Human Papillomavirus (HPV): Teen Version

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KEY POINTS

• Human papillomavirus (HPV) is a group of viruses that can cause papillomas (warts), including genital warts. Warts are small growths or bumps on the skin. They may be found on the vagina, penis, and scrotum, and in the area around the anus.
• Treatment may include medicine on the warts or removal of the warts with freezing or surgery. If you have genital warts and plan to get pregnant, get treatment for the warts before you get pregnant.
• A vaccine is available to prevent types of HPV infection that can cause genital warts and cancer of the cervix.

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What is human papillomavirus?

Human papillomavirus (HPV) is a group of viruses that can cause papillomas (skin warts and genital warts) and some forms of cancer. Warts are small growths or bumps on the skin.

There are many types of HPV. Most of the time, HPV does not cause health problems. Some types of HPV cause genital warts, and others cause warts on other parts of the body. However, some types of HPV can cause cancer of the cervix, vagina, or vulva in women, and cancer of the penis in men. In both females and males, HPV can cause cancer of the anus, mouth, or throat.

What is the cause?

HPV is a common sexually transmitted disease spread by skin-to-skin contact. Most sexually-active people will get at least one type of HPV at some time in their lives. Genital warts are more contagious and more easily spread than other warts. They may spread to other nearby parts of the body and they may be passed from person to person during sexual activity.

It is not known why some people develop cancer or other health problems after being infected with HPV. You may be at higher risk if you have a weakened immune system from:

• Taking medicines to prevent organ transplant rejection
• Cancer treatment
• HIV/AIDS

What are the symptoms?

You can be infected with HPV without having visible warts or any other symptoms, and symptoms may vary based on what body part is affected:

• HPV infection may cause a neck mass, persistent sore throat, trouble swallowing, mouth sores, or bleeding in the mouth.
• HPV infection on the genitals of either a male or female may be a single visible wart or a large cluster of warts that can be painful and bleed during sex.
• HPV infection in the anus can cause rectal itching, bleeding, or discharge.

The warts usually first appear 1 to 6 months after contact with an infected person. You may have many warts or just 1 wart. In men, warts can grow on the tip or shaft of the penis and sometimes on the scrotum, in the urethra (the tube that carries urine out of the body), or around the anus. In women, warts can grow in the vulva (the folds of skin around the opening of the vagina), on the cervix, inside the vagina or urethra, or around the anus.

How are they diagnosed?

Your healthcare provider will ask about your symptoms, activities, sexual and medical history, and examine you.

In women, genital warts that are not causing symptoms may be found during a routine pelvic exam and Pap test, which is a screening test done to check for abnormal changes in the cells of the cervix or vagina. An HPV-DNA test can be done at the same time for women age 30 and over to see if the type of HPV causing the warts is the type that may cause cancer. Because some types of HPV can cause precancerous or cancerous changes in the cervix, it is important for women who have had HPV infection to have regular Pap tests to check for abnormal cells. Cervical cancer can be prevented with regular Pap tests and follow-up.

Your provider may put a liquid on the skin to make it easier to see warts or use a magnifying scope to look closely at your genitals. A biopsy may be taken to help make a diagnosis. A biopsy is the removal of a small sample of tissue for testing. There is no test to check for HPV infection in the mouth and throat.

How are they treated?

HPV is a common virus and may not need treatment unless it causes warts or other skin changes. If you have an HPV infection on your cervix, your healthcare provider will talk with you about treatment choices to remove abnormal cells or to do more testing and have follow-up visits.

There are several ways to treat warts caused by HPV. Usually the treatment is done in the provider's office. Your healthcare provider may:

• Put medicine on the warts
• Surgically remove the warts
• Freeze the warts with liquid nitrogen (cryotherapy)
• Destroy the warts with a laser

You may need a local anesthetic to numb the area before some of these treatments. In some cases, your provider may advise waiting to see if the warts go away on their own. Removal of the warts does not get rid of the virus. You may get more warts after treatment.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Keep your genital area clean and dry.
• Wash your hands well after touching the area where you have warts.
• Don’t scratch the warts.
• Ask your provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
• If you have genital warts and plan to get pregnant, have your warts checked by your provider.

How can I help prevent the spread of HPV?

The best way to prevent the spread of HPV is by not having sex.

HPV vaccines are available to prevent several types of HPV infection, including those that can cause genital warts and cancer. If you already have HPV, the vaccine will not cure your infection, but it will help prevent infections from other types of HPV.

HPV vaccines are approved for people age 9 to 45 years old. The vaccine is most effective if it is given before a young man or woman has sex for the first time. The best age to give the vaccine to children is at 11 to 12 years of age. It is given as a series of shots over 6 months. The HPV vaccine is usually not given to pregnant women.

Here are some other things you can do to help prevent HPV or its complications:

• Women: Get an exam every year and a Pap test as often as your healthcare provider recommends.
• Use latex or polyurethane condoms the right way during foreplay and every time you have vaginal, oral, or anal sex. Even after your warts are gone, you can infect your partner because the virus is still in your body. Condoms can lower the risk of getting genital warts from another person, but HPV can spread from areas not covered by a condom.
• Have just 1 sexual partner who is not sexually active with anyone else and who will use protection every time you have sex.
• Avoid sexual contact until the genital warts or HPV is completely treated and healed.