Genital verrucous condyloma | Condyloma acuminatum

A condyloma is a wart usually found on the genitals. These are manifestations of a sexually transmitted infection, the human papillomavirus, also known as HPV.

This STBBI (sexually transmitted and blood-borne infection) is very prevalent in Canada. In fact, the majority of people with an active sex life will contract one form of HPV during their lifetime. It is still more likely to get it if you have many sex partners, have unprotected sex, or have a weakened immune system (due to taking immunosuppressive therapy, HIV/AIDS, etc.).

Symptoms of condyloma

Condylomas appear as warts and can take many forms. They range from lesions not visible to the naked eye, with a small, flat red patch, to a cauliflower-shaped growth. They can measure from a few millimeters to 1 cm.

In women, they are found inside or outside the vagina, around the cervix and around the anus.

In men, they are found on the tip or body of the penis, the scrotum and around the anus. 

It is also possible, but rarer, to get sores on the mouth or in the throat after having oral sex with an infected person.

Condylomas usually appear between 3 weeks to a few months after exposure to the virus, but can also occur several years later. They may go away on their own, without treatment, after several years.

Condylomas are usually painless, that is, they do not cause pain to the affected person,  but they can cause itching and bleeding. Depending on the location of the lesion, bleeding may be more or less prevalent and may occur after sex. Warts can make it harder to urinate, have a bowel movement, and have sex.

It is also important to understand that condylomata are a symptom of only certain types of HPV and that they do not happen in everyone. In fact, many people find themselves carrying HPV without ever having a single symptom. They can still pass it on.

Moreover, despite the discomfort they can cause, condylomas are neither dangerous nor cancerous.

Cause of HPV transmission

HPV is spread during sex when there is contact between the skin or mucous membranes of partners. It can be transmitted during oral, vaginal and anal sex, as well as through contact between the genitals even without penetration or when sharing sex toys. You don't need to have lesions to pass it on.

There are also different types of human papillomavirus. Some cause plantar warts, others cause condylomata, and some can even cause precancerous lesions, especially in the cervix in women. About 40 types are sexually transmitted.

Several types of HPV can cause warts, but types 6 and 11 are involved in about 90% of cases. Note that the types of HPV that can cause condylomata generally have a low risk of causing cancer. As a result, they rarely produce pre-cancerous cells, and few cancers are associated with them..

In rare cases, transmission can also occur during childbirth.

Diagnosis

When you discover a lesion in your genital area, it is important to see your doctor so that they can find the cause. In fact, several other STBBIs can cause lumps or lesions on the genitals. If your doctor is unsure of the cause, a biopsy may be required. 

You can also be diagnosed with HPV without having warts. In women, a cervical smear, or pap test, can determine the presence of HPV as well as precancerous or cancerous cells.

Treatment

No treatment is available to stop the virus. The single objective of the treatments is to make visible lesions disappear. These may recur. However, the virus usually becomes undetectable after a few years and warts no longer occur. Note that there are more recurrences in smokers, as their immune system seems to have more difficulty fighting the virus.

Destroying the condyloma reduces the risk of transmission, but it may still occur.

The treatment options are as follows:

• A cream prescribed by the doctor to apply to the wart at home
• Cryotherapy: freezing the wart with liquid nitrogen
• Electrocoagulation: burn the wart off with electricity
• Laser: destruction by intense light
• Chemical burning by using trichloroacetic acid or dichloroacetic acid.

The choice of treatment varies depending on the size, number and location of the warts.

No effective treatment exists without a prescription. Do not use plantar warts products, they will do you more harm than good.

Prevention

The only completely effective prevention is abstinence. However, you can still reduce your risk of contracting HPV by having only one sexual partner and making sure that the partner does not have other partners. In addition, you should refrain from having sex if you or a partner has lesions until they are destroyed.

It is recommended that you use a condom when having sex regardless of the type of relationship. However, despite the condom's proven effectiveness in protecting against many other STBBIs, it does not fully protect against HPV. In fact, since lesions may be found in places not protected by the condom, such as the scrotum, the risk remains very present.

In addition, there is an excellent preventive measure for some of the types of sexually transmitted HPV: vaccination. One of the vaccines prevents certain types of HPV that increase the risk of cancer, as well as types 6 and 11 which cause condyloma. This vaccine is included in the Quebec Immunization Protocol (PIQ) and is free for children under 18 as well as certain specific groups of adults. The rest of the population can get access to it at a certain cost. For more details, contact your nurse, doctor or pharmacist.

When should you see a doctor?

• If you have a condyloma or other lesion/lump on the genitals.
• If you are a sexually active woman between the ages of 21 and 65, it is recommended that you have pap tests periodically.
• If you have had unsafe or unprotected sex, it is recommended that you take tests for STBBIs.