See also abnormal paps, Aldara.

Venereal warts (condylomata accuminata)
This is a common form of infection in males and females. The change in the genital skin which produces the wart is caused by a virus. This virus is transmitted by sexual contact with an individual who carries the virus or who has venereal warts. The warts are quite contagious in their early stages, less so when they have been present for a long period of time. These warts differ in structure from the common type of skin warts that people get on their fingers and other skin areas. Common skin warts do not usually affect the genital region. They look like white or fleshy protrusions and may be itchy or irritating.
In the female, venereal warts usually affect the skin of the vulva, (external genitalia) and the skin around the anus. They can, however, develop in the vagina and cervix as well. When they are present in the vagina and cervix, they can cause an abnormal pap smear. The pap smear will return to normal when the warts have been eradicated. Venereal warts are not a form of cancer. In males, the warts can develop around the entrance to the urethra, on and under the foreskin, on the shaft of the penis, and around the anus. While the warts may itch or be irritated, usually the first symptom a woman notices is a "bump" on the skin in the affected area. The warts frequently increase rapidly in size and number. For this reasons, and to prevent infecting a sexual partner, the warts may be treated relatively easily by applying a solution, Bichloroacetic Acid which causes them to shrink and fall off over a number of days or weeks. In many cases, repeated applications of the Bichloracetic Acid may be necessary to completely eradicate the warts. Therefore, it is very important that you return for your scheduled follow up visits(s) until the doctor or nurse tells you further visits are unnecessary. Warts tend to recur, and if they do, reapplication of the medication is necessary. Bichloracetic Acid will irritate normal skin, so it is very important that it be applied only to the warts. To avoid damaging normal skin, it is usually necessary to have a doctor or nurse apply the medication each time. Any associated vaginal infection will be treated at the same time.
If you have just had a Bichloracetic Acid treatment and experience discomfort 6 - 8 hours after a treatment. Sitz baths, (sitting in several inches of warm water) three or four times a day for 10-15 minutes will help. You can take Tylenol or Advil. If you still have severe pain, call us and we will prescribe some cream to apply to the sore areas.
Aldara is another treatment for warts. It is a cream that is applied to the skin, and through the immune system, makes the warts go away. It may require repeat applications. It can cause some burning and discomfort. It requires a prescription and you may re-apply it when you need it for recurrences.
As with any venereal disease, the use of a condom during intercourse may be helpful. Likewise, washing the vulva with soap and water following intercourse may help prevent infection if exposure has taken place. Other options include laser therapy, LEEP (electrocautery), and watchful waiting. Please feel free to discuss this with us.
Please inquire as to the need for your sexual partner to be examined.
Please be aware that only you can stop the spread of HPV by using condoms. Do not take chances. Some strains of the HPV virus are cancer producing. Discuss the need to get a viral typing done. If you elect laser treatment for external warts, please ask for the patient booklet on laser treatment.

This is a viral infection that can be transmitted by close body contact. Sometimes children get them in school from other children. They can be treated chemically with Aldara or can be scraped off after numbing the area with Novocain. They look like brown or red spots that are raised and have a central white core.
You may be given a prescription for EMLA cream to apply to the area prior to removal.  This is a local numbing cream and it is applied one hour prior to the procedure.

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