Genital Warts: Symptoms, Causes, and Treatment Options

Genital warts

Hello doctor, about a year ago, I noticed two small growths on my penis, approximately in the mid-shaft area.
One is about the size of a sesame seed, and the other is about the size of a grain of rice.
The two are connected and are the same color as the surrounding skin, slightly darker.
They are not painful or itchy, and there are no unusual discharges.
Additionally, there are no signs of enlargement or spreading.
At the time of discovery, I was abroad and unable to seek medical attention.
In terms of sexual activity, I only had intercourse with my ex-girlfriend a few times in May last year, during which we did not use condoms for the entire duration.
This year, I have been in a steady sexual relationship with my girlfriend, and we have used condoms consistently.
Today, I visited a dermatologist, and the doctor mentioned that these are warts caused by a filtered virus.
I would like to ask if this is commonly known as genital warts.
Thank you.

peter, 20~29 year old female. Ask Date: 2009/12/15

Dr. Du Zhiqiang reply Dermatology

Dear Peter,
Genital warts refer to viral warts located near the genital or anal areas; they are named for their resemblance to cauliflower.
Regardless of whether it is in foreign countries or domestically, immediate treatment is necessary, as they can multiply rapidly.
As for the fact that you have only had one girlfriend in recent years and used condoms during sexual intercourse, it does not guarantee that you were not previously infected, as this type of virus can remain dormant in the body for a long time without showing symptoms.
Wishing you safety and health.
Sincerely,
Dr.
Chih-Liang Tu
Attending Physician, Dermatology Department
Taoyuan General Hospital, Ministry of Health and Welfare

Reply Date: 2009/12/15

More Info

Genital warts, also known as condylomata acuminata, are a common sexually transmitted infection caused by certain strains of the human papillomavirus (HPV). They typically appear as small, flesh-colored or gray growths in the genital area, including the penis, vulva, and anus. In your case, the small protrusions you described on your penis could indeed be genital warts, especially since they are painless, do not itch, and have not shown signs of growth or spreading.

Symptoms
The symptoms of genital warts can vary significantly. Some individuals may experience no symptoms at all, while others may notice:
- Small, flesh-colored or gray growths in the genital area.

- A cauliflower-like appearance in some cases.

- Itching or discomfort, although this is less common.

- Bleeding during intercourse if the warts are irritated.

Causes
Genital warts are primarily caused by HPV, particularly types 6 and 11, which are considered low-risk strains. HPV is transmitted through skin-to-skin contact during sexual activity, including vaginal, anal, and oral sex. It is important to note that even if an individual does not have visible warts, they can still transmit the virus. The fact that you had unprotected sexual encounters increases the likelihood of HPV transmission.

Diagnosis
Diagnosis is typically made through a physical examination by a healthcare provider. In some cases, a biopsy may be performed to confirm the diagnosis, especially if the warts appear atypical. Given that you have already seen a dermatologist who suggested that the growths are likely caused by HPV, it seems you are on the right track.

Treatment Options
While genital warts can sometimes resolve on their own, treatment is often recommended to reduce symptoms and prevent transmission. Treatment options include:
1. Topical Treatments:
- Podofilox: A topical solution that can be applied directly to the warts.

- Imiquimod: A cream that boosts the immune response to help fight the virus.

- Sinecatechins: An ointment derived from green tea extract.

2. Procedural Treatments:
- Cryotherapy: Freezing the warts with liquid nitrogen.

- Electrosurgery: Burning the warts using electrical currents.

- Laser Treatment: Using laser therapy to remove warts.

- Surgical Excision: Cutting out the warts, which may be necessary for larger or more persistent growths.

Prevention
Preventive measures include:
- Vaccination: The HPV vaccine (Gardasil or Gardasil 9) can protect against the most common high-risk and low-risk strains of HPV. It is recommended for preteens but can be given to adults up to age 45.

- Safe Sex Practices: Using condoms can reduce the risk of HPV transmission, although they do not provide complete protection since HPV can infect areas not covered by a condom.

Conclusion
In summary, the growths you described on your penis may indeed be genital warts caused by HPV. It is advisable to follow up with your healthcare provider for a definitive diagnosis and to discuss appropriate treatment options. Additionally, consider discussing HPV vaccination with your healthcare provider to reduce the risk of future infections. Remember, open communication with sexual partners about STIs is crucial for maintaining sexual health.

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