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What is Human Papillomavirus (HPV) Infection?

HPV, which is short for human papilloma virus, is the virus that causes warts. There are many different strains of HPV – which type of wart you get will depend on the strain of HPV that you’ve been infected with. The most common types of wart are:

  • Common warts (Verruca vulgaris), which typically appear on your face or hands as raised lumps with a roughened, almost cauliflower-like appearance
  • Plantar warts (Verruca plantaris). These are the flat, hard “verrucas” that appear on your feet. They can be irritating or painful because they often occur on the parts of the sole or heel where your feet experience most pressure while walking
  • Flat warts (Verruca plana). These usually affect the hands or face but they can appear on other parts of the body, e.g. the knees or elbows. They are slightly raised but have a flattened top, and are either a bit darker than your normal skin, or have a reddish-brown tinge
  • Genital warts (Condylomata acuminata). These are transmitted via sexual contact and are in fact the most common type of sexually transmitted disease. They can be very small or they may grow into large bumps, or even have a stalk-like appearance. Genital warts can appear in, on or around the penis, scrotum, vulva, cervix, vagina, anus, or even occasionally in the mouth or throat, depending on what form the sexual contact has taken

Some people become infected with genital HPV without developing warts or even having any idea that they are infected – the virus can remain undetected within the body for up to two years, before being eliminated by the immune system. However, it is still possible for them to pass HPV on to other sexual partners.

There are two strains of genital HPV that cause cervical cancer in women instead of warts. In some cases, these two strains of HPV may also cause cancer in other areas such as the penis or anus.

Fast Facts about Human Papillomavirus (HPV) Infection

  • HPV infection is often symptom-free, but it can cause warts or cervical cancer
  • Warts caused by HPV generally fall into one of four main categories: common, plantar, flat and genital
  • There are over a hundred strains of the HPV virus
  • Genital HPV infection is spread via sexual contact. It does not cause symptoms in most cases, but can remain in the body for up to two years
  • Over-the-counter remedies are available to treat common and plantar warts, and your doctor may also recommend certain prescription drugs for all types of warts
  • Cervical cancer, which is usually caused by one of two HPV strains, does not cause any symptoms until it is quite advanced
  • Women should have regular screening via Pap tests to detect the early signs of cervical cancer

Types of Human Papillomavirus (HPV) Infection

There are over one hundred different strains of HPV, each of which has a number. For example, HPV 6 and HPV 11 are responsible for nine out of ten cases of genital warts.

Causes of Human Papillomavirus (HPV) Infection

Genital HPV is spread by sexual contact with an infected person, who may not even realize that they are infected. The virus enters the skin via tiny abrasions in its surface.

Common warts are spread by coming into contact with an object that has been used by an infected person, such as a towel. The infection is more likely to take hold if the skin has been damaged – for example, if you bite your fingernails, there is a greater chance that you will get common warts because they can develop on the broken/bitten skin next to the nails.

You can catch plantar warts by walking barefoot on a damp or wet surface, typically somewhere that receives a lot of visitors like a public swimming pool.

Risk Factors for Human Papillomavirus (HPV) Infection

People who have multiple sexual partners are more at risk of genital HPV, especially if they have unprotected sex.

Children and teenagers are more at risk of common and plantar warts than older people. People who bite their fingernails are also at greater risk of developing common warts on broken areas of skin next to the nail.

People who handle meat and work in abattoirs are at greater risk of developing warts.

In general, you are more at risk of catching HPV (of whatever type) if your immune system is weakened in some way, for example if you have HIV or AIDS, or if you are on immunosuppressant drugs.

Symptoms of Human Papillomavirus (HPV) Infection

Since they appear on the outside of the body, common and plantar warts are fairly easy to recognize. They can occasionally cause irritation or pain, particularly in the case of plantar warts which are subject to pressure when you walk.

