Any unplanned change in appearance is questionable, especially for women. The appearance of any neoplasm is a reason to visit a medical institution, especially when it comes to condyloma.
Condylomas are warts, the appearance of which causes the human papillomavirus. There are several varieties of these warts in the list of which includes the peaked type. All the answers to the most common questions related to genital warts are the topic of this article.
It is interesting
The first classification of human papillomavirus (HPV) was made in the 70s of the 20th century. At this point in time, 400 strains have been discovered, 40 of them are capable of causing genital warts. The most common types are 6 and 11. However, a person can be a carrier of several types of ICP at the same time.
There is no medicine that can defeat HPV, and vaccinations against the virus are also not being done. A virus cannot exist without a carrier and is rapidly inactivated.
External signs and causes
In appearance, the genital warts are very similar to the common wart, the only difference is the stem at the base on which, strictly speaking, the new growth rests.
Touching it does not cause pain, sensitivity is preserved, the color of the warts can be, as close to the color of the skin, and with a pink subtone. Feels soft, the structure of the skin is not broken.
In appearance may resemble cauliflower (florets). The number and diameter of tumors can be very different (from 1 to 100 growths, from the smallest size to several millimeters). The photo below shows one of the variants of genital warts in women and men:
The cause of the appearance is the presence of papillomavirus in the body. There are several methods of transmission:
- Having sex with an infected person,
- When breastfeeding (mother-to-child),
- At the time of delivery (mother-to-child transmission),
- Contact - household (when using the personal hygiene of the infected),
The papillomavirus is very common, according to statistics, every third woman on the planet can find its trace in the blood. However, this does not mean that practically everyone has genital warts. Most people act only as carriers of the virus. And not only women can become infected, but also men, and the probability for both is almost the same. The only difference is that the neoplasms in women appear more often than in men.
Papilloma spread throughout the body with the help of blood, and the main habitat is skin cells. In them it multiplies, which causes a change in the functions of cells and the formation of genital warts. The neoplasm is initially benign, but under certain conditions it can cause the appearance of a malignant tumor.
The latent (latent) period of the disease can be from several months to several decades, therefore the probability that the carrier does not know so much about his diagnosis in his entire life is quite large. In order for the virus to become active and the first visible signs of condyloma appear, a “trigger” is needed, the role of which is a decrease in immunity.
The medical community identifies several possible causes of genital warts:
- Disruption or decreased activity of the immune system,
- Relapse of candidiasis (thrush in women and thrush in men),
- Diseases of the urogenital system of inflammatory nature,
- Unprotected intercourse,
- Overcooling or overheating,
- Constant stress
- Lack of proper rest,
- Hormonal imbalance in women
Particularly high probability of occurrence in women over 25 years old, who do not have a regular partner and have an active sex life.
The main location of the center of education condylomaof women - genitals, anus and mouth. In the photo below you can see neoplasms in the anus area:
Most of the concerns that concern them are:
- Lower abdominal pain
- Small lips irritation caused by wearing underwear
- Drop in the quality of intercourse,
- Scalls that impair appearance and hygiene,
- Discomfort when going to the toilet,
The initial stage of development has its own characteristic symptoms:
- The appearance of itching
- Changing the texture of the skin, the skin becomes noddy to the touch,
- Irritation and redness of the skin on the lips,
In men, the symptoms are similar to those of women, the main place of appearance on the head, bridle or scrotum. Genital warts in men most often appear in places of microdamages. The photo below shows the genital warts on the head of a man.
How is the diagnosis?
Genital warts in women and men are the same. After finding out the reason for the request, the gynecologist or urologist makes a diagnosis:
- Specify the time of unprotected contact,
- Visual inspection (for women in an armchair),
- PCR analysis (scraping skin cells), allows you to determine the type of virus and the degree of its spread,
- Histological examination (examination of the skin area),
- Cytological examination (study of the site at the cellular level)
- Anoscopy (inspection of the anus area)
- Urethroscopy (examination of the urethra). It is conducted to diagnose the channel and search for outgrowths in it
- Taking a sample for oncocytology (in men, a smear is taken from the urethra, in women, the cervical canal and cervix),
- Biopsy. Taking a sample of condyloma for analysis,
- Examination of the mucous membrane of the vagina with a solution of Lugol and acetic acid (for women),
There is also an additional blood sample for analysis, an immunologist and a dermatovenerologist are being visited.
How is it treated?
The treatment is aimed at strengthening the immunity and "taking the virus under control." Those. prevent the emergence of new processes and the deterioration of the patient. Another procedure that needs to be done is the removal of already existing genital papillomas.
Deletion is done locally. There are several removal methods:
- With the help of current (electrocoagulation). Exposure to genital warts with high temperature. In place of the outgrowth a crust forms, which disappears within a few days. The procedure is performed under local anesthesia. Considered to be one of the most affordable and most painful,
- Using nitrogen. The condyloma just freezes, under the influence of low temperature, the protein inside is destroyed. The neoplasm dies off and disappears, in its place a wound appears that heals within 2 weeks. The procedure is performed in the hospital. Pain does not cause, but the cost is much higher
- Using concentrated alkali or acid. The treatment of a neoplasm is performed only by an experienced doctor, it is necessary to observe high accuracy of application, since there is a probability of damage to healthy skin,
- Using radio waves.
- With a laser. Exposure to a narrow beam leads to drying of the condyloma with the formation of a scab (disappears within a week). The advantage of the method is the absence of marks and scars after removal,
- Surgical intervention. It is an obsolete method, rarely used. Performance is possible only under anesthesia, local or general. In place of the incision is a seam. Scars may appear,
Selection of a suitable method depends on the results of the study, technical support and cost of the procedure. And carrying out the removal is possible only after passing the study and testing.
Another direction is the strengthening of immunity, the course of treatment is selected individually based on the analysis of the immune status. This course helps to reduce the activity of the papilloma virus in the body, which leads to slowing or stopping the growth of new warts.
Drugs for treatment
In some cases, anti-herpes drugs are used for treatment, but their effectiveness in the case of genital warts is very low. As often before the removal procedure, the attending physician may prescribe a course of medication, for example:
- Oxolinic ointment (3%). Used to remove tumors. The affected area is treated for 2 weeks 3 times a day,
- Trichloroacetic acid (concentrated 80-90%). Causes local tissue death, but refers to weak drugs. Assigned to pregnant women
- Solkoderm. Apply to the affected areas and cause them to die. It is applied from 1 time per week to 1 time per month,
- Feresol. Condylomas are treated once a week, the drug is a mixture of tricresol and phenol,
- Podofillin. Application is possible only in a medical institution, is produced in the form of a solution with a concentration of from 10 to 25%,
Acute warts and pregnancy
A characteristic phenomenon for the CIS countries is the lack of planning measures for pregnancy. And most often, a woman finds out about the presence of a particular disease already during pregnancy when visiting a antenatal clinic.
A woman in an interesting position, the body works in a different mode, and any, even the most harmless, at first glance, the disease can be dangerous.
During pregnancy, a woman’s immunity drops sharply and the likelihood that the virus is activated increases dramatically. During pregnancy there is no danger for the baby in the womb. but condyloma in women on mucous membranes and in the vagina can lead to significant and even dangerous for mother and baby complications during childbirth. It:
- Obstruction of the birth canal,
- Breaks in the vagina and small lips,
Therefore, if a condyloma appears in a pregnant woman, then after all the research, she is prescribed a course of drugs that are safe for her and the baby, allowing for a reduction in the rate of condyloma. Removal is made only in the 3rd trimester shortly before delivery.
If there is no treatment and removal, then during the childbirth, the baby risks contracting the condition of the larynx with the condition of the larynx if his first breath occurs during the passage through the birth canal. In such situations, the expectant mother is under caesarean section.
If the warts are removed, then the probability of infecting the child is close to zero. Genital warts in women only planning to become mothers require a complete examination, removal of these tumors and undergoing a course of treatment before pregnancy.
One of the main and most dangerous complications is the formation of a malignant tumor from benign warts and the further appearance of skin cancer.
Side and not so dangerous complications are: the formation of ulcers on the mucous membrane, on small lips, bleeding, inflammation and the formation of pus with trauma growth. It is characteristic of condyloma that if the blood is removed improperly, it is difficult to stop the blood, and in place of one growth, several new ones usually appear.
The next type of complications are developing problems of the reproductive system. Papillomavirus can cause erosion or dysplasia on the cervix and in women with further education of oncology.
Genital warts in men able to cause inflammation of the urethra, which in turn leads to difficulty urinating and severe pain.
The treatment process is also important. On how correctly it was carried out depends on the further quality of life of the patient. With the wrong or unprofessional removal of the warts are possible:
- Desensitization of the genital lips,
- Scars and scars on the head and mucous membranes,
- Loss of tissue elasticity, which is dangerous, especially for women planning children,
- Narrowing of the vagina
- Formation of re-neoplasms
Is there prevention?
Measures for prevention of genital warts are, their list includes:
- Permanent partner
- Regular medical examination
- Maintaining immunity
- Healthy lifestyle,
- A varied and balanced diet
- Full rest,
Even people with papillomavirus in the active phase can lead a full life. This is not a sentence, such people are quite able to live actively, have a family and children. For them, some precautions and strict personal hygiene are necessary.
Definition of the disease. Causes of disease
Genital warts - formations on the skin caused by the presence of human papillomavirus (HPV) in the tissues. Activation of viruses leads to the appearance of growths on the skin surface in the anus, the external genital organs and the anal canal.
Another common synonym for this pathology is anogenital warts. This disease is described by Hippocrates as a "genital wart". It is sexually transmitted and prone to relapses.
Anogenital warts are bulky soft outgrowths of a pale pink color with an uneven surface protruding above the skin surface. The size and number of warts range from single warts 1-2 mm in diameter to multiple, often draining formations up to 9-10 cm in size and even more.
Condylomas can appear and grow to significant sizes in just a few days.
The reason for the appearance of warts is the presence of human papillomavirus in the blood. The virus enters the body through sexual contact through defects in the mucous membrane or skin. The perinatal route of transmission is possible - the child becomes infected during labor from a sick mother as it passes through the birth canal. There is also a contact-household transmission path, but the data on this transmission variant are few.
For a long time after infection, a person may be unaware of his HPV carrier state.. The incubation period depends on the characteristics of the individual's immunity and can last from two months to three years. Later, with a decrease in the activity of immune mechanisms, warts (warts) appear in characteristic locations.
