Ankara HPV and Genital Wart Treatment | Dr. Armin Müştak

What Are HPV and Genital Warts?
Human papillomavirus (HPV) is a group of common viruses comprising numerous types that can affect the skin and mucous membranes. Some HPV types cause warts on the hands and feet, while others cause warts in the genital area; certain high-risk types can contribute to the development of specific cancers in cases of long-term infection.

Genital warts are most commonly caused by low-risk HPV types that are not associated with cancer. It is incorrect to assume that a person with genital warts will inevitably develop cancer. Conversely, the absence of visible warts does not definitively rule out a high-risk HPV infection.

HPV is very common, and the infection can remain asymptomatic for a long time. It is often impossible to determine exactly when or from which partner the virus was transmitted. Therefore, an HPV diagnosis should not be approached with accusatory or stigmatizing language.

How Is HPV Transmitted?
Genital HPV is most frequently transmitted through sexual contact and close skin-to-skin contact. Full sexual intercourse is not always required for transmission. HPV can spread from person to person even when there are no visible warts.

Condom use can reduce the risk of transmission; however, it does not provide complete protection because it does not cover the entire genital area. Behaviors such as sharing razors or picking at warts can contribute to the spread of the virus to surrounding skin areas.

Is There a Cure for HPV?
Currently, there is no proven medication that directly clears HPV from the body. Many HPV infections can be suppressed by the individual's immune system over time. The treatments administered target visible genital warts, cellular changes, and other diseases caused by HPV.

There is insufficient scientific evidence to support claims that commercially available supplements—purported to "clear HPV" or "eliminate the virus by boosting immunity"—actually eradicate HPV. Vitamins, supplements, or herbal products should not be used as a substitute for medical treatment.

How Are Genital Warts Diagnosed?
Genital warts can usually be identified through a dermatological examination. However, not every bump in the genital area is an HPV wart. Conditions such as molluscum contagiosum, skin tags, sebaceous glands, moles, syphilitic lesions, and certain benign or malignant growths can be mistaken for genital warts.

A biopsy may be required in the following situations:

The diagnosis is uncertain
The lesion is dark-colored, hard, or irregular
Bleeding or ulceration develops
There is no response to administered treatments
Lesions continue to grow during treatment
The individual has a suppressed immune system
HPV testing is not routinely used to confirm the diagnosis of visible genital warts or to determine which wart treatment should be administered.

How Are Genital Warts Treated?
The treatment method is determined by considering the number, size, and location of the warts, pregnancy status, previous treatments, and the individual's preferences. There is no single treatment method that is ideal for every patient or every wart. Methods that may be considered for genital warts include:

Physician-prescribed topical treatments
Cryotherapy
Physician-administered methods such as trichloroacetic acid application
Electrocauterization
Curettage or surgical excision
CO2 laser treatment for suitable patients
Certain topical medications cannot be used during pregnancy. Therefore, wart medications, acids, or over-the-counter products intended for hand or foot warts should not be applied to the genital area without a doctor's recommendation.

CO2 Laser for Genital Warts
CO2 laser treatment may be considered for genital warts that are large, widespread, numerous, or unresponsive to previous treatments. Local anesthesia may be administered prior to the procedure, allowing for the controlled removal of wart tissue.

Undergoing laser treatment does not mean the HPV virus has been completely cleared from the body. Even if visible warts are eliminated, the virus may persist in surrounding tissues, and new warts may develop.

Post-procedure effects may include pain, tenderness, sores, scabbing, infection, discoloration, or scarring. The suitability of the procedure and the specific device parameters to be used must be determined based on the location of the lesion.

Do Genital Warts Recur?
Genital warts can recur after successful treatment. Recurrence may occur, particularly in the months immediately following treatment. This does not necessarily mean the treatment failed or that reinfection has occurred; the virus already present in the area may give rise to new visible lesions.

There is no treatment that definitively prevents the recurrence of warts. Follow-up examinations are scheduled based on the individual's clinical status and the treatment administered.

Is the HPV Vaccine a Treatment?
The HPV vaccine does not treat existing HPV infections or established genital warts. However, it can help protect the individual against HPV types covered by the vaccine that they have not previously encountered.

For individuals who have previously been exposed to HPV or treated for genital warts, the suitability of the vaccine can be discussed with a physician, taking into account age, prior vaccination history, and personal risk factors.

Partners and Other Infections
Partners may carry HPV even if they do not have visible warts. Routine HPV testing for partners is generally not recommended in the management of genital warts; however, a physical examination and screening for other sexually transmitted infections may be beneficial.

Depending on the clinical situation, testing for HIV, syphilis, hepatitis, or other sexually transmitted infections may be planned for individuals with genital warts.

HPV and Cancer Screening
The HPV types most commonly causing genital warts generally differ from the high-risk HPV types associated with cancer. The presence of genital warts does not, in itself, necessitate more frequent cervical cancer screening than usual.

Individuals with a cervix should undergo follow-up by a gynecologist—in accordance with national screening guidelines—using Pap smears and, where necessary, high-risk HPV testing. Lesions located in the cervix, vagina, anal canal, or urethra may require evaluation in consultation with relevant medical specialties.

Office-Based Evaluation and Treatment Plan
At Dr. Armin Müştak’s dermatology practice, lesions in the genital area are evaluated with the utmost regard for patient privacy. An appropriate, personalized treatment plan is determined after assessing whether the lesions are indeed genital warts and examining their number, size, location, and any prior treatments.

When deemed necessary, a biopsy, testing for other sexually transmitted infections, or consultations with specialists in gynecology and obstetrics, urology, or general surgery may be recommended.