Genital warts are a common skin manifestation of the human papillomavirus (HPV), the most common sexually transmitted infection worldwide. Dermatologists are skin specialists with extensive training in diagnosing and treating all types of skin growths, including those in the genital area. They are a primary resource for managing genital warts and offer a full range of therapeutic options.
Recognizing the Signs and Diagnosis Process
Genital warts are caused by low-risk strains of HPV, most often types 6 and 11, which are different from the high-risk types that can lead to certain cancers. These warts can appear weeks or months after exposure, making it difficult to pinpoint the exact time of transmission. The growths vary widely in appearance, sometimes presenting as small, flesh-colored or whitish-grey bumps.
They may occur individually or in clusters, occasionally taking on a rough, textured look that resembles a miniature cauliflower. The most common locations include the penis, scrotum, groin, vulva, vagina, and around the anus. While often painless, the warts can cause symptoms such as bleeding, a burning sensation, irritation, or itching when located in areas of friction.
Diagnosis typically begins with a thorough visual inspection of the affected area by a healthcare provider. In many cases, a dermatologist can confirm the presence of genital warts based solely on their characteristic appearance. A provider may apply an acetic acid solution to the skin, which can help make subtle or flat warts temporarily whiter and therefore more visible. On rare occasions, if the growths are unusual, do not respond to treatment, or if there is concern about an alternative diagnosis, a biopsy may be taken for microscopic analysis.
Specific Treatments Provided by Dermatologists
Dermatologists offer treatments for genital warts, which are generally categorized into in-office procedures and patient-applied topical medications. The choice of treatment depends on factors like the size, number, and specific location of the warts, as well as the patient’s overall health. While no treatment cures the underlying HPV infection, removing the warts can relieve symptoms and reduce the chance of transmitting the virus to others.
Provider-applied treatments are ablative methods designed to physically destroy the wart tissue during an office visit. These procedures are often preferred for larger or more resistant lesions.
- Cryotherapy: Liquid nitrogen is applied to the warts, freezing and destroying the cells, causing a blister to form and the wart to shed.
- Electrosurgery: This uses a high-frequency electrical current to burn and destroy the wart tissue.
- Surgical Excision: For larger lesions, dermatologists may cut out the warts under local anesthesia.
- Laser Therapy: Using a carbon dioxide laser, this precisely destroys affected tissue with focused light, often preferred for widespread or resistant warts.
- Chemical Solutions: Trichloroacetic acid (TCA) is applied in the clinic to chemically destroy the wart tissue.
In addition to in-office treatments, dermatologists frequently prescribe patient-applied topical medications for use at home. Imiquimod is a cream that works by stimulating the patient’s local immune system to attack the HPV virus and clear the warts. This medication is typically applied several times a week over a period of weeks or months.
Another common prescription is podofilox, a solution or gel that directly interferes with the wart cells’ ability to grow and divide. This is usually applied by the patient twice daily for a few days, followed by a break, and the cycle is repeated for several weeks. Sinecatechins, an ointment derived from green tea extracts, is also prescribed for external and anal warts, acting through both antiviral and antioxidant properties. Patient adherence to the specific application schedule is important for the success of these treatments.
Other Specialists Who Treat Genital Warts
Dermatologists are not the only medical professionals involved in the management of genital warts, as the condition often intersects with other areas of medicine. Primary care providers, such as family physicians, are frequently the first point of contact for patients with external genital warts. They can often diagnose and treat straightforward cases, though they will refer patients with complex or recurrent warts to a specialist.
Gynecologists (OB/GYN) play a significant role for women, especially when the warts are located internally, such as on the cervix or inside the vagina. They are also equipped to perform specialized procedures like colposcopy and manage the condition during pregnancy. For male patients, particularly when warts affect the urethra or deeper structures of the genitourinary tract, a urologist may be the most appropriate specialist. Dermatologists remain experts in the specific skin-based procedures and topical therapies.