may not have guessed it, but human papilloma viruses (HPV)
are extremely common. Although many people associate this
virus with sexually transmitted genital warts, HPV are
also responsible for common warts. It is estimated that
common warts can be found on the hands of about one-fourth
of the U.S. population. Warts are small, painless, rounded
growths that are beige, pink, or brown and may have either
a smooth surface or a rough surface like a cauliflower.
Between 60% to 70% of sexually active individuals have
been exposed to HPV viruses. Furthermore, HPV affects
approximately six percent of women with a normal pap smear
and more than 60% of those with an abnormal pap smear.
HPV viruses have also been associated with cervical and
vulvar cancer in women. However, nobody knows the long-term
problems this virus might cause in men.
than 60 types of HPV have been identified, and different
types have been associated with different medical conditions.
Types 1, 3, and 5 have been linked to warts on the hands
and feet, while types 6 and 11 have been associated with
genital warts. Other types, such as 16, 18, 31, 33, and
35 have been associated with pre-cancerous and cancerous
lesions of the cervix.
is considered a sexually transmitted disease, but common
warts--those not involving the sexual organs--can be spread
through skin contacts such as shaking hands. In one study,
the DNA of HPV was found in about 20% of virgins.
comes in a few different forms:
Flat warts - flat warts are flesh-colored and can occur
in any area of the skin. They are most common in teen-agers
and young adults.
Plantar warts - thick, painful overgrowths of the sole
of the feet, sometimes mistaken for calluses.
Genital warts - usually appear as one or multiple painless
growths with a rough surface like a cauliflower. In
women they can appear anywhere on the outside of the
vagina, labia, vulva, urethra, peri-anal skin, or rectum.
In the male they commonly affect the tip of the penis,
the opening of the urethra, and in the skin around the
anus in men who practice anal sex. Symptoms can vary
from none to itching, and occasionally bleeding when
they are disrupted.
Asymptomatic HPV is usually detected through the pap smear,
showing cellular changes consistent with HPV. These changes
can range from mild or pre-cancerous lesions of the cervix
to dysplasia (the abnormal development or growth of tissues,
organs, or cells). In a recent study, 50% of male partners
of women with genital warts had clinically visible lesions
and 25% had lesions that were detected only when a solution
of 5% of acetic acid was applied to the genital area.
HPV: what you can do
there is no definite way to prevent HPV, nor is there
a cure. However, avoiding contact with someone with obvious
lesions as well as practicing safe sex may reduce the
chance of acquiring HPV, although the use of condoms has
not been proven to reduce the risk of reinfection.
infections are often marked by spontaneous regression
and recurrence. Without treatment, about 50% of common
warts spontaneously disappear within six to 12 months.
Treatment depends on the presentation and usually consists
of a variety of chemical, mechanical, and ablative techniques.
These include topical solutions such as podophylin, trichloroacetic
acid, and AldaraT cream. Some lesions may take anywhere
from six to eight months of continuous treatment with
one of these topical solutions. Other approaches, such
as cryoablation, simple excision, electrosurgical excision,
and laser vaporization are only used when simple topical
is imperative that those people infected with HPV understand
that there is no cure and that the lesions can spontaneously
regress and recur. Treatment sometimes may be tedious
and long, but with patience they usually go away. Fortunately,
being infected with HPV does not mean a death sentence
or sterility; women with HPV will simply have to be followed
very closely with pap smears.