Genital Warts and Their Treatment

Bulaşıcı hastalıkların neden olduğu parazitler, virüsler, bakteriler ve enfeksiyonlar vücutta deri yüzeyinden beyne kadar çeşitli yerlerde belirti gösterebilir.

Infectious diseases caused by parasites, viruses, bacteria, and infections can manifest symptoms in various parts of the body, from the skin surface to the brain.

Infectious diseases caused by parasites, viruses, bacteria, and infections can manifest symptoms in various parts of the body, from the skin surface to the brain. Infections that occur in the genital area are significant issues that can affect an individual's living conditions and health. Genital warts, caused by viral infections in this area, can be observed in both men and women. Genital warts can appear on the genital organs, around the anus, and may be accompanied by itching, irritation, and sometimes bleeding. The agent responsible for warts among genital infections is the “Human Papilloma Virus” (HPV). HPV has a significant prevalence among sexually transmitted viral infections.

What are Genital Warts?

The Human Herpes Virus, known for its most recognized agents HPV 6 and 11, is a type of pathogen that settles in the genital area of both women and men and is named according to its location. The disease it causes is called condyloma acuminatum. In women, it can be found around the vulva, anus, groin, and cervix; in men, it appears on the testicles, scrotum, groin, and anus. Brown or red bumps resembling moles may form, sometimes manifesting as small, barely visible red skin lesions in the infected area. Patients may not notice these viruses in asymptomatic stages and may fail to take early action for treatment. Another virus that causes genital warts is the poxvirus, known as the smallpox virus. The smallpox virus rarely settles in the genital area and responds quickly to treatment. However, HPV-related genital warts can present more serious clinical pictures. Although complete recovery from HPV-related warts is not expected, treatment aims to control wart outbreaks. Genital warts are transmitted through sexual contact or skin contact with the genital area of an infected person.

Causes and Risk Factors of Genital Warts

The causes of genital wart infections can vary from person to person, and multiple factors may justify a viral infection. Among these, the most common causes are types of HPV. The HPV types that cause genital warts can be divided into those that only cause warts on the skin surface and those that can lead to cancer. The most common cancer-causing HPV types are 16 and 18, while those that cause warts on the skin without cancer are HPV 6 and 11. HPV generally appears at an early age, presenting more seriously in women at younger ages. Risk factors that cause genital warts can be listed as follows:

• Impaired or suppressed immune system: The immune system is the most important system in the body that fights against viruses and other pathogens. If it does not function normally, the risk of infection increases.
• Contact with someone who has genital warts: Engaging in anal, oral, or vaginal intercourse with someone who has a wart infection poses a risk to the individual. Additionally, even if there is no direct sexual intercourse, contact between a healthy individual's genital organs and a skin surface that has touched the genital area of an infected person is also a risk.
• Unprotected sexual intercourse: Using condoms during intercourse reduces the risk of infection. However, it is not accurate to say that the risk of infection is 100% prevented, as skin contact with exposed infected areas in the genital region during sexual intercourse is also a situation to be avoided.
• Multiple partners: Having sexual relations with multiple partners is a significant source for acquiring and transmitting infections. An individual may carry the virus without showing symptoms, but another individual who has contacted the same person may quickly show symptoms if their immune system cannot suppress the virus, presenting a more serious condition.
• Active sexual life at a young age: Beginning sexual life at an early age can lead to more serious cases, such as cervical cancer, due to not noticing or treating genital wart infections in later years. Additionally, genital wart infections are notably diagnosed more frequently in women aged 18-24. While men may experience it at slightly older ages, early diagnosis has been recorded in both genders.

What Are the Symptoms of Genital Warts?

The differences in individuals' immune systems play a significant role in the symptoms, causes, treatments, and all stages of viral infections. In some individuals, warts may only appear as reddish, slightly raised skin lesions. This can lead to delays in seeking medical help and starting treatment promptly. In other cases, raised, cauliflower-like warts may develop, which can be brown or lighter than the surrounding skin. Generally, pain and discomfort do not accompany either situation. This may prevent individuals from suspecting genital warts and seeking immediate treatment. Warts can appear not only in the genital area but also in the mouth and lips, throat, hands and feet, groin, and abdominal area. Due to the sexually transmitted nature of the disease, the genital organs are the first areas where lesions are observed. Additionally, oral intercourse with an infected individual can lead to warts around the mouth, while anal intercourse can cause warts around the anus, and other skin contact can lead to warts on limbs. Genital warts can progress without symptoms or with symptoms, and their numbers can increase. Particularly in women, genital warts forming around the vagina can cause bleeding due to the stretching of the vagina. Especially in pregnant women with genital warts, the viruses transmitted from the cervix to the baby can cause warts in the baby’s throat, leading to respiratory difficulties. This means that HPV infections occurring in the mother can be transmitted to the baby during the prenatal period. After contact with an individual infected with HPV, the incubation period lasts between 2-6 months before the infection develops. However, no infection may develop after some contacts.

How is Genital Wart Diagnosed?

The severity of symptoms related to genital warts varies from person to person, making accurate diagnosis and treatment crucial. Genital warts observed at an early age can lead to cancer if left untreated. In women, these may progress to cervical cancer, and in men, to penile cancer; in both genders, oral and throat cancerous tissues may also develop. The diagnosis of genital warts is made using several different methods:

• Vaginal examination with a speculum
• Collection of a sample using a Pap smear test
• Direct visualization of warts through colposcopy
• Biopsy and blood tests
  Patients diagnosed with genital warts through differential diagnosis tests receive treatment based on the condition of the infection and the viral load in their body.

How are Genital Warts Treated?

In the treatment of HPV, which causes genital warts, the focus is on completely removing the lesions from the skin rather than claiming a total cure. Even if treatments to alleviate symptoms and complaints are applied, the warts can recur as long as the virus remains in the body. Various treatment methods aim to reduce and completely stop the patient's wart outbreaks:

• Cryotherapy (freezing)
• Burning lesions with cautery or laser beams
• Surgical removal of enlarged lesions through incision
• Dermatological treatment of warts with creams that modulate the immune system
• Destruction of lesions using methods similar to radiofrequency ablation
  After treatment, it is recommended to avoid contact and sexual intercourse for a while to allow the affected area to heal. Additionally, the treatment aims to maintain the patient's body function values within a normal range with medications that regulate and strengthen the immune system. Patients are advised to pay attention to personal hygiene, nutrition, and to avoid unprotected relationships with multiple partners. Effective healing is observed as long as the patient follows the doctor's recommendations after treatment.