Genital Warts (HPV)
๐ง Genital warts are common and benign, but psychologically distressing.
Incubation can be weeksโmonths, so theyโre not a reliable marker of recent exposure.
๐ฆ Cause
- HPV types 6 & 11 ๐ฟ cause most genital warts (low oncogenic risk).
- Transmission ๐ค via skin-to-skin contact; condoms reduce but donโt eliminate risk.
- High-risk HPV (16/18) โ ๏ธ relates to cancer risk but usually not typical warts (screening addresses this).
๐ Diagnosis
- Clinical diagnosis ๐ based on appearance is usually sufficient.
- Biopsy ๐ฌ if atypical (pigmented, ulcerated, bleeding, indurated, fixed) or not responding to therapy.
- HPV testing ๐งพ is not used for wart diagnosis; itโs part of cervical screening pathways.
๐ Treatment Options
- Patient-applied ๐งด: podophyllotoxin or imiquimod (warn about local irritation).
- Clinician-applied โ๏ธ: cryotherapy (often several sessions).
- Procedural โ๏ธ: excision/laser for large, resistant, or obstructive lesions.
- HPV vaccination ๐: reduces future HPV disease; follow national eligibility.
๐ฃ Practical Counselling
- Recurrence is common - it doesnโt mean โtreatment failedโ, it reflects HPV persistence.
- Discuss partner notification pragmatically (partners may already have HPV; testing is symptom-led).
- Advise re-attendance if lesions change, bleed, ulcerate, or donโt respond to standard therapy.
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