HPV is spread by skin-to-skin contact during sexual activity; there does not need to be vaginal or anal intercourse to spread the infection. Most people who become infected with HPV will not have symptoms and will clear the infection on their own. For people who do develop genital warts, there are many options for treatment, all of which are meant to remove the visible warts. There is no cure for genital warts.
Gardasil® is a vaccine that protects against the 4 strains of HPV that cause 70% of cervical cancers and 90% of genital warts. In the US, Gardasil is approved for girls/women and boys/men ages 9–26. In 2011, Health Canada approved the vaccine for women up to the age of 45.
HPV is spread through skin-to-skin contact and does not require actual intercourse to be passed from one person to another. A person can be infected without any visible signs of infection and, therefore, can pass the infection on without knowing it. Condoms can decrease the risk of spreading the virus, but they do not completely prevent transmission.
For women, it is important to have a Pap smear and general gynecologic examination, usually every year, to look for any signs of abnormal cervical cells, which can be the first sign of cervical cancer.
Some treatments are applied by the patient. These include the following:
- Imiquimod 3.75% cream (Zyclara®) – Imiquimod works by boosting your immune system to kill the virus. Apply once daily for up to 8 weeks. This medication may weaken condoms, and you should avoid sexual activity while the cream is on your skin. Do not use imiquimod during pregnancy.
- Imiquimod 5% cream (Aldara®) – Apply once daily (at bedtime) 3 times a week for up to 16 weeks.
- Podofilox 0.5% gel or solution (Condylox®) – This should not be used during pregnancy.
- Podophyllin resin, 15–25% solution – This should not be used during pregnancy.
- Trichloroacetic acid
- Cryotherapy – Liquid nitrogen is used to freeze the warts.
- Surgical removal – This may need to be performed by a specialist with local anesthesia; usually for large amounts of warts.
- Laser treatment – Carbon dioxide laser treatment is useful for a large amount of urethral or vaginal warts.
In 2006, the FDA approved the first HPV vaccine (Gardasil®). It protects against the high-risk strains, 16 and 18, that can cause cervical cancer and the low-risk strains, 6 and 11, that cause most genital warts. The HPV vaccine is a series of 3 shots over a 6-month period. In the US, Gardasil is approved for girls/women and boys/men ages 9–26. In 2011, Health Canada approved the vaccine for women up to the age of 45. The vaccine is most effective when given before an individual becomes sexually active, but it can be given after sexual activity has begun.
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