Understanding HPV and How it can be Treated

What is HPV?

HPV, or Human Papillomavirus, is a DNA virus from the Papillomaviridae family that is usually asymptomatic and resolves spontaneously in 90% of conditions. But rarely, the infection persists and gives rise to genital warts that sometimes develop into cancerous lesions. There are over 170 strains of HPV, out of which 40 types can spread through sexual contact and affect the anus and genitals. Dermatologists usually identify warts by examining them. If required, pap smears and cervical cancer screening help diagnose their malignancy level to initiate treatment methods.

How can be Treated Genital Warts?

Though Genital warts impact people of either gender, usually women are more affected than men. The chief symptoms of genital warts include flesh-colored or whitish bumps with a rough texture and a cauliflower-like appearance. These warts can disappear, stay the same or increase in size and number.

Treatment options for genital warts include invasive and noninvasive treatments to relieve the pain and itching. Some of the treatment options are

Topical Options are

Imiquimod

Imiquimod belongs to a class of drugs known as immune response modifiers that increases the activity of the immune system to get rid of genital warts. Patients may start seeing improvement within four weeks of treatment, but observing a visible clearing of warts may take up to sixteen weeks.

You will know that Imiquimod is working when your warts start flaking, and you see scabs instead of active lesions.

Avoid sexual contact while using Imiquimod as it can weaken condoms and vaginal diaphragms. The cream is usually used three days a week at alternate intervals. Wash your hands before applying the cream and let it rest for 6-8 hours afterward.

Inform your health provider if you develop symptoms of redness, itching, bleeding, and burning of the treated area after applying it to warts.

Podofilox

Podofilox or Podophyllotoxin is a topical solution used to remove warts on the outer skin of the genital areas by inhibiting cell mitosis and causing visible necrosis of the wart tissue. It usually takes 7-10 days to observe improvement in wart size as they turn whiter and smaller.

Podofilox does not destroy the virus but it successfully works on warts. During the treatment, old warts may return, or new warts can form, irrespective of their successful effect on genital areas.

Studies have shown that 0.5% Podofilox solution has good efficacy and is well treated on anogenital warts. Bleeding, tingling, tenderness, and occasional ulceration are some adverse reactions to using Podofilox.

Its use is contraindicated during pregnancy and in people with allergic or hypersensitive reactions to the gel/ solution or its ingredients. Podofilox is meant for use only on external genital warts. Do not use it on warts on the mucous membranes inside the urethra, vagina, or rectum.

Trichloroacetic Acid

Trichloroacetic acid is a potent topical solution that heals genital warts by destroying the proteins of the cells. Studies have shown it to have an efficacy comparable to cryotherapy in treating genital warts.

Regularly applying trichloroacetic acid results in shrinkage and, ultimately, the disappearance of warts. The solution is not for self-use and must be used by a doctor or nurse who will apply it once a week for four to six weeks to observe satisfactory results.

While a safe and effective treatment option, trichloroacetic acid does not kill the virus. Even after the elimination of warts, the virus remains in the body and can be transmitted to another person through unprotected sexual contact.

It is safe for pregnant women with genital warts but contraindicated in people with hypersensitivity and malignant and premalignant lesions.

Sinecatechins

Sinecatechins are used to treat conditions of condylomata acuminate ( HPV type 6 and 11 induced genital warts ) that, in mild conditions, resemble skin-colored papules and progress into cauliflower-like masses when left untreated.

Sinecatechins are among the first FDA-approved botanical extracts that inhibit the proteins involved in oxidative stress to block the kinases in tumor cell signaling and induce apoptosis of the genital wart cells.

Studies have shown the medication to have a moderate success rate in dealing with genital warts, with 20.9% of patients achieving visibly reduced wart intensity within eight weeks. You are required to clean the area daily before applying the cream and avoid sexual contact during its use.

Surgery

Surgery or other invasive methods are the second line of treatment modes that are practiced when topical treatments don't produce the required results. Surgery is also preferred in more prominent or extensively spread warts or pregnancy conditions that may harm the fetus if not removed on time.

Some of the surgical methods

Cryotherapy

Cryotherapy is a highly effective method of eliminating genital warts, with studies recording a 78% success rate. In the cryotherapy method, the surgeon uses liquid nitrogen to freeze warts, making removing them easier. In addition to successfully removing warts, it also decreases the concentration of the HPV virus and removes potential cancer triggers resulting from the multiplication of the wart cells.

Usually, the warts are individually frozen, and three to four sessions are conducted with a gap of seven days between each treatment to get satisfactory results.

Electrocautery

Electrocautery is conducted using local anesthetics and involves the surgeon using a low-voltage electrified probe to remove genital warts on the vulva, penis, or around the anus. Studies have shown electrocautery to have a success rate of working in eight out of ten persons with less chance of warts recurrence after completing the treatment.

Recovery time after electrocautery is usually 2-4 weeks, but it depends on the size and intensity of warts with your tolerance to the treatment method.

Surgical Excision

Surgical Excision is performed under the influence of anesthetics and involves the surgeon using a scalpel to remove warts. While the process is not painful because of the anesthetic administered, you might experience mild pain and discomfort afterward when the anesthetics start wearing off.

It takes two to four weeks to heal from the surgery completely, but you can resume your normal activities within 4-5 days.

Laser Treatments

Laser treatment is preferred in complex warts that do not respond to other methods and with a tendency to recur frequently. Laser treatments use an intense beam of light to destroy warts.

Studies have shown that laser has a two-fold efficacy than cryotherapy and has a lower recurrence rate. But it causes more discomfort and is more expensive than other procedures.

HPV-related Cancers

Precancerous HPV lesions present as symptoms like itching or bleeding. And if an HPV infection develops into cancer, cancer may cause symptoms like bleeding, pain, or swollen glands. Usually, HPV-related cancers have a high cure rate of 70-90% when treated on time. Radiation and chemotherapy help in treating cancerous lesions to a vast extent.

Conclusion

In conclusion, HPV is a real thing and it shouldn't be taken lightly. While it can be easily contracted, there are treatments and ways to avoid getting the virus completely. Thankfully, today’s medical technologies allow us to diagnose, prevent, and treat HPV when necessary. Vaccinating yourself against certain strains can safeguard you from certain types of cancers down the road. Additionally, regular check-ups with your doctor can help detect any abnormal changes that may indicate the presence of HPV. With proper attention to our bodies and hygienic practices, we can ensure the safety and health of ourselves for many years to come. Let’s continue to protect ourselves by getting informed, staying up-to-date on all vaccinations, maintaining proper hygiene habits, and visiting our doctors at regular intervals so we can defeat HPV together!