HPV infection is a viral infection that commonly causes skin or mucous membrane growths (warts). There are more than 100 varieties of human papillomavirus (HPV). Some types of HPV infection cause warts, and some can cause different types of cancer.
Most HPV infections don't lead to cancer. But some types of genital HPV can cause cancer of the lower part of the uterus that connects to the vagina (cervix). Other types of cancers, including cancers of the anus, penis, vagina, vulva and back of the throat (oropharyngeal), have been linked to HPV infection.
These infections are often transmitted sexually or through other skin-to-skin contact. Vaccines can help protect against the strains of HPV most likely to cause genital warts or cervical cancer.
In most cases, your body's immune system defeats an HPV infection before it creates warts. When warts do appear, they vary in appearance depending on which kind of HPV is involved:
Genital warts. These appear as flat lesions, small cauliflower-like bumps or tiny stemlike protrusions. In women, genital warts appear mostly on the vulva but can also occur near the anus, on the cervix or in the vagina.
In men, genital warts appear on the penis and scrotum or around the anus. Genital warts rarely cause discomfort or pain, though they may itch or feel tender.
Nearly all cervical cancers are caused by HPV infections, but cervical cancer may take 20 years or longer to develop after an HPV infection. The HPV infection and early cervical cancer typically don't cause noticeable symptoms. Getting vaccinated against HPV infection is your best protection from cervical cancer.
Because early cervical cancer doesn't cause symptoms, it's vital that women have regular screening tests to detect any precancerous changes in the cervix that might lead to cancer. Current guidelines recommend that women ages 21 to 29 have a Pap test every three years.
Women ages 30 to 65 are advised to continue having a Pap test every three years, or every five years if they also get the HPV DNA test at the same time. Women over 65 can stop testing if they've had three normal Pap tests in a row, or two HPV DNA and Pap tests with no abnormal results.
If you or your child has warts of any kind that cause embarrassment, discomfort or pain, seek advice from your doctor.
HPV infection occurs when the virus enters your body, usually through a cut, abrasion or small tear in your skin. The virus is transferred primarily by skin-to-skin contact.
Genital HPV infections are contracted through sexual intercourse, anal sex and other skin-to-skin contact in the genital region. Some HPV infections that result in oral or upper respiratory lesions are contracted through oral sex.
If you're pregnant and have an HPV infection with genital warts, it's possible your baby may get the infection. Rarely, the infection may cause a noncancerous growth in the baby's voice box (larynx).
Warts are contagious. They can spread through direct contact with a wart. Warts can also spread when someone touches something that already touched a wart.
HPV infections are common. Risk factors for HPV infection include:
It's difficult to prevent HPV infections that cause common warts. If you have a common wart, you can prevent the spread of the infection and formation of new warts by not picking at a wart and not biting your nails.
To reduce the risk of contracting HPV infections that cause plantar warts, wear shoes or sandals in public pools and locker rooms.
You can reduce your risk of developing genital warts and other HPV-related genital lesions by:
Gardasil 9 is an HPV vaccine approved by the U.S. Food and Drug Administration and can be used for males and females to protect against cervical cancer and genital warts.
The Centers for Disease Control and Prevention (CDC) recommends routine HPV vaccination for girls and boys ages 11 and 12, although it can be given as early as age 9. It's ideal for girls and boys to receive the vaccine before they have sexual contact and are exposed to HPV. Research has shown that receiving the vaccine at a young age isn't linked to an earlier start of sexual activity.
Once someone is infected with HPV, the vaccine might not be as effective or might not work at all. Also, response to the vaccine is better at younger ages than older ones. But, if given before someone is infected, the vaccine can prevent most cases of cervical cancer.
The CDC recommends that all 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart. Younger adolescents ages 9 and 10 and teens ages 13 and 14 can also receive vaccination on the updated two-dose schedule. Research has shown that the two-dose schedule is effective for children under 15.
Teens and young adults who begin the vaccine series later, at ages 15 through 26, should continue to receive three doses of the vaccine.
The CDC recommends catch-up HPV vaccinations for all people through age 26 who aren't adequately vaccinated.
The U.S. Food and Drug Administration recently approved the use of Gardasil 9 for males and females ages 9 to 45. If you're age 27 to 45, discuss with your doctor whether he or she recommends that you get the HPV vaccine.
Your doctor might be able to diagnose HPV infection by looking at your warts.
If genital warts aren't visible, you'll need one or more of the following tests:
Warts often go away without treatment, particularly in children. However, there's no cure for the virus, so they can reappear in the same place or other places.
Medications to eliminate warts are typically applied directly to the lesion and usually take many applications before they're successful. Examples include:
If medications don't work, your doctor might suggest removing warts by one of these methods:
If you have an abnormal HPV or Pap test, your gynecologist will perform a procedure called a colposcopy. Using an instrument that provides a magnified view of the cervix (colposcope), your doctor will look closely at the cervix and take samples (biopsy) of any areas that look abnormal.
Any precancerous lesions need to be removed. Options include freezing (cryosurgery), laser, surgical removal, loop electrosurgical excision procedure (LEEP) and cold knife conization. LEEP uses a thin looped wire charged with an electric current to remove a thin layer of a section of the cervix and cold knife conization is a surgical procedure that removes a cone-shaped piece of the cervix.
You'll likely start by seeing your primary care provider. Depending on where your warts are located, you may be referred to a doctor who specializes in disorders of the skin (dermatologist), feet (podiatrist) or reproductive organs (gynecologist or urologist).
Here's some information to help you get ready for your appointment.
Before your appointment, make a list of:
For HPV infection, questions to ask your doctor include:
Don't hesitate to ask other questions.
Your doctor is likely to ask you questions, such as:
