- ATHENS OFFICE MED4WOMAN ATHENS
- VOLOS OFFICE MED4WOMAN VOLOS
Obstetrician-Gynecologist
PhD, University of Athens Medical School
Obstetrician-gynecologist Panagiotis Polyzos practices at the Institute of Life, the IVF Unit of IASO Maternity Hospital.
Human papillomavirus (HPV) is one of the most common causes of sexually transmitted infections (STIs). There are many different types of the virus, classified as higher-risk or lower-risk. Some types are transmitted through sexual contact, and some cause genital warts (single or multiple lesions that develop in the genital area in both men and women).
Many people who are infected with HPV do not develop any symptoms. In others, the incubation period may last for a prolonged period of time before any clinical signs become apparent.
High-risk HPV infection can cause abnormal changes in the cervical sample of the Pap test, increasing the likelihood of cervical cancer, or of vulvar, vaginal, anal or penile cancer.
Low-risk HPV infection may cause abnormal findings in the cervical smear (Pap test) or genital warts, which, although usually harmless, are highly contagious.
Genital warts are soft, moist lesions that appear in the genital area several weeks or months after infection. They may be single or multiple. However, many people may have genital HPV infection without developing visible warts. Genital warts are highly contagious and are transmitted through oral, vaginal, and anal sexual contact with a partner who is already infected. They occur more frequently in women and may be located on the vulva, inside the vagina, at the cervical opening, or around the anus. In men, they may be found on the glans penis, along the penile shaft, on the scrotum, or around the anus.
Genital warts have been known to the medical community since the time of Hippocrates. Human papillomavirus (HPV) is an epitheliotropic virus with more than 100 genotypes identified to date, of which approximately 35 affect the genital area.
Today, the role of HPV in cervical carcinogenesis has been clearly established. The risk of developing cervical intraepithelial neoplasia (precancerous lesions of the cervix) or invasive squamous cell carcinoma of the cervix is directly associated with the specific type of HPV involved.
Low-risk types include 6, 11, 34, 40, 42, 43, 44, 53, 54, 57, and 66. High-risk types include 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 64, and 70. Notably, HPV types 16 and 18 are currently considered responsible for approximately 70% of all cervical cancer cases.
HPV viruses cause two main types of cervical lesions: exophytic (raised) genital warts and flat lesions.
Infection occurs through sexual contact, and viral entry is facilitated by some degree of disruption of tissue integrity (microtrauma to the area during intercourse).
Predisposing factors for HPV infection include inadequate sexual education, age over 30 years, various immunosuppressive conditions such as HIV/AIDS infection, pregnancy, diabetes mellitus, chemotherapy, corticosteroid therapy, smoking, and multiple pregnancies.
The incubation period ranges from one week to nine months.
Despite the high rate of HPV infection among young women, only a small percentage will develop neoplasia. This is because HPV requires cofactors, such as smoking or a particular hormonal environment, to promote the development of precancerous changes. Many women will become infected with HPV at some point in their lives, but in the majority of cases, the infection resolves spontaneously.
HPV types 16 and 18 are responsible for approximately 70% of cervical cancer cases. The quadrivalent vaccine, which includes components from HPV types 16, 18, 6, and 11, has been made available. The period just before the onset of sexual activity appears to be the most appropriate time for vaccination. It is self-evident that vaccinated women are not exempt from the need for regular cervical cytological screening, namely the widely known Pap test.
Diagnosis is made through clinical examination of the lesions by a gynecologist. In women, the cervix should also be examined, and a cervical smear (Pap test) should be performed, which may reveal abnormal cells and/or HPV infection.
There is no way to predict whether the lesions will progress or regress. There are many different treatment methods available for genital warts.
For a personalized assessment of your case, book an appointment with Dr. Panagiotis Polyzos at his office in Athens or Volos.
Genital warts are small benign tumors that appear mainly on the genital organs of both women and men and usually around the anal ring. They are pink or brown in color and resemble miniature cauliflower-like growths. They are most commonly caused by HPV infection.
Genital warts are a condition that may appear even in the absence of sexual intercourse. However, once present, they can be transmitted to a sexual partner if one of the two partners has developed them. Treatment depends on the type of lesion and may include either cauterization (destruction of the lesions) or the use of specialized topical medications.
If you have genital warts, avoid sexual intercourse or use a condom, as transmission is possible. Consult your doctor for appropriate treatment.
HPV is not transmitted through blood or body fluids like other viruses. It spreads mainly through direct skin-to-skin and mucosa-to-mucosa contact in the genital area.
Condoms significantly reduce the risk, but they do not eliminate it, because the virus may be on skin that is not covered. Towels, toilet seats and swimming pools are not considered meaningful routes of transmission.
The time from infection to the appearance of warts or lesions varies widely. The virus can stay silent for months or even years, which is why it is usually impossible to tell when and from whom the infection came.
There is no single “best” treatment for everyone. The choice depends on the number, size and location of the warts, whether you are pregnant, and your own preference.
Both require patience and careful application only on the lesions, following your doctor's instructions.
Whichever method you choose, treatment removes the visible lesions. In the end, it is your immune system that controls the virus.
During pregnancy, warts may grow in number and size because of hormonal changes and the normal shift in immunity. They often shrink again after delivery.
Cervical screening can be done as usual during pregnancy, and if needed, colposcopy is safe throughout pregnancy.
HPV infection is so common that most sexually active people will come into contact with the virus at some point. The good news is that, in the vast majority, the immune system clears it on its own. In large studies, about nine in ten infections are no longer detectable within two years.
The problem starts when a high-risk type persists for years. It is this persistent infection that can, slowly and gradually, lead to precancerous changes. That’s why screening is repeated at regular intervals: to catch persistence in time.
The virus affects men just as much, although we talk about it less in their case. In men, HPV causes warts on the penis, the scrotum and around the anus, and the high-risk types are linked to rare cancers of the penis, anus and oropharynx.
You will find more about ages and doses on the page about the HPV vaccine.
Not every small bump on the genitals is a wart. Several benign conditions look similar, and the right diagnosis spares you unnecessary treatment and worry.
If you notice something new, do not remove it yourself and do not use products meant for common warts on the hands. Ask for an examination. A visual check by your gynecologist is usually enough for a diagnosis.
In some cases they clear up without treatment within months. Usually, however, they are removed to limit their spread and transmission.
They are mainly caused by HPV types 6 and 11, which are low risk. High-risk types may be present at the same time, though, which is why cervical screening continues as usual.
Yes, transmission is possible even without visible warts. Condoms reduce the risk but do not eliminate it.
Yes. It protects against the types you have not been infected with.
Recurrences are common in the first months, because treatment removes the lesions, not the virus.
It is better to avoid it until the skin has healed, because the area is irritated and the virus spreads more easily. Creams can also weaken the latex of condoms, so ask your doctor about the right timing of application.
If he has visible lesions or symptoms, yes, by a urologist or dermatologist. If not, no routine test is needed. Testing for other sexually transmitted infections, however, is a good idea for both of you.
Yes, less often, after oral sex. They appear as small, painless lesions on the lips, tongue or palate and are treated by an ENT specialist or oral surgeon.
Usually within a few weeks to a few months, but it can take much longer. Many people never develop warts, even though they carry the virus.