HPV is one of the most frequent sexually transmitted infections (STIs) - up to 55-65% of the total number of diseases. Its danger also lies in the fact that the carrier may be unaware of its disease and not have external signs of infection (growths, warts).
Most often, HPV is diagnosed in young people aged 18–25 years. Sexual contact, even with the use of barrier contraceptives (condoms), is likely to infect partners.
There are up to 600 types of HPV (HPV), some of which appear as skin warts on the chest, face, and underarms. Others choose the localization of the mucous membranes of the mouth, genitals or anal canal. In anogenital warts, 6 and 11 types of HPV (papillomavirus) are more often detected.
Symptoms of genital warts
Outside of exacerbation, the presence of HPV in the blood does not manifest itself. When a viral infection is activated symptoms of the disease can appear in just a few hours:
- the formation of genital warts (often in the places of the greatest trauma, friction during sexual contact):
- on the skin around the anus, in the perineum, on the bridle, the head of the penis, the lips of the external opening of the urethra in men,
- on the mucous membrane of the genital lips in women, in the urethra in men,
- itching, burning, discomfort at the site of the appearance of warts - such unpleasant sensations are often very intense and significantly affect the patient's well-being,
- feeling of a foreign object in the anal canal (with the formation of warts inside the anus),
- the release of a small amount of blood in the form of scarlet stripes during defecation (if the warts are located inside the anal canal and are injured during the passage of fecal masses),
- dysuria, painful urination, if the warts are in the urethra,
- pain during intercourse (dyspareunia).
Another option for the manifestation of HPV can be the presence of papules with a velvety surface in the crotch area or spots of grayish-brown, pink or reddish-brown color. Such morphological forms are much less common and often cause difficulty in making a primary diagnosis.
Pathogenesis of genital warts
The key point in the pathogenesis of the disease is the penetration of HPV into the host organism. With a single sexual contact, the probability of infection is 80%, then in good condition of the immune system, infectious agents are eliminated (destroyed).
Viruses of various types are adapted to a specific host. There are hundreds of types of viruses, many of them are not dangerous for humans, as they are tropic to the tissues of mammals, reptiles and birds and cause benign tumors in them (formation of papillomas).
In the study of HPV identified three types of viruses - alpha, beta, gamma. Of these, anogenital lesions cause papillomaviruses of the first group (α). Infectious agents belonging to the Beta and Gamma genera are more common in case of papillomas of the cornifying epithelium — plantar, palmar warts appear.
At birth, when classifying viruses, types (genotypes) were identified. They are denoted by Arabic numerals. Of the hundreds of virion genotypes, particles with a high carcinogenic risk are identified - these are α 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59. They are detected in 90-95% of cases in malignant cervical processes , vagina and vulva. 16 and 18 types are especially significant. Such oncogenic types of HPV, containing E6 and E7 proteins in their DNA, are capable of suppressing the activity of p53 and pRb tumor suppressor proteins, leading to a rapid malignant transformation of papillomas into carcinomas.
About 90% of cases of anogenital warts are caused by HPV α 6 and 11. These are pathogens of low carcinogenic risk. This low risk group includes HPV 40, 42, 43, 44, 54, 61, 72, 81.
Virions through microscopic damage penetrate into the basal layer of the epithelium, then attach to the proteins of the cell membrane. Then they use the mechanism of receptor endocytosis (with the participation of integrin and L1 protein from the viral capsid) and enter the cytoplasm. Protein L2 from the capsid of the virus contributes to the release of the virus DNA and its penetration into the nucleus.
Proteins E1 and E2 from the DNA of the virus are involved in the replication of a foreign genome in the nucleus of the affected cell. At the same time, the cell retains the ability to divide and reproduce its own DNA. Multiplying its DNA, the virus ensures its presence as episome in the cytoplasm (about 100 per cell). Such joint “work” of the virus and the host cell leads to a failure in the processes of proliferation (cell reproduction) and differentiation in the basal layer, leading to visual manifestations.
Abnormal endophytic or exophytic outgrowths of the epithelium appear - papillomas, spots or condylomas. Loose mucous membrane or atypical epithelium of the processes is prone to rapid traumatization and maceration (softening). Against this background, a secondary infection more quickly joins, pain, discomfort, abundant discharge, inflammation, swelling, unpleasant smell, and ulceration of the condylo appear.
In the cells of the basal layer, active replication of the virus occurs, and as the cells of the warts differentiate, their blood supply is drastically depleted, reducing the central vessels. But, remaining in the upper layers of the epithelium in an inactive form, it is here that the virus is dangerous in terms of contact infection.
During histopathology of biopsy materials, the epithelium is thickened, areas of acanthosis, papillomatosis are detected. Coylocytes (resizable cells with bright cytoplasm, multiple vacuoles, perinuclear bright rim) are detected. Their nuclei are hyperchromatic. Often there are cells with two nuclei or more.
From the above, we can conclude that the viruses that cause the formation of anogenital warts, in 90% of cases, belong to the types α 6 and 11 HPV. With a low degree of probability, they can cause malignancy (cancerous degeneration). However, there are frequent cases of joint persistence (stay) of viruses of various types in one carrier. This obliges the patient and the doctor to pay special attention to preventive examinations, their quality and regularity to prevent anorectal cancer.
Classification and developmental stages of genital warts
Genital warts are the most common, classic manifestations of human papillomavirus infection of the skin and mucous membranes in the anogenital area - up to 65% of the number of sexually transmitted diseases.
