Genital warts are small growths in the genital region, caused by a virus. The virus causing them is the human papilloma virus (HPV). The greater family of HPV have more than 100 subtypes so there are several different clinical presentations of genital warts (also called condylomata).
Essentially, the virus enters the epidermal cells, in the upper layers of the skin and causes their increased multiplication, leading to localised skin outgrowths appearing as small lumps.
It is also worth noting that there also also flat genital warts that are not evident with the naked eye and need the application of a specific solution on the area to show.
The HPV virus is very common and anyone with an active sexual life has at some point come into contact with one of its subtypes. Whether or not that person will develop genital warts depends on the presence of skin incontinuity in the genital area, to facilitate skin entry, his/her sensitivity to the virus and to the state of his/her immune system.
It is important to note that this virus is not spread exclusively though sexual contact, although this is by far the most common way. Moreover, since the time the lesions grow to become evident may be over 7-8 months after exposure to the virus (and some believe it may be even more), when a person has genital warts their sexual partner needs to be checked but this may not be considered proof of sexual promiscuity etc.
Of the outmost importance is that certain HPV subtypes are associated with the development of cervical cancer in women and with certain skin cancers in the genital regions of both sexes. Recently, two vaccines have been marketed that have some success in 'protecting' against the most common subtypes associated with cervical cancer. We are not yet convinced on their effectiveness, but we strongly believe it is crucial for sexually active women to follow up regularly with their Pap tests.
The goal of any therapy, pharmaceutical or interventional, is to destroy genital warts, but unfortunately, even when nothing is evident, there are almost always some viral remains that are essentially kept at bay by our immune system. This is the reason relapses are fairly common with any treatment modality and it is essential to have a holistic approach taking into account the state of the individual's health and their lifestyle.
In our practice, we tend to have a pre-therapy regime, followed by an interventional approach and then by a post-therapy regime. This, along with patient compliance leads to almost no relapses.