HPV | WART care at PULSE

Dr.Deyn  | 9 August 2019

What's HPV and how does it spread?

HPV is very common and you can catch it through intimate sexual contact with another person who already has it.

There are over 200 types of HPV. Because it's so common, most people will get infected at some point in their life.

People are often infected without knowing it as there are usually no symptoms and infections tend to go away on their own.

HPV is the most common sexually transmitted infection. HPV is spread mainly by skin-to-skin contact, not just anal and vaginal and oral sex.

Genital HPV infections are highly contagious and usually associated with sexual contact. Nearly all sexually active people get infected with HPV at some point in their lives. The risk increases with the number of sexual partners you and/or your partners have.


What diseases can it cause?

HPV infections that persist can lead to cancers – anal, throat and penile (penis) cancers in men, and cervical cancer in women.

HPV type 16, 18 are the major cause of cervical cancer  and are the main cause of HPV-associated cancers in male and female such as
- Anus and back of the throat, including the base of the tongue and tonsils (oropharynx), in both women and men.

- Penis in men

- Cervixvagina, and vulva in women.

HPV type  6, 11 are the main causes of anal wart and genital wart
HPV type 31, 33, 45, 52, 58 are 15% cause of cervical cancer.


When do genital warts develop?

It may take weeks, months, or years after exposure before warts develop. Sometimes there are asymptomatic carriers of HPV that can infect others. Hence, genital warts may not necessarily translate to unfaithfulness of your partner in some instances, it could be that complicated.


How are genital warts diagnosed?

The diagnosis can be made clinically by the doctor by taking history especially your sexual history and performing a physical examination. The doctor most times makes a “spot diagnosis” by just observation of your perianal area for visible warts.

For women, a full pelvic examination is performed with a pap smear from the cervix taken for further investigation to rule out cervical cancer.

For both males and females, an instrument called proctoscope may be introduced into your rectum for examination and to take samples for investigations.


Can genital warts be treated?

Yes. A variety of treatments are available for established cases of genital warts. The following are treatment options on how to get rid of genital warts:

Podophyllotoxin, 0.5% solution or 0.15% cream. Apply twice daily for 3 days, followed by 4 days’ rest, fore up to 4 weeks. It is suitable for home treatment of external warts. Rub Vaseline or petroleum jelly at the base of the warts before rubbing the cream to avoid burns. Podophyllin should not be used in pregnant women.

  • Imiquimod cream applied 3 times weekly (and washed off after 6-10 hours) for up to 16 weeks is also suitable for external warts. Contraindicated in pregnancy)
  • podophyllin and imiquimod creams are used as home remedies for getting ride of genital warts.
  • Cryotherapy which involves freezing of the warts with liquid nitrogen is also a treatment modality but the rate of recurrence is high.
  • Surgery can be used for genital warts removal. This is done under local or general anesthesia
  • Electrocautery, involving cutting the warts with electric current is a treatment option for warts. It is now discarded because of the risk of inhalation of HPV associated with. An inhaled HPV can cause laryngeal carcinoma to the doctor.

Do you provide Anal wart or genital wart treatment?
Of course we do provide treatment for Anal Warts, Book an appointment for STD test and treat or Consultation. The cost is only 500-600THB per treatment.

We use podophylin or trichloroacetic acid (TCA) following sexually transmitted infections treatment and prevention guidelines. 

Chemical cautery with a solution of 60 to 90 percent trichloroacetic acid (TCA) is most effective when treating few small, moist lesions.

Trichloroacetic acid (TCA) kills genital warts by destroying the proteins in the cells. TCA also can destroy normal cells, which is why you need a careful application by a well-trained doctor. A doctor applies TCA once a week. It is important that only the wart be treated to avoid irritation to surrounding normal tissue.


How Well It Works?

Studies show that TCA treatment can remove warts in up to 80 out of 100 cases after 6 weeks of treatment, depends on the size and location of lesions.
TCA is most effective on small, moist areas of warts.


What are side effects from treatment?

TCA usually causes several minutes of mild to moderate discomfort at the site where it is applied. The medicines are not absorbed easily by the body. So it may cause local skin irritation but not whole-body (systemic) side effects. It is hard to control how deeply the acid penetrates the skin. If the acid burns too deeply, you may have pain, skin irritation, and ulcers which will heal. Common side effects of this medicine include: Burning. Swelling of the area where medicine is applied. Tenderness of the skin.


What else do I need to know?

If large areas of warts are being removed and multiple treatments are needed, doctors may not recommend TCA treatment because of the pain and burning. Genital warts may go away on their own. Treating warts may not cure infection with human papillomavirus (HPV), the virus that causes genital warts. The virus may remain in the body in an inactive state after warts are removed. A person treated for genital warts may still be able to spread the infection. Condoms may help reduce the risk of HPV infection. The benefits and effectiveness of each type of treatment need to be compared with the side effects and cost. Discuss this with your doctor.


Can HPV infection be prevented?

Condoms don't guarantee protection from infection. This is because HPV can be transmitted by skin contact with areas not covered by condoms.

One of the best ways to protect yourself from HPV infection is to get the vaccine. The vaccine protects against 4 types of HPV (types 6, 11, 16 and 18) that can cause cancer and genital warts.

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