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What is HPV?
Human papillomavirus (HPV) is the name of a group of viruses that includes more than 150 different types that cause infection on the skin surface. Certain types of HPV cause warts on the hands or feet, while others can cause visible genital warts. However, sometimes HPV infection causes no warts, and many people with genital HPV do not know they have it.
HPV and genital warts are usually spread by direct, skin-to-skin contact during vaginal or anal sex. It is also possible, but rare, to transmit them to the mouth by oral sex.
Warts on other parts of the body, such as the hands, are caused by different types of HPV. Contact with these warts does not seem to cause genital warts.
Warts may appear within several weeks after sexual contact with an infected person, they may take months to appear, or they may never appear. This makes it hard to know exactly when or from whom you got HPV.
What are the symptoms of HPV?
Genital warts are growths or bumps that appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin or thigh. They may be raised or flat, single or multiple, small or large. Some cluster together, forming a cauliflower-like shape.
Sometimes HPV causes changes in the cells just under the surface of the skin that can’t be seen, in other words are there but are invisible. Doctors or nurses can find these ‘microscopic HPV changes’ only with the help of special instruments.
Sometimes people do not notice warts because they are inside the vagina, or on the cervix, or in the anus. In addition, they are often flesh coloured and painless. In rare cases they cause symptoms such as itching, pain or bleeding.
For women, an abnormal cervical smear may be the first warning sign that HPV is present, though a cervical smear is not a test for HPV.
How serious is HPV?
If you have not had the HPV vaccination most of us [80%] are likely to have an HPV infection at some stage in our lives. If you have had the HPV vaccination this will protect you from getting HPV.
HPV that causes warts is not a serious infection, is easily treated, and usually disappears on its own. However, genital HPV that can't be seen can cause skin cell changes that, if not found and treated, can lead to cancer.
Genital HPV can be prevented by vaccination, which is most effective if given before you become sexually active. It is currently free for males and females aged between 9 and 26 years inclusive (up to your 27th birthday). Ask your nurse or doctor about it.
How do I get tested for HPV?
You can check yourself and your partner(s) for warts, but remember: warts sometimes can be very difficult to see. Also, sometimes it’s hard to tell the difference between a wart and other bumps and pimples.
If you think you have warts or have been exposed to HPV, go to a nurse or doctor at your local clinic who can check more closely and may use a magnifying lens to find small warts.
Find a local clinic now.
What is the treatment for HPV?
For genital warts, treatment is optional. Most genital warts will clear up on their own sooner or later. However you may want to have them treated as they can be unsightly and/or uncomfortable. There are several available treatments, and no one treatment is ideal for all people or all warts.
• Podophyllotoxin (Condyline™) solution is a patient-applied treatment for external genital warts, recommended for men only as it is too difficult for women to self-apply. For men, it is easy to use and safe if instructions are followed.
• Imiquimod (Aldara™) cream is a patient-applied treatment for external genital and perianal warts. It is easy to use and safe if instructions are followed. Not recommended in pregnancy.
• Cryotherapy (freezing off the wart with liquid nitrogen) can be performed by a trained health practitioner.
• Trichloroacetic acid (TCA) is a chemical applied to the surface of the wart by a trained health practitioner. TCA is unavailable in some areas.
• Laser therapy (using an intense light to destroy the warts) or surgery (cutting off the warts) has the advantage of getting rid of the warts in a single visit. Laser treatment can be expensive and the healthcare provider must be well trained in these methods. It is only available in a few centres. Recurrences may occur.
Factors that might influence selection of treatment include size, location and number of warts, changes in the warts, your preference, cost of treatment, convenience, adverse effects, and the healthcare provider’s expertise.
It is advisable to seek medical advice before starting treatment for genital warts. Ask your doctor for an explanation of the treatment, including the costs and likely benefits. Be sure to understand the follow-up instructions, such as what to do about discomfort and when to seek help.
Be patient—treatment often takes several visits and a variety of approaches. None of the available treatments is a cure for HPV. The virus can remain in the skin after treatment. Because the virus can lie dormant in the cells, in some cases warts can return months or even years after treatment. In other cases warts never recur.
If you are pregnant or think you might be, tell your doctor so that they can choose a treatment that won’t be harmful to you or your baby.
Don’t use over-the-counter treatments which are not specifically for genital warts. These are not meant for sensitive genital skin.
It is recommended to avoid sexual contact with the infected area during treatment, to protect the treated area of skin from friction and to help it heal.
Other important information about HPV
If you are diagnosed with warts and you have a partner it is a good idea to discuss this. They can see a nurse or doctor to have a check up too. Reading our page on How do I tell a partner? may help you with this discussion.
The types of HPV linked to cervical cancer usually are not the types linked with genital warts. However, a woman with genital warts, like any other sexually active woman, should have regular smears as advised by her nurse or doctor. HPV vaccination and regular cervical smears prevent cervical cancer. Cervical smears find changes in skin cells on the surface of the cervix. Cancer can almost always be prevented through finding and treating them.
Vaccines are available that prevent some of the most common genital HPV types, including genital warts. Vaccination before becoming sexually active is best and is currently available free for males and females aged between 9 and 26 years inclusive (up to your 27th birthday). Ask your nurse or doctor about the HPV vaccine.
For more information about the vaccine visit the Ministry of Health HPV immunisation page.
For more information about HPV phone the New Zealand HPV Project Helpline, Freephone 0508 11 12 13 or visit the HPV New Zealand website.
For information on the National Cervical Screening Programme, Freephone 0800 729 729 or visit the National Screening Unit page