1. Condyloma = definition
Genital warts are also commonly called genital warts. It is a sexually transmitted disease caused by viruses. Certain strains of these viruses may be responsible for the appearance of cancers, in particular that of the cervix.
However, condyloma can affect both men and women, mainly at the start of their sexual life. These condyloma are due to human papillomaviruses and manifest themselves in the form of small warts at the level of the genitals.
Where do warts develop in men and women?
In humans, warts develop on glans, frenulum, foreskin, urinary orifice and anus (even directly inside the rectum). They are usually painless, but can be itchy.
In women, they appear on vulva, perineum, labia majora and labia minora. It can also develop in the region surrounding the anus, and manifest itself years after contamination. It is a painless infection, which can lead to itching or even bleeding during sexual intercourse.
As a general rule, people infected with the viruses responsible for condyloma manage to eliminate them without having felt the symptoms. Others, on the contrary, will develop symptoms. The responsible virus is then eliminated through treatment.
The different types of warts
There are three types of warts:
– Condyloma acuminata: they are the most frequent. They take the form ofgrowths of skin, pinkish or whitish. They can be single or multiple, localized or disseminated. This type of condyloma is usually benign. The other types of condyloma arouse more mistrust;
– Papular warts: they have the appearance of small dry pimples, the same color as the skin. They are generally isolated or in sheets.
– Flat warts: they are generally invisible to the naked eye and look like red spots, even dew. They are revealed by the application of 5% acetic acid.
2. Symptoms of condyloma
The symptoms of these external warts are mostly visual. They develop in the form of particular lesions. In men, they are present particularly in the penis, the foreskin, the glans and the perianal region. And in women, they mainly develop in the vulva, perineum and perianal region.
These lesions may appear several months after infection. Depending on their type, warts do not have the same appearance: large red or pinkish pimples, multiple pimples, budding lesions… When warts are visible to the naked eye, their shapes can be flat, raised or in the shape of a “cockscomb”. They can sometimes lead to itching or bleeding during intercourse. This is why the development of condyloma usually leads to a significant physical and psychological discomfort.
These warts can also appear in the mouth, urethra, vagina or cervix.
3. The causes of condyloma
Genital warts are the result of infection of the skin and mucous membranes by a family of viruses: human papillomaviruses (HPV).
There are low cancer risk HPVs, which are generally responsible for condyloma. These are located at the level of the external genitalia and the anus. Much more rarely, they can be found inside the vagina, urethra or anal canal.
There are also HPVs with a high risk of cancer. These are associated with the development of precancerous and cancerous lesions, particularly in the cervix, vagina, vulva, anus and penis.
How do you get condyloma?
Genital warts spread through direct sexual contact, with or without penetration. Contamination may also occur through contaminated objects or clothing, although this is rarer. The probability of contracting the virus increases when the subject has an active sex life, with many sexual partners. Unprotected intercourse and STDs (sexually transmitted diseases) also favor contamination by human papillomaviruses.
Transmission of infection also depends on the effectiveness of the immune defenses of the person. This explains in particular the fact that only one of the partners is affected. Certain immunosuppressive diseases or certain immunosuppressive drugs favor the disease.
4. Condyloma: when to consult?
It is necessary that quickly consult a gynecologist after a risky sexual relationship unprotected. The patient is also advised to make an appointment as soon as warts appear on his genitals. The doctor can then prescribe screening tests.
He is important to detect quickly, warts can cause some complications in some people. Specific strains of the virus can promote the appearance of cancers, from infected cells: cancer of the cervix, vulva, anus, rectum and sometimes, of the penis. Persistent infection causes infected cells to turn into precancerous cells and then into cancerous cells. In pregnant women with warts, contamination of the child can occur during childbirth and cause warts in the infant’s mouth, but this remains quite rare.
5. Examinations and diagnosis of condyloma
Sometimes the diagnosis is quite simple, with the lesions visible to the naked eye. It is however essential to carry out additional tests, in order to look for the possible existence of cancerous lesions at the level of the cervix.
The existence of condyloma also requires a examination of less visible parts which may also be suspicious, such as the anus, vagina, etc.
The doctor can then request an anoscopy: this examination makes it possible to detect condyloma inside the anus. He can also perform a ureteroscopy to visualize the inside of the urethra, in case some condyloma is located at the level of the urethral meatus. These tests are only carried outin case of clinical doubt or location of warts near the anus or urethral meatus in men.
Finally, a biopsy can also be performed in case of diagnostic doubt. It can also be done if the genital wart resists treatment.
6. How to treat genital warts?
Most genital warts disappear without any intervention. The others will need treatment. There are different types, which aim to make the lesions disappear. However, any treatment does not protect the patient from recurrences. There are three ways to treat warts: chemical, surgical or drug, via the taking of immunomodulators.
The doctor usually prescribes treatment based on the location, number, extent and nature of the lesions. Several methods can be tested successively.
chemical treatment
The chemical treatments consist of apply chemicals locally to destroy the lesions. They can be applied by the doctor or by the patient himself, depending on the case. It is usually about cream that the patient can apply himself, using a cotton swab. The applications are weekly and can last between four and six weeks maximum, depending on the different substances. With some products there is a risk of irritation, pain and ulceration.
Surgery
There are many surgical treatments. It can be cryotherapy, that is to say a cold treatment by applying liquid nitrogen. This is often the preferred treatment for small lesions. The location, type and extent of lesions dictate the frequency of applications. This can range from one session per week to one session per month. A local anesthetic may be offered to reduce the pain of the intervention. The laser can be used. Depending on the extent of the lesions, local or even general anesthesia is required. This treatment is not necessarily more effective, however the doctor may prefer it if it is more suited to the management of the patient’s lesions. Finally, surgical excision of lesions may be considered as a second treatment. It can be used in case of isolated lesions.
Medication
Finally, immune-modifying drug treatments can be considered. They are in the form of a cream and are applied three times a day. This application is accompanied by local side effects such as redness or skin erosion, generally not serious.
7. How to prevent condyloma?
Condoms are not very effective in combating contamination. In case of contamination, the ideal is to stop all sexual relations before being completely cured of his condyloma.
Regular screening by a gynecologist can be a good way to prevent the spread. Women are then better off, since their gynecological follow-up allows them to be screened frequently. Cervical smears can detect viruses responsible for condyloma and to better treat them. Men are often victims of recurrences, because they are less well followed.
A vaccine has been marketed in France since 2007. It can prevent more than 90% of warts and certain cancers such as that of the cervix. This vaccine is recommended for young girls from the age of 14, before any sexual intercourse or the first year of sexual life. In men, the vaccine is offered up to 26 years of age.
Sources:
Dermato Info French Society of Dermatology – Condyloma
Livi – Condyloma: how to treat them?
Center for Digestive System Diseases and Nutrition – Condyloma
French National Society of Gastroenterology – Condyloma
Read also :
⋙ MST: what is a condyloma?
⋙ STD screening: where to go, causes, procedure
⋙ STDs and STIs: what are the differences?