“Warts" usually appear in only 10% of people carrying HPV, as in many cases the virus is fought by the immune system and does not manifest itself, remaining in a latent state." says Dermatologist - Venereologist Dr. Amalia Tsiatoura.
The human papilloma virus (HPV) is the most common cause of sexually transmitted diseases. There are about 70 different genotypes of HPV and they are divided into high-risk and low-risk. The former are responsible for the development of various malformations, as well as for the development of cancer, especially cervical cancer. The latter are mainly associated with warts, with HPV genotypes 6&11 being responsible for 90% of cases.
The transmission of warts is mainly through sexual intercourse (vaginal, anal, or orogenital), as well as through any contact with the skin or mouth. Transmission of warts is easiest when clinically visible warts are present, whereas in subclinical cases transmission of warts is significantly less, but not non-existent. The appearance of warts occurs either in internal or external areas of the genital organs (internal warts and external warts). In many cases, there is also extensive spread to the surrounding areas. The virus enters the skin and mucous membranes through small lesions in the genital area, which are formed during sexual intercourse.
Today, thanks to the HPV DNA Test, it is possible to make an accurate diagnosis of warts and HPV infections and identify the type of virus responsible for the lesion. We can also determine whether the virus is low or high risk. It is applied to all HPV lesions in both men and women by taking a cervical smear in women or a tissue sample from the lesion in men.
At Cosmetic Derma Medicine, DNA Test is performed in all cases of recurrent genital warts and HPV infections. Our Dermatology & Plastic Surgery Department provides a full range of genital warts treatment, even in a single visit.
This is achieved with CO2 Laser treatment, combined with Surgical treatment where required. Genital warts treatment aims to treat warts radically, where possible, in order to prevent infection or the development of symptoms in the future.
Low-risk HPV genotypes, the ones responsible for the development of warts, can occur in any sexually active person. The only way, therefore, to reduce the risk of infection is to abstain from sexual intercourse or to have intercourse only with a partner who only has intercourse with you. Even the use of condoms does not offer 100% protection against transmission of the virus. If a person develops genital warts, then abstinence from all sexual activity is recommended until the lesions are completely removed.
Because "strict monogamy" is practically impractical, the best way of prevention is to use a condom at every sexual intercourse, not to change sexual partners too often, to regularly visit and get examined by a dermatologist and to apply the HPV vaccine before starting sexual intercourse.
In addition to people who regularly change sexual partners, people with weakened immune systems are more susceptible to infection. The percentage of sexually active men who are about to become infected with HPV is as high as 50%, and research has shown that a woman's chance of becoming infected with HPV is higher in women who consume several alcoholic drinks, as well as in those who have regular sexual intercourse. The riskiest age for a woman is in her 20s and gradually decreases until 35.
The diagnosis of genital warts is clinical, as their form is characteristic and should be carried out by an experienced dermatologist in order to suggest the appropriate method of treatment for the affected area, Whereas biopsy is used only in cases where a differential diagnosis of warts from other lesions occurring in the area and presenting the same clinical picture is required, such as syphilis, nevi, papillomas, warts, infectious tremor, genital malformations and cancers.
The symptoms of genital warts vary and are never the same in every patient. In many cases the virus does not cause warts to appear and is only detected by clinical and laboratory tests. Furthermore, there are cases where warts are not immediately visible as they are covered by the hair in the area. When they do occur, genital warts appear as skin protrusions and may look like small pimples or moles. They may be white or the same colour as the skin and are often extremely difficult to detect with naked eye due to their small size. In this case, they can only be detected with an HPV DNA test and are called "subclinical".
Many times, the symptoms of genital warts can mimic the clinical picture of other lesions, such as syphilis, moles, infectious termites, which can take a brownish form, papillomas and warts. The clinical distinction of the above lesions from warts can only be made by a Dermatologist – Venereologist.
Warts may be numerous, small and isolated, clustered or solitary and quite large with a smooth or blossom-shaped surface. Usually, the symptoms of warts do not include pain or bleeding, but these are not excluded in very large warts that can be injured. The most common areas are:In women, genital warts are usually found on the vaginal area, cervix, labia, urethra and sometimes, more rarely, they may develop on the bladder. The causes that help acute warts to develop are infection with trichomoniasis, some other infections that cause the area to be wetted by vaginal secretions and pregnancy. In pregnancy warts can become hyperplastic strongly exophytic and can spread very easily.
In men, the location of warts is usually in the area of the glans, the penis, the scrotum, the epididymis, the inner petal of the foreskin, the urethra and, less frequently, the bladder. Causes that help acute warts to develop are topical corticosteroid use, urethritis, mucositis, immunosuppression and oxyuria. High incidence rates in the development of warts are seen in HIV carriers, chronic use of immunosuppressive drugs and in cases of diabetes mellitus.
Pregnant women are also potential targets of the human papillomavirus (HPV). In general, infection should not be a cause for concern as it does not cause any problems. However, in some cases, multiple warts may develop or increase in size.
Less commonly, the presence of warts may lead to cellular changes. For this reason, it is very important that all pregnant women have a cervical screening, especially those who have not had a test at least a year before pregnancy.
If there are active warts at the time of delivery, a Caesarean section should be performed.
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