Other diagnostic findings can be:
- papule warts
- mucosal infiltration in the form of pinkish-gray or brown spots,
- intraepithelial neoplasia,
- bovenoid papules, Bowen's disease is a separate type of papules, they appear as spots on the mucous membranes of a reddish-brown, orange-brown color, on the skin the color of the formations is grayish-pink,
- giant papilloma (Bushke - Levenshteyna). Its growth begins with genital warts, which quickly grow in size and quantity, merge and turn into a large tumor with an uneven surface covered with vegetations and villous-like projections.
Although the disease (giant papilloma) is associated with virus types 6 and 11, with a low risk of carcinogenesis, it is in the case of giant papillomas that the suppressor protein of p53 tumors is suppressed, and the formation is transformed into squamous cell carcinoma. The reason for such frequent malignancy (malignancy) may be the presence of immunodeficiency states, associated infections, chronic dystrophic skin conditions (scleroatrophic lichen, lichen planus). Even after radical surgical treatment of papilloma Buschke - Levenshteyna is prone to frequent recurrence.
Complications of genital warts
Aesthetic problems. The rapidly growing tissue of the condylo, in addition to physical discomfort, brings a lot of inconvenience to the patient. Outgrowths in the region of the external genital organs, the anus significantly reduce self-esteem and interfere with full sexual life and proper hygiene.
Suppuration, inflammation. Anogenital warts tend to be quickly injured with minor mechanical effects or friction. These microtraumas, wounds become a gate for secondary infection. Erosions, perifocal inflammation appear. Wounds begin to macerate (soak), suppurate. With the development of complications join the unpleasant smell and pain. It is impossible to carry out a thorough hygienic treatment of the perianal area due to overgrowths, which further aggravates the inflammatory process.
Malignancy. The types of viruses with high carcinogenic activity, persisting (being long) in the skin and mucous membranes, lead to the transformation of cells and their transformation into atypical (cancer) cells. As already mentioned, anogenital warts are usually not as dangerous in terms of cancer transformation as a viral lesion of the cervix (HPV 16, 18 types, etc.). But the problem may arise if the patient has two or more types of virus with different carcinogenicity indices and there is an immunodeficiency state.
Relapse after surgical treatment. In the presence of a viral infection in the body, it is impossible to get rid of it, because the virions have already penetrated into the cells, passing through the protective membrane. Surgical treatment can radically eliminate visible symptoms. If you stop only on the removal of warts, then the probability of relapse will be up to 50-60%. Conservative treatment with immunomodulators will significantly reduce the activity of the HPV DNA reproduction process, the reproduction of foreign elements will stop. The risk of relapse will be already 10%, but they will remain in the cytoplasm inside the cells in the form of epis and will be “ready” for a massive onset with a decrease in the immune mechanisms in the host organism - such moments can happen during stressful situations, in the case of acute diseases and exacerbations of chronic ones. That is why relapses often occur, and warts reappear.
It is important to change the way of life in general in order to constantly maintain health and prevent activation of dormant virions.
Diagnosis of genital warts
When detecting genital warts in the perianal zone, the purpose of additional diagnostic studies is to clarify the HPV genotype, as well as the exclusion of structures that are externally similar to them:
- intradermal nevus
- molluscum contagiosum,
- syphilitic chancre,
- seborrheic keratosis.
A quick way to establish HPV in the formations (condylomas) during the reception is a test with a 5% solution of acetic acid. Under the influence of this substance, papillomas, caused by HPV, turn pale, acquiring a grayish, pale tint, in which a characteristic capillary pattern is visualized. The study is preliminary in nature.
Minimal laboratory tests:
- serological reaction to pathogens of syphilis,
- detection of antibodies to HIV, hepatitis B, C,
- PCR for virus typing,
- cytology of cervical smear in women
- cytology of smears,
- study of biopsy specimens and distal formations - anogenital warts.
With frequent recurrences of the disease, large sizes of tumors, their rapid growth, or a dubious diagnosis, they resort to additional methods of research.
With frequent exacerbations, a study of the immune status is conducted.
If you suspect a malignant degeneration of the warts, papillomas on a broad basis, atypical vaginal or rectal secretions are performed:
- Ultrasonography vaginal and rectal sensor,
- Ultrasound of the abdominal organs,
- x-ray of the chest,
- STI studies.
Often patients are sent for consultation to the gynecologist, urologist, oncologist and dermatovenerologist.
Treatment of genital warts
In the case of genital warts, an integrated treatment approach is most effective. It is imperative to inform the patient about the need for treatment of sexual partners, their possible carrier of HPV.
General recommendations are given on the need to modify the lifestyle in order to maintain an adequate state of immunity, to prevent additional infection with other STIs:
- streamlining sexuality
- use of barrier methods of contraception,
- weight correction
- sufficient exercise
- proper nutrition, etc.
Used drugs that stimulate the local and humoral immune response. This is necessary, since all patients with papillomatous lesion revealed violations of interferon status (innate immunity system). Contraindications to immunomodulatory therapy are papillomas on a broad basis.
- rectal suppositories with “Genferon”,
- "Panavir" in the form of ointment and injection,
- "Inosine pranobex" for oral administration according to the scheme.
Symptoms can be reduced in three out of four cases (up to 84%) with single condylomas of small size.
