This is an information sheet on condyloma (warts). Warts are caused by the Human Papilloma Virus (HPV) infection. This infection is one of the most common sexually transmitted diseases. Most men and women are carriers of this virus.

CONDYLOMA PHYSIOLOGY

• Warts are an overgrowth of tissue caused by the Human Papilloma Virus (HPV). The virus lives in your cells and can either remain dormant or activate the cell to create warts.

HPV TRANSMISSION

• The most common way of contracting the Human Papilloma Virus is through anal intercourse or anal sexual activity. This could have happened years ago and now the warts are developing. It is known that women who engage in intercourse at an early age (15) and with more than 2 partners have a 95% chance of contracting the Human Papilloma Virus. This shows the prevalence of this virus.

TREATMENT

• There are typically 2 ways to treat warts.
• Topical therapy
  • Podophyllin (requires office visits for application.
  • Bichloroacetic acid – a mild acid applied by a physician in the office. The acid burns the condyloma which sloughs off in 36-48 hours. Typically this treatment will cause mild discomfort/pain. It must be washed off with a warm bath 6 hours after application.
  • Aldara – a cream used 3 days a week for 12 weeks Efudex – a cream used 2 times a day for 2-4 weeks.
• Surgery
  • Typically for warts located outside the anus I remove them with a scalpel. For warts inside the anus I burn them off with cautery.

POST SURGERY PAIN

• Is the surgery painful? This question depends on where the surgery is performed. If done in a surgery center, the pain will be excruciating for up to a week or longer. If done in the office the majority of patients do quite well with pain lasting only 2-3 days. I find that patients having surgery done in the operating room require 40 or more Vicoden and most need a refill. When the same procedure is done in the office patients, on average, use 6-8 Vicoden with no refills needed. As a specialist who truly is dedicated to this problem I strive to treat warts efficiently with minimal pain.

CONDYLOMA RECURRENCE

• Once you are infected with the virus you are infected with thousands of virus particles, and therefore, it is always prevalent within your cells. Like weeds, once removed, new warts will grow back as only some of the virus particles are destroyed. For this reason even if celibacy is entertained, you always be at risk for recurrence.

RE-INFECTION

• Re-infection occurs when you contract more virus from your partner or other people with whom you are sexually active. After you are treated for warts one cause of recurrence is obtaining more virus after intercourse.

HPV AND ANAL CANCER

• The natural history of the Human Papilloma Virus and anal cancer is unknown. This means that at present there is no scientific data to support that having HPV will cause cancer. Recent studies; however, suggest that this virus may be associated with anal cancer. It is well known that the Human Papilloma Virus causes cervical cancer. Cervical cells and anal cells are very similar. The incidence of anal cancer is rising (especially in the HIV population) and the theory is that the same virus types that cause cervical cancer may be associated with anal cancer.

***For more information regarding anal cancer and HPV please read the pamphlet “Human Papilloma Virus (HPV) and the Risk of Anal Cancer”