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Causes
Genital Warts are caused by the human papillomavirus (HPV). There are hundreds of strains of HPV but the strains most often implicated in cases of genital warts are type 6 and 11. Most people will notice the appearance of warts around 3 months after becoming infected with these strains of HPV but warts can appear around 12 months post infection. The warts can appear as individual warts or as a small cluster. The warts that appear on female bodies can be different from those that appear on male bodies. The female warts will tend to be small lumps whereas male warts can look quite similar to warts that appear on other parts of the body, such as our hand where the warts can take on a cauliflower-like appearance.
Diagnosis
Genital warts need to be diagnosed by a healthcare professional. This can be done in a face to face environment at a GUM clinic or a GP surgery. There are even online medical services where warts can be diagnosed from a photograph. Warts are rarely swabbed for identification as results can be misleading so diagnosis is done by sight. If the diagnosis is done by a GP then they may prescribe a treatment for home use or they may refer you to a GUM clinic for treatment. Virtual clinics will normally prescribe a medication to be sent to you for home use. The Online Clinic has a genital warts photo assessment clinic. This website is licensed in the UK so you can be sure that you are dealing with qualified medical professionals.
Treatments
Podophyllotoxin
Podophyllotoxin is the active ingredient in two different branded medications. Warticon is perhaps the market leader and this comes in the form of a cream or solution. The other brand is Condyline and this is a solution. Both of these medications are suitable for home use and are applied in cycles. These treatments are only really suitable for warts that are no more than 4mm in diameter and they tend to work better for softer warts. Warticon and Condyline work by slowly destroying the cells that make up the wart making it impossible for the cells to replicate so the wart slowly dies.
Imiquimod
Imiquimod is a cream that is branded as Aldara. Imiquimod works well on larger warts and its mode of action very different from podophyllotoxin. Aldara works by stimulating the immune system in a localised area around the wart. The body then recognises the virus that is causing the warts and attacks the virus from within. Many users of Imiquimod report a more permanent solution than those who have used either Warticon or Condyline. You can read more about Aldara at the Electronic Medical Compendium.
Tricholoroacetic Acid
TCA, for short can be applied to warts but this must be done by a healthcare professional and repeat applications are required so it is not going to be a convenient method for most people. TCA is suitable for use by pregnant women whereas the creams and solutions mentioned above are not.
Ablation
Ablation can take the form of cryotherapy (the most common variety) where the wart is frozen using liquid nitrogen. Other forms of ablation include laser therapy (usually under local or general anaesthetic) if the wart is internal. Excision can also be used but this method will generally leave a scar so it is not the first line of treatment and will only be used if all other treatments have failed.
Prevention
A large percentage of the population has been exposed to HPV and many will have developed warts. The most practical way of preventing the spread of genital warts is the use of a condom. There is also a vaccination available called Gardasil. This vaccination is given to girls aged 12-13 as part of a national vaccination programme. Boys are not vaccinated on the national programme but can be vaccinated privately. Heterosexual boys will become immune to HPV based on herd immunity. Clearly this will not apply to the MSM population. More information on Gardasil can be found here.
Further information about genital warts can be accessed from the NHS website.