With a persistent, recurrent course of the disease, as well as if the patient is concerned about aesthetic aspects, for the prevention of cancer transformation they resort to surgical methods.
Depending on the size, shape, location of the condyloma and the surgeon’s preferences, chemical, physical, cytotoxic removal methods can be used.
Physical methods used for any size and location of anogenital warts. A scalpel, laser vaporization, cryodestruction (destruction of the wart tissue by extremely low temperatures under the influence of liquid nitrogen) or radio wave method (radioSURG) is optionally used.
Tissues excised inclusive with its own plate of the dermis. If the condyloma of the anal canal is removed, the internal sphincter forms the bottom of the wound. In the perianal zone, the bottom of the wound should be subcutaneous tissue.
Removal of formations is not carried out without consulting an oncologist, if there is the slightest suspicion of malignancy (ulceration, necrosis, infiltrative growth).
Usually, when excision of condyloma, local or spinal analgesia is enough (reduction of sensitivity to pain). Hospitalization can be carried out in cases of some concomitant diseases (coagulation pathology and others), as well as in case of impossibility of outpatient treatment.
Cytotoxic methods suggest the use of drugs "Podofillin" and "Podofillotoksin." There are restrictions to the use of the method: only a few small condylomas located outside the anal canal and vagina are treated with this type. The use of drugs in every fifth case can cause a local reaction in the form of irritation, itching, inflammation, etc. The frequency of relapses ranges from 31 to 70% of cases.
Chemical methods imply the use of 80-90% solution of trichloroacetic acid, “Solkoderma” (combination of concentrated acids) or “Feresol” (combination of tricresol and phenol). The action of drugs is based on local destruction of papillomas: a necrotized area of coagulated tissue is formed, the warts are mummified and disappear. The method is effective for small single warts. The recurrence rate is less than the previous method.
The prognosis for timely and adequate treatment of genital warts is favorable. It is necessary to conduct a histological examination of distant lesions to exclude the diagnosis of a malignant tumor. In doubtful cases, additional consultations by a gynecologist, dermatologist, oncologist, radiologist, laboratory and instrumental examinations are necessary.
With complex treatment, all symptoms usually disappear. However, relapses are not excluded, the frequency of which varies from 10 to 50% and more. The patient’s general health, the presence of concomitant diseases and immunodeficiency states affect the increase in the risk of relapse.
- timely, preventive examination by a gynecologist, urologist and proctologist,
- correction of lifestyle, nutrition,
- streamlining sex.
Before sexual activity, you can follow the vaccination scheme with the polyvalent HPV vaccine of 6, 11, 16, 18 types (the most common causes of genital warts are HPV 6 and 11) and cervical cancer (HPV 16 and 18). The recommended age for vaccine administration is 9–17 years (for example, in the US calendar of 2015, the recommended vaccination age is 9–11 years). In a number of countries (USA, Austria, Germany, France, etc.) vaccination is included in the mandatory vaccination schedule. In Russia, this is currently a voluntary procedure.
Is it possible to understand that there is a problem?
External manifestations of such ailment as condilomatosis occur, however, not always. Therefore, many people learn that they are affected by the human papillomavirus only after examining blood for infections, which are usually sexually transmitted.
If you notice small shoots of pink or flesh-colored, which are located in the intimate areas, then this is most likely the manifestation of the disease under consideration. Genital warts in men can spread to all genitals.They are found on the pubic part, on the head of the penis, on its crown, on the bridle, on the foreskin. Often they extend to the anus. But this does not mean at all that a man prefers non-traditional intimate relationships, and not only they cause candilomatosis in this area.
Genital warts in women can appear on both the large and small labia, in the vagina itself and on the eve of it, in the area of the external opening of the urethra. They also affect the cervix. Not an exception is the hymen, if it has not yet been damaged. But even the apparent absence of manifestations does not mean that there is no disease. It happens that they can be considered only after special treatment of the skin.
This type of warts often affects several areas at once. Solitary warts can combine to form large growths. As a rule, they are painless, but some people talk about the appearance of itching and irritation.
Danger of warts
Do not think that enough to get rid of the external manifestations of the disease. It is very important to suppress the virus that causes genital warts. Treatment should be aimed at strengthening the immunity and the fight against microorganisms that caused this infection. Sometimes it takes several months and does not always produce results from the first course. But throw therapy halfway should not be at least for the reason that almost 90% of patients who have discovered cervical canal, were infected with human papillomavirus.
The presence of this infection does not mean that you will develop oncology, but people affected by it are at risk. They should be more attentive to their health. Malignant growths can develop in the vagina, on the penis, or in the anus.
Diagnosis of infection
Syphilis, which causes skin changes, also called broad condylomas, or molluscum contagiosum, can also give similar manifestations. Therefore, when detecting condylomas are recommended to be tested for HIV and syphilis, as well as a number of other sexually transmitted infections.
Treatment of manifestations of human papillomavirus infection often begins with the fact that they remove growths. Removal of genital warts can be performed by one of the following methods: electrocoagulation, cryodestruction, and laser therapy. They are also sometimes simply cut with a scalpel or scissors.
The most appropriate method should be chosen exclusively by the doctor depending on the manifestations of the disease. But do not forget that his preferences will be affected by the technical equipment of the clinic where he works. Therefore, at first it is important to independently figure out what are the methods of getting rid of the manifestations of the disease, how they differ. Knowing this, you can not rely on the equipment, which is equipped with a regular city hospital, and pick up a medical center with the latest equipment, with the help of which the genital warts are removed. Treatment with this approach in some cases will be more effective.
