We are talking about one of the most common sexually transmitted diseases (STDs).
The disease is transmitted from one individual to another through direct sexual contact, including genital, anal, or oral sexual practices with an infected partner.
It is also known as genital wart or anogenital wart
Condyloma is caused by human papillomavirus (HPV) type 6 or less commonly HPV type 11.
Infection is a benign (non-cancerous) growth of the skin and mucous membrane (tumor) that occurs in the genital and perianal region.
Warts appear as multiple, smooth, skin-colored bumps on the genitals and adjacent areas
Most people do not need treatment, but informing and educating infected people about the importance of safe sex is essential to prevent the spread of HPV infection.
There are many treatment options available, however there is a chance that the infection will return, even after successful treatment.
Who has condyloma?
The US Centers for Disease Control and Prevention (CDC) estimate that about 50% of all sexually active people can become infected with the genital human papillomavirus.
Condyloma occurs most commonly in sexually active individuals including adolescents and young adults; But, it can also occur in older people.
Although the condition occurs with equal incidence in men and women, women appear to have the infection more often (including subclinical infection) and therefore have symptoms more often than men.
The infection occurs throughout the world; no ethnic or racial preference is observed.
What are the risk factors for condyloma?
Risk factors for condyloma include:
- Unprotected sex or sexual contact.
- Early age of sexual contact.
- Having sexual contact with a person whose sexual history is not known.
- Smoking and drinking alcohol.
- A weak immune system increases the risk.
- The use of birth control pills.
- The pregnancy.
It is important to note that having a risk factor does not mean that one will get the condition.
A risk factor increases the chances of contracting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that a person does not have the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the causes of condyloma?
Condyloma is caused by the human papillomavirus (types 6 and 11). HPV is a very small microorganism that is transmitted sexually.
The virus subtypes commonly associated with condyloma are types 6 and 11, and less frequently types 16, 18, 31, 33, and 35.
Direct skin-to-skin contact of the genital areas is sufficient for genital warts. This implies that penetrative sexual intercourse is not really necessary for the spread of the infection.
Using sex toys can help spread the infection.
What are the signs and symptoms of condyloma?
There can be several symptoms when you have condyloma. It can take from 1-8 months after exposure to be affected by genital warts.
Signs and symptoms of condyloma can include:
People can have the infection, but they may not have visible warts. This is called a subclinical infection, or the individuals are called carriers (who have no signs or symptoms).
A subclinical infection is common. These people have the potential to infect other uninfected people.
Often the lesions or warts are present in multiple numbers; less commonly, they may appear as a single lesion / wart. Genital warts are usually skin-colored (flesh-colored).
In most individuals, genital warts do not cause any discomfort, such as pain or itching.
Warts are usually present as small to large bumps in the genital areas. These can occur in groups.
Some of these groups give the appearance of a cauliflower. Sometimes warts are very small and not visible to the naked eye.
The lesions are usually soft to the touch in regions where it is moist (vulva) and firm in areas where it is dry (thigh, penis, etc.)
In men, warts are usually noticed on the tip and shaft of the penis, under the foreskin, in the coronal groove (under the head of the glans), the urethra, the scrotum, or the thighs.
In women, it is usually seen inside and outside the vagina (vulva), at the opening of the womb (cervix) or urethra.
In both men and women, it can be seen in and around the anus (perianal).
Condyloma can also be found inside the mouth or throat, when the infection is spread through oral sexual contact.
Some people may have itching or burning.
Women may complain of bleeding or pain during intercourse.
How is condyloma diagnosed?
The following procedures can be used to diagnose condyloma:
Thorough evaluation of the individual’s medical history and a complete physical examination, including examination of the penis, scrotum, vagina, vulva, thigh, anus, perineum, adjacent skin, and oral cavity.
During the history, the doctor may want to know the following:
- Check when symptoms started and if they are getting worse.
- About personal history of sexual practices, barrier methods used, history of other sexually transmitted diseases, etc.
Consultation with an infectious disease specialist may be necessary if warts are associated with other STDs.
Condyloma is usually diagnosed by its characteristic appearance on physical examination.
The doctor may also look for signs and / or tests to confirm the presence of other sexually transmitted diseases, precancerous or cancerous lesions, etc.
The colonoscope : a device to closely look at the vulva, vagina, and cervix for abnormal areas.
Acetic acid test: During colposcopy (or using a magnifying glass), a small amount of mild acid is placed on the suspicious area to distinguish the wart (which gives a whitish color) from the surrounding normal regions.
Sometimes infected areas that are not visible to the naked eye can become visible through this test.
A biopsy can be taken during a colposcopy.
HPV tests can also be done.
Pap smear : cells are collected from the tip of the womb (cervix) and examined under a microscope for associated precancerous or cancerous lesions
Human papillomavirus tests: These tests are done on cells taken during a Pap smear, to check for the presence of HPV
Tissue biopsy and histopathology : In this procedure, the doctor removes a sample of the wart tissue and sends it to the laboratory for histopathological examination.
The pathologist examines the biopsy under a microscope and makes a definitive diagnosis after a thorough evaluation of the clinical and microscopic findings, as well as correlation of the results of special studies, such as HPV, ISH, or DNA testing. PCR on tissues (if necessary).
Many clinical conditions can have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible complications of condyloma?
Complications of condyloma include:
- Recurrence after treatment.
- The genital area can be disfigured.
- Urethral injuries can cause obstruction of urine flow.
- During pregnancy, these genital lesions can become active (can become large), cause bleeding, or interfere with delivery.
- Some of the individuals may be very distressed with the presence of these lesions on their genitals.
- Genital warts do not usually become cancerous. However, they may have a cancer-causing HPV-associated infection that can later lead to cancer.
How is condyloma treated?
Not all genital warts require treatment. In some individuals, if the lesions are asymptomatic, then no treatment is possible.
Treatment options for condyloma include:
Medications : It is important to note that the medications available for the treatment of “warts” over the counter are designed for non-genital areas only.
Your doctor may try one of the prescription topical medications based on your clinical situation. These medications must be applied directly to the warts.
It may take several months for warts to completely disappear. Topical medications include:
Imiquimod : works by increasing the body’s immunity to fight warts.
It is recommended to avoid sexual contact while using this medicine, as it may dampen the effect of condoms or it may irritate a partner’s skin.
Podophyllin : works by destroying the wart tissue. This ointment should not be applied internally and should not be used during pregnancy.
Trichloroacetic acid : works by destroying the wart tissue and is applied by the doctor.
Surgical treatment: Surgery may be warranted if the wart is large, does not respond to medication, or if the person is pregnant. Surgery can cause swelling, pain, redness, or even a scar. Available options include:
- Cryotherapy : Liquid nitrogen is used to freeze the wart tissue and form a blister on the skin. The wart comes off as the blister heals.
- Surgical excision : The wart can be removed with simple surgical tools as an outpatient procedure at the health center.
- Electrocautery : consists of burning the wart tissue using an electric current.
Counseling and treatment of the couple is important to prevent the spread of the disease.
Follow-up is necessary to see if treatment options are working well and for follow-up for other associated conditions.
Despite the variety of treatment options available to remove warts, there is a possibility of recurrence, as the available treatments are primarily aimed at removing the warts and not the underlying infection, which caused the warts.
The healthcare provider will recommend the best treatment options based on the individual’s health circumstances.
How can condyloma be prevented?
Condyloma preventive measures include:
As with any other sexually transmitted disease, warts can be largely prevented by using condoms (practicing safe sex).
It is important to note that your partner may not have visible warts, but may have the infection and can therefore infect you.
Even areas without a condom can have a subclinical infection and you can be infected.
Avoid multiple partners; Try to maintain monogamous relationships.
If possible, avoid sexual contact with people who have genital warts
Vaccines are available against HPV (for both women and men between the ages of 9 and 26) to help prevent cervical cancer and genital warts.
Properly inform your partners if you are being treated for the condition, as they could have the same infection and require treatment.
What is the prognosis for condyloma?
Condyloma has a variable prognosis; varies from individual to individual
The infection may go away on its own with or with treatment.
It can recur (come back) after successful treatment, or many years after successful treatment.
Men, compared to women, have fewer symptoms, although both can have the infection.
Additional useful information relevant to condyloma
It is important to note that other types of HPV, especially 16 and 18, cause cervical cancer. And other types apart from 6, 11, 16 and 18 cause warts on other parts of the body.