Human Papilloma Virus (HPV)

Most people with HPV infection will not develop visible warts and the virus will go away on its own.

This means you may not know whether you or your partner has the virus. However, if warts do appear, this can happen from three weeks, to many months, or even years after coming into contact with the virus. It does not mean your current partner has cheated on you.

You might notice small, fleshy growths, bumps or skin changes which may appear anywhere in or on the genital or anal area.

In women, warts can be found on the vulva (the lips around the opening to the vagina), cervix (entrance to the uterus [womb]), and upper thighs, in the vagina and on, or inside, the anus.

In men, warts can be found on the penis, scrotum, urethra (wee pipe), the upper thighs, and on or inside the anus.

• You might see or feel them, or your partner might notice them. Often they are so tiny, or so difficult to see, that you don’t even know you have them.
• They can be flat or smooth small bumps or quite large, pink, cauliflower-like lumps.
• Warts can appear on their own or in groups.
•  Genital warts are usually painless but may occasionally itch and cause some inflammation.
• They may cause bleeding from the anus or the urethra.
•  If your flow of urine is distorted this may be a sign of warts in the urethra.

The HPV virus can only be diagnosed if you have the visible warts appear, if you notice the symptoms listed above contact the sexual health clinic to be seen by a doctor or nurse.

The virus is diagnosed by the doctor or nurse looking at the lumps, as most warts are easily diagnosed by looking at them. It is advisable to have a full health screen for other infections whilst you are at the clinic.

Tests taken within a sexual health clinic are treated confidentially, a unique clinic number being issued and used in place of a name for each person attending. Results can be accessed in whichever way is most convenient, whether this is via text, email, telephone, mail, phoning into clinic or via another person  (e.g. friend)

You will only be offered treatment if you have visible warts. The treatment will depend on what the warts look like, how many you have and where they are. The treatment is to remove visible warts, and most people choose to have the treatment as they do not like the sight of the warts and the treatment is likely to make the warts go away more quickly.

How effective the treatment is varies and depends on the size and type of warts, the treatment that is used and how good your immune system is at fighting the virus.

As genital warts are caused by a virus and not bacteria, antibiotics will not get rid of warts.

Visible warts can be removed by:

• Using a cream or a liquid on the warts (for a few days each week), this is usually done by yourself at home. Some people ask a partner to apply the cream or liquid for them if they find it difficult to see the warts. You may have to apply this treatment for a number of weeks before the warts disappear.
• Freezing (cryotherapy) – this treatment is done by a nurse at the sexual health clinic spraying a liquid gas onto the warts to destroy the virus. You may have to attend weekly to fortnightly for follow up treatment.
• Saline bathing (mild salt solution) can help to heal the warts following treatment with cryotherapy.

Some creams can weaken latex condoms, diaphragms and caps. Polyurethane types can be safely used. The doctor or nurse will be able to give advice if needed.

These treatments may be uncomfortable, but they are not usually painful. Treatments can cause irritation and soreness for a couple of days, so the doctor may recommend you use some pain relieving drugs, (paracetamol, ibuprofen or aspirin).

Avoid perfumed soap, bath oils, bubble baths, creams and lotions until treatment is completed as these may irritate the skin.

Tell the doctor or nurse if you are pregnant, or think you might be, as this may affect the type of treatment you are given.

Wart treatments sold at the pharmacy (chemist) are not suitable for genital warts.

In very rare cases the warts need to be treated at a hospital and the sexual health clinic can refer you for this treatment which can be;

• Heat (electrocautery), using local anaesthetic.
• Surgery, using local anaesthetic.

If left untreated genital warts may disappear, stay the same, or grow larger in size or number. Over time most warts will eventually go away without treatment. For some people this may take a long time (years) particularly if you have an illness that affects the way your immune system works, making it difficult to fight off infection. It is not usually harmful to your health if the warts are not treated, but you may find them uncomfortable and may not like the way they look.

Treating the warts may reduce the risk of you passing them on to someone else.

The virus that causes genital warts is easily passed from one person to another through sexual contact. Anyone who is sexually active can get the virus. Both men and women can have the virus, and pass it on.

• Genital warts can spread from one person to another during vaginal or anal sex.

• The virus can be spread by skin to skin contact so it can be passed on by close genital contact. You don’t need to have penetrative sex (vaginal or anal) to pass it on.
• The virus will not pass through a condom but as condoms do not cover all of the genital area it is possible to infect surrounding skin that is not covered by the condom.
• The virus is most likely to be passed on when warts are present but it is still possible to pass the virus on after the warts have disappeared.
• It is possible, but very rare, to develop warts in the mouth or throat, or on the lips from oral sex.
• Warts can spread from the genital area to the area around the anus without having anal sex.
• It is possible for warts on the hand to be passed to the genitals, but this is very rare.
• It is possible for a pregnant woman who has genital warts at the time to pass the virus to her baby at birth, but this is rare.
• You cannot get genital warts from kissing, hugging, sharing baths or towels, from swimming pools, toilet seats or from sharing cups, plates or cutlery.
• If you are worried about passing the virus on speak to a health advisor, nurse or doctor at the sexual health clinic who can explain to you about the virus.
• Some people only ever get one episode of genital warts. For many others, the warts can come back.
• If you do get new warts it is not possible to say if these are due to the original infection or a new infection.

Gardasil is a vaccine that protects against HPV 6 and 11 (genital warts) and HPV 16 and 18 (the types that can cause cell changes that lead to cancer).

All girls aged 12-13 years are currently offered Gardasil as part of a national vaccination programme.