If the patient has recurrent relapses, and genital warts appear after removal again, then it is recommended to change the tactics of dealing with the manifestations of the disease. In this case, laser treatment is recommended. It is also used if a large area is affected. But laser procedures are quite painful, therefore, local, and in some cases even general anesthesia is required before they are performed. With a laser beam, all genital warts are destroyed. The reasons for their appearance still need to be treated. This means that simply removing the manifestations of the disease by this method is not enough. Antiviral and immunostimulating therapy is required. Otherwise, warts may appear in adjacent areas.
Despite its high efficiency, this method has many disadvantages. So, first of all, patients talk about the high cost of the procedure, which is not available to every patient. Also referred to as negative moments are a long period of healing and scarring.
The treatment is carried out by a specialist who must be dressed in overalls and have a mask on his face, because during the burning of the warts with a laser, pieces of the virus get into the air and create the potential danger of infection of others.
New growths can also be removed by exposure to high temperatures. This procedure is called electrocoagulation. It is done using local anesthesia. The main disadvantage is that scars remain after it. As with the laser procedure, personnel must be protected. Particular attention is paid to the shelter of the respiratory tract. The room where the removal of warts, should be equipped with a special hood.
Alternative methods for getting rid of the problem
Genital warts must be lubricated with a special applicator twice a day with an interval of 12 hours. This is done for three days, after which a break is taken. Its duration can vary from 4 to 7 days. Courses are repeated until the complete disappearance of the manifestations of the disease.
Also, the pharmaceutical industry developed Imiquimod Cream, which is applied directly to genital warts in men. Treatment with its use can last up to 16 weeks. Stop its use as soon as warts disappear. It can also be used by women if these warts have affected only the external genitalia.
Your doctor may prescribe a course of such drugs as Proteflazid, Interferon, Viferon, Isoprinosine, designed to combat various viruses. Particular attention should be paid to strengthening the immune system. For this you can use both medical stimulants and tempering procedures.
Given that human papillomavirus infection is quite widespread, there are many non-drug methods to combat the manifestations of the disease. With their help, you can completely remove genital warts in men. Treatment consists of using plant materials to combat skin warts in intimate areas. By the way, these methods can also be tested by women, but only if the affected area does not affect the mucous membrane.
One of the most common ways is to use garlic. On the area affected by warts, you can apply a compress. To do this, cut off the plate from a clove of garlic to the size of education and fixed on the warts with a plaster. Also, warts can be lubricated with the juice of this plant.
Very often there are recipes in which genital warts are treated with the help of pharmacy tincture of celandine. It is applied at least three times a day on the warts. People say that all manifestations of the disease take place somewhere in a month.
Onion compresses are also popular. They need to impose 7 days in a row. For this, the onion is cut in half and soaked in vinegar. Heated it, attach the cut to the warts overnight. Do not forget to fix the remedy.
Some advise lubricating formations of raw egg white. It is also recommended to make applications from the dough, which is mixed with flour and vinegar.
The risk of infection will be minimized if barrier contact methods are used at every sexual intercourse. Only condoms are included. When using other methods of protection, the risk of infection is quite high. Although condoms do not provide one hundred percent protection, because during sexual intercourse, skin areas that it does not cover are in contact. Therefore, the most reliable method is the proximity only with the surveyed partner who does not have this virus in the body. But if you see that the genitals are affected by condominal candidiasis, it is better to refrain from contact.
Regular visits to the gynecologist and conducting all the necessary research is the best way to monitor your health. For example, if you have already suffered from HPV, then colposcopy is recommended every year.
To prevent infection with this virus, two vaccines were developed: Cervarix and Gardasil. The first of them prevents infection of the 16th and 18th types of high-oncogenic virus. It is designed for girls aged 10 to 25 years, in whose body there is no infection.
The vaccine "Gardasil", as well as "Cervarix", protects against the 16th and 18th types of the virus, in addition, it is still effective against the 6th and 11th species. It is intended for persons aged 9-26 years.
Clinic and symptoms
Infection occurs through contact (sexual way - this is the same contact route of infection).
The source of infection is condyloma in a sick person, that is, modified cells of the skin or mucous membrane in which the virus develops.
The condyloma itself may not yet be seen by the eyes, but there are already altered cells on the skin. Upon contact with the skin of another person, the virus from these cells gets on his skin, penetrates into microcracks and begins to develop in the skin.
- small bubbles and bumps on the skin and mucous membranes,
- slight redness around
- slight itching
- formations grow in size up to 1-1.5 cm
- the appearance of "cauliflower" or "cockscomb",
- itching increases
- next appear new bubbles.
- Genitalia: groin, pubis, genitals in man and woman (glans, foreskin, vulva, vagina, labia),
- anus (anus). This arrangement gave the second name: anogenital warts.
- rarely - inside the urethra and on the cervix,
- rarely in the mouth, lips, cheeks and tongue.
1) in adults, the main mode of transmission is sexual.
2) very rarely is the contact way of transmission possible - through a dirty rim of a toilet bowl, taking a common bath, using common hygiene items, common cutlery, etc. The virus persists for several minutes in a viable state in a warm, humid environment. This mechanism of transmission explains such cases when genital warts are detected in virgins, in children.
