission of HPV-related genital warts, however, they are not completely effective because not all HPV-infected skin areas are covered by condoms. Abstinence or decreasing one’s number of lifetime sexual partners can help decrease the risk of HPV transmission and genital warts.
For young girls and women from 9 to 11 years old, there are two vaccines Cervarix and Gardasil which protect against the types of HPV that cause most cervical cancers. These vaccines are also shown to be effective in helping to prevent HPV-related genital warts. These vaccines should typically be given between age 9 and 11 however they are recommended for young women through the age of 26 years who did not previously receive the vaccine.
For young men, age 11-12 Gardasil vaccine is shown to protect against genital warts and anal cancers. It can also be used for men up to age 26 especially for those at elevated risk with multiple sexual partners or men who have sex with men.
In about 10-20% of people our body can fight off the virus on its own and genital warts will disappear spontaneously. However, in many people genital warts do not resolve spontaneously, or more commonly they are bothered by the appearance of warts and would like treatment. When genital warts are small and few, there are topical gels and creams such as podophyllin and Imiquod which are effective. A physician can apply Trichloroacetic Acid (TCA), a chemical that burns genital warts.
There are many quick and easy office-based treatments for genital warts that can be performed with local anesthesia. These techniques are minimally invasive and highly effective. These include:
Electrodesiccation: This highly effective and minimally invasive technique involves using an electric current to destroy warts. Miami urologist, David Robbins, MD uses this technique most commonly in the office for the treatment or removal of genital warts.
Cryotherapy: This technique involves freezing warts with liquid nitrogen.
For more extensive warts or warts involving the urethra, it may be necessary to make a trip to the operating room. In the operating room, various techniques can be employed under general anesthesia. For larger warts or patches of warts that are close in proximity, surgical excision can be employed which may include circumcision in males. A C02 laser is additionally highly effective for the treatment of larger or more advanced genital warts. If a trip to the operating room is necessary, David Robbins, MD is associated with Miami Medical Center, Aventura Hospital, and Medical Center in Aventura, Jackson North Medical Center as well as North Shore Medical Center.