The majority of people who catch a genital HPV infection do not actually develop any symptoms; the immune system fights off the infection before symptoms have the chance to develop. If you develop warts as a result of a genital HPV infection, the warts can appear in any part of the body that has come into contact with an infected person: the penis, scrotum, vulva, cervix, vagina, anus or sometimes the mouth or throat. They may vary in size and appearance, sometimes forming singly, sometimes in groups.

Cervical cancer caused by HPV infection does not usually cause symptoms until it’s quite advanced. These symptoms include abnormal or very heavy vaginal bleeding or discharge, fatigue, unexplained appetite or weight loss, pain in the pelvis, legs or back and leakage of urine/feces from the vagina.

Diagnosing Human Papillomavirus (HPV) Infection

If you think you have common, plantar or flat warts, your doctor will be able to confirm this from giving you a physical examination.

If you believe you have genital warts – particularly if they’re hard or impossible to see because of their location, you may be given at least one of these tests:

  • A vinegar solution test. When dabbed onto an infected area, this turns white in contrast to the surrounding skin
  • A DNA test that recognizes viral DNA
  • A Pap test (short for Papanicolaou test, after the Greek doctor who invented it). A sample of cells is taken from your cervix and are examined under a microscope, to see whether any of the cells show abnormalities that indicate cervical cancer or precancer

Treatment Options for Human Papillomavirus (HPV) Infection

If you have warts, they may cure themselves eventually without your having to do anything.

There are several over-the-counter remedies for common and plantar warts – these contain salicylic acid, the same active compound that is present in aspirin. They dissolve the wart away, layer by layer. You should not use salicylic acid-containing medication for genital warts.

Your doctor may prescribe Podofilox or trichloroacetic acid for genital warts – both of these are administered topically.

Another common topical treatment for genital warts is Imiquimod. This is an immunostimulant that helps the body fight off infection. It can also be used for hard-to-treat common warts.

Prevention of Human Papillomavirus (HPV) Infection

It is difficult to guarantee prevention of common warts. You should avoid borrowing towels and facecloths, especially from people who have common warts themselves. Don’t touch other people’s warts. If you have common warts, don’t pick or scratch them, as this will make them more likely to spread. You should also avoid nail biting, for the same reason.

You can help prevent plantar warts by avoiding damp, frequently-visited places like public swimming baths, locker rooms and showers – if you do go there, wear a pair of rubber pool shoes or flipflops. Since the virus likes damp conditions, it also helps if you keep your feet dry and clean, and change your socks every day.

The risk of genital warts increases the more sexual partners you have. If you are at all sexually active, you can’t guarantee that you’ll always remain 100 per cent clear of genital HPV infection but you can cut down the risk of infection by staying in a mutually faithful relationship rather than leading a promiscuous lifestyle. Wearing a condom helps to minimize the chances of infection, but again, it doesn’t confer 100 percent immunity and you should bear in mind that HPV infections can still occur in areas of the body that aren’t covered/protected by a condom!

There is a vaccine on the market that protects against most strains of genital HPV, including those that can cause cancer of the cervix. The vaccine is called Gardasil and is recommended as a routine inoculation for girls and young women.

Women should also get regular screening for cervical cancer, via a Pap test. This will help identify precancerous cells.

Coping with Human Papillomavirus (HPV) Infection

  • Most warts cure themselves eventually but there are some effective over-the-counter remedies available to treat common and plantar warts. Your doctor can also recommend prescription drugs
  • If you have warts of any kind, practice good hygiene to minimize the risk of infecting other people – wear something on your feet if you use a shared shower or visit a public swimming pool, and don’t lend people your towels or facecloths. You should also avoid scratching your warts or biting your nails, as this will make them more likely to spread
  • If you have genital warts you should ideally tell partners or potential partners about this. Use a condom and restrict your sexual contact to areas of the body that can be protected by the condom. However, you should bear in mind that a condom is not 100 percent effective at preventing HPV infection
  • Try to eat healthily in order to boost your immune system and help it fight off the infection

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