3) condoms reduce the risk of transmitting HPV. But not 100%. Contact of unprotected skin during intercourse (for example, contact of the scrotum and labia) - risk of infection.
From the moment of sexual contact until the appearance of the formation - 2-3 months or more. If the immunity is strong, then this period can last for several years or even decades.
At the time of weakening of the immune system appear warts. In women, sometimes during pregnancy, when there is also a strain on the woman’s immune system.
What is the immune system and how it works is described in detail HERE.
How to improve immunity - read HERE.
Complications of condyloma.
- Condyloma inflammation
- Trauma and ulcers
- Phimosis and paraphimosis in men (narrowing of the foreskin)
- Disease progression
- Infection of the child in labor.
Attention: warts do not affect the ability to get pregnant.
Diagnosis - how to make a diagnosis?
- The characteristic picture is "cauliflower", "cockscomb".
- Sexual contact 2-3 months in advance.
- Acetic acid test. A cotton pad is moistened with 5% (.) Acetic acid. Position it on the affected area for 5 minutes. If after 5-10 minutes the area turned white, then this is a condyloma.
- PCR diagnostics. Find out the number and type of HPV virus. It is advisable to immediately pass on the disease, sexually transmitted diseases (STDs). Often condilomatosis is combined with other STDs - trichomoniasis, chlamydia, syphilis, etc.
- Women - required (.) examination of the cervix and taking a cytological smear to exclude dysplasia and cervical cancer. Read more about dysplasia and CIN here: link.
- Control analysis of PCR for HPV is performed 2 months after the end of treatment.
Genital warts in the initial stage can be confused with:
- Pyoderma (acne and ulcers) on the skin of the pubis and genitals.
- Filamentous papillomas on the hips.
- Molluscum contagiosum in the pubis and genitals (read about molluscum contagiosum)
- Red lichen planus on the genitals (read about lichen planus)
- Pearly papules. They can occur in both men and women. And this is a variant of the norm. This is not condyloma at all. But in order to distinguish them from venereal diseases, it is better to consult a doctor (venereologist, urologist or gynecologist).
1) Liquid nitrogen, or cryodestruction.
Read more about the technique read HERE
Liquid nitrogen freeze papillomas on the labia, penis, on the skin in the groin area. In this case, the papilloma dies off, falls off. The frostbite site heals quickly. The method is effective, but should be carried out by an experienced specialist.
About what types of papillomas are, I tell in detail here.
2) Cauterization with Necrotizing Substances
Concentrated acids, alkalis and a number of other substances cause chemical burns of warts. She dies off and falls off. In its place remains a small wound, which heals quickly.
You must be very careful with cauterizing agents so as not to burn healthy skin around, otherwise there will be a scar. Treatment of condylomas with such aggressive substances should only be carried out by a doctor.
- Super Cleaner (read more about the product - link).
The drug contains alkali. It is extremely aggressive to the skin, therefore it is mainly used for the removal of common warts. On the skin of the genitals is not recommended.
The drug contains phenol and metacresol. It acts softer, scarring almost does not remain. Can be used on the skin in the groin area.
The drug acts gently, but the treatment period is longer.
More about solkoderma here
The drug contains nitric, acetic and oxalic acids, which burn the tissue of warts.
Scheme: It is necessary (!) to smear the skin around with a cream to protect it, apply 1 drop of solcoderm to the condyloma once with an applicator, if the formation is large, then 2-3 drops, so that they cover the entire surface, not flowing to healthy skin, a break - 1 week, if education not gone, then repeat processing.
- Condilin, or podofilin.
Detailed instructions here
This drug contains the substance podophyllotoxin. It delays the division of human cells, thereby destroying them.
If you smear the surface of condyloma with warts, it will decrease in size. The drug is dangerous for healthy skin. Treatment should be under the supervision of a physician.
Scheme: skin around is treated with cream, 2 drops a day with an applicator apply 1 drop to the surface of each formation, or more, if the condyloma is large, the time for drying the condilin is 3-5 minutes, repeat the treatment for 3 days, then a break for 4 days.
Read more about laser removal here.
And here's a reader review of laser removal: link.
Removal of condyloma by laser - low-impact and low-painful. The laser beam evaporates the formation. A small wound quickly tightened.
Watch the video of papilloma removal with a laser:
This excision of genital warts by electrocautery. The surgeon relieves the tissue with novocaine. Then the electrocautery burns the warts. The operation is not easy and can have consequences in the form of scars on the skin.
On the video: removal of papillomas by a coagulator.
5) Radio wave method, or Surgitron apparatus. In more detail about this method I tell here
The excision of the condyloma by radio waves of high frequency. This method is similar to a laser. But the apparatus "Surgitron" is very expensive, so the price of this procedure is also high. There are no complications after it.
In the photo: the device Surgitron
6) Scalpel removal
Outdated technique. It is rarely used - only for large sizes. It is performed under local anesthesia or under general anesthesia. After excision with a scalpel, the skin is sutured with surgical sutures.
- Isoprinosine (or groprinosin): 2 tablets - 3 times a day, 14-28 days. More detailed instructions: here.
- Allokin-alpha: 1 ampoule, the powder is dissolved in 1 ml of 0.9% sodium chloride, injected subcutaneously 1 time in two days, the course - 6 injections. Detailed article about allokin: link.
- Epigenes intimate spray: spray the area of the warts 4 times a day throughout the entire period of treatment. Details about the epigenes: link
- Panavir: available in different forms - gel, spray, suppositories, injection solution - it all depends on the prevalence and localization of condyloma. Details about Panavir: link
The following immune preparations are used in the general course of treatment for condylomas: immunal, polyoxidonium, cycloferon, reaferon, leukopid and a number of others.
Attention: Immunostimulants are drugs. They must be prescribed by a doctor.
- Immunal: on 1 tabl - 4 times a day, a course from 2 to 8 weeks.
- Reaferon: Dilute 1 vial powder (1 mln. ED) with water (half a spoon), drink 30 minutes before meals - 2 times a day, for 10 days.
- Polyoxidonium: 1 candle (12 mg) inside the vagina or into the rectum overnight every day - 10 times.
Detailed article about the immune system and its functions: read.
- therapeutic methods of treatment only complement the surgical, so that after the removal there is no recurrence,
- relapses occur in 30% of patients who have had warts removed,
- Independent cure for warts can be, but rarely. The basis of self-healing - strengthening immunity,
- viruses in large numbers are in the thick of each condyloma, so they must be removed.
Treatment of folk remedies
1) Tincture of iodine.
I do not recommend. Lose time and health.
Lubrication of the surface with condylo tincture of iodine gradually dries it, and it should fall off. BUT: this does not always happen, but very, very rarely. In addition, lubrication of the skin and mucous membranes with iodine can cause burns and the appearance of further scars.
And most importantly - iodine is absorbed through the skin, accumulating in the thyroid gland, and in excess leads to disruption of the thyroid, which is very, very bad. Take care of your thyroid, go to a cosmetic clinic or a dermatologist, and he will remove your tumors quickly and painlessly.
2) Celandine (grass!).
More details about the celandine here.
Genital warts are smeared with fresh celandine juice several times a day. BUT: the effect of such lubrication is positive only if the condyloma is small in size - several millimeters in diameter. If it is large, then there will be no effect. Spend time in vain.
In this case, it is better to do this: remove a large condyloma in a cosmetic clinic or from a dermatologist. And the little ones nearby - grease with celandine.
3) Healthy lifestyle in all its forms: hardening, healthy eating, minimizing stress, eliminating alcohol and tobacco, adequate sleep, exercise and walks in the fresh air.
Recall a sanatorium or a rest home - its entire regime is aimed at improving the body's defenses. Try as much as possible to repeat the regime of the day of the sanatorium, and your immunity will gradually begin to deal with such misfortunes as genital warts or other viral infections.
More about pathology
Genital warts are papillary warts formed on the skin surface of the genital organs and the anus. In rare cases, warts are formed in the oral cavity. These are specific skin tumors that occur when an organism is infected with the human papillomavirus (HPV). Condylomas often form peculiar clusters that look like cauliflowers. A fragrant liquid containing more viral particles can be released from the damaged wart. Such manifestations of HPV infection lead to only minor pain and psychological discomfort, but there is also a risk of malignant degeneration of abnormal cells or dysfunction of organs.
Unlike non-hazardous mother-of-pearl papules, which form in the area of the penis in men, genital warts are soft and diverse in shape. The appearance of such tumors increases the likelihood of transmission to the sexual partner. In this case, the warts may not form immediately or have a small size, so not all patients seek medical attention in a timely manner. To reduce the risk of infection by vaccination.
HPV infection is a sexually transmitted disease. In most cases, the pathology does not appear symptomatic and is spontaneously resolved, however, patients often have benign tumors in the genital area, the anus and the oral cavity. Flesh-colored warts are the only sign of HPV infection. Studies have shown that the growth of such tumors increases the risk of cancer of the cervix, vagina, penis and anus.
Experts know a large number of types of HPV, differing genome and virulence. Genital warts usually appear when human papillomavirus 6 or 11 is invaded. These pathogen varieties are less likely to provoke malignant tissue degeneration, but the risk of carcinogenesis remains. In addition, several types of virus can be detected in a single person. In this regard, it is recommended to carry out vaccination in a timely manner and be regularly examined by a venereologist with an active sex life.
Human papillomavirus is the most common sexually transmitted infection. According to epidemiological data, the disease in a hidden form can be detected in 40% of people. In most patients, the infection does not manifest symptomatically, and the warts of the anogenital region are found only in 1% of sexually active men and women. The highest risk of HPV complications is in HIV-infected patients, since only a healthy immune system can suppress the activity of the virus.
Skin changes occur on the background of viral invasion and changes in the nature of cell division. However, in 90% of cases, HPV infection is transmitted through oral, vaginal or anal sex. Using a condom significantly reduces the risk of infection with oncogenic HPV strains, however, the types of virus that cause genital warts can also be transmitted during protected sexual intercourse.
Other ways to transmit the virus
- Domestic infection. The infectious agent can persist in the external environment and enter the new organism through skin microtraumas.
- Transmission of the virus to the newborn during childbirth. In this case, the baby may appear warts in the larynx.
- Self-infection - the transfer of infection from one anatomical region to another.
Despite the fact that in 90% of cases, HPV infection is eliminated by a healthy body within two years after infection, the pathogen may persist in infected cells and cause symptoms of the disease several years after invasion. Also note that the virus can be transmitted to the sexual partner, even in the absence of warts in the genital area.