Feeling frustrated with warts?
Understandably so – most of us have probably been forced to deal with warts at one time or another, whether personally or while supporting the loved ones.
And how much do you know about warts?
Wart is That?
Wart is an infection of the skin caused by Human papillomavirus (HPV). The virus enters the body through a break in the skin such as a cut, subsequently produces an excess amount of keratin (a hard protein) that causes the top layer of skin to grow rapidly and form a rough bump on the surface of skin, resulting in a wart.
For some types of wart, tiny blood vessels grow into the core of the wart and may appear as black or dark dots in the center, whereby the dark dot is the wart’s nutrients and oxygen supply.
Click and watch this brief video on What Causes Warts?
What is HPV?
Human Papillomavirus (HPV) is a family of over 100 viruses that can affect human skin and the moist membranes that line the body, such as the mouth, throat, anus and cervix.
HPV types are categorized into:
- Low Risk HPV that can cause wart, and
- High Risk HPV that may cause cancer like cervical, vaginal, and penile.
Wart is highly contagious and can be easily spread by direct contact or indirect contact, while it can take multiple months after exposure to HPV infection for warts to show. The key to prevent wart from growing and spreading is to avoid contact with HPV.
Types of HPV
There are over 100 HPV viruses and it is possible to be infected with multiple HPV types simultaneously.
Below are some key HPV types alongside the corresponding HPV disease and effects. Not all HPV viruses cause warts:
- High risk HPV-16 and HPV-18 that cause cervical, anal, vulvar, vaginal, and penile cancers.
- High risk HPV-31, HPV-33, HPV-45, HPV-52, and HPV-58 as causes of cervical cancers.
- High risk HPV-16 that can cause throat / oropharyngeal cancer.
- Low risk HPV-6 and HPV-11 that cause 90% of genital warts.
- Low risk HPV-2 and HPV-7 that may cause common warts.
- Low risk HPV-1, HPV-2, HPV-4, and HPV-63 that causes plantar warts.
- Low risk HPV-3, HPV-8, and HPV-10 as causes of flat warts.
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Disease
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HPV Strain
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Plantar warts
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1, 2, 4
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Common warts
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1, 2, 4, 26, 27, 29, 41, 57
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Flat warts
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3, 10, 27, 28, 41, 49
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Genital warts
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6, 11, 30, 40-45, 51, 54
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Cervical cancer
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16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58
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Precancerous changes
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16, 18, 34, 39, 42, 55
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Laryngeal papillomas
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6, 11, 30
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Watch the natural history of HPV virus replication and HPV disease progression in video below.
HPV in Women From Venus
According to the World Health Organization (WHO), high risk HPV-16 and HPV-18 cause 70% of cervical cancers and precancerous cervical lesions, which signifies the importance for women to go through regular Pap smear test to early detect and treat precancerous cells or dysplasia to prevent human papillomavirus infection develop into cervical cancer. Recommended minimum pap smear frequency is every 2 or 3 years.
Women with HPV should take note that studies show long-term use of oral contraceptives can increase the likelihood of HPV turning into cancer by up to four-fold. Consult the doctor to decide on next method of birth control if protection against pregnancy is desired.
On the other hand, there is no evidence that HPV will affect fertility or result in miscarriage and premature delivery. HPV during pregnancy usually does not harm the fetus, but there is low risk of HPV transmission to the baby and caused Recurrent Respiratory Papillomatosis (RRP) that grow tumors in the respiratory tract, according to the U.S. Centers for Disease Control and Prevention (CDC).
Pregnant women with HPV might experience genital wart growth due to hormone changes during pregnancy, or encounter abnormal tissue changes on the cervix, thus regular visit to doctor and routine cervical cancer screening are necessary.
As you would learn more details later on how to prevent HPV and warts, Cervarix is a cervical cancer vaccine that fights off HPV-16 and HPV-18, and Gardasil is the alternative vaccine that helps cervical cancer prevention while protect against HPV strains that cause genital warts. Check out HPV vaccine guidance from World Health Organization here.
In the CBC News health watch video Debunking HPV Myths below, Dr Jennifer Ashton discussed HPV and what all women should know.
HPV in Men From Mars
HPV can cause warts and increase men’s risk of getting uncommon genital cancers like penile and anal. About half of penile cancers found HPV infection, while anal cancer risk is about 17 times higher in sexually active gay and bisexual men than in men who have sex only with women.
While Gardasil is a HPV vaccine for male through age of 21 to help fight low-risk HPV virus that cause genital warts, there is presently no routine HPV test for men to check for high-risk HPV virus that can cause cancer.
Practice safer sex with condom and limit your number of sex partners, while boost your immune system with healthy habits like avoid smoking and reduce alcohol, are good prevention steps to fight HPV virus.
Visit the doctor for regular check-up, especially if you find warts or other skin abnormalities on penis or around the anus, whereby any detected precancerous cells should be removed before they lead to cancers.
Watch the CBC News below on how Michael Douglas’ comments that his throat cancer was caused by HPV has sparked the HPV discussion.
HPV Symptoms
The infected people often have no signs and symptoms of HPV, as majority of the HPV infection will be cleared by the immune system and disappear within 2 years. When there is no visible HPV symptom, the infection is called subclinical.
If the person does get symptoms, there is no definite duration of when do HPV symptoms appear, as the signs of infection can appear within weeks or months, or even years after the HPV infection.
For high risk HPV, the symptoms of HPV in women may include pelvic pain and abnormal vaginal bleeding as potential signs of cervical cancer, while HPV symptoms in men could be changes in the color of penis or a lump on the penis as potential signs of penile cancer.
The most common sign caused by low risk HPV on the other hand, is the presence of skin warts. Section Types of Warts elaborate more details on warts symptoms and characteristics, that are varying based on wart types and location.
How is HPV Transmitted
Wondering how do you get HPV? Is HPV contagious?
Around 30 of the 100 HPV strains that infect the genital area are primarily sexually transmitted through skin-to-skin contact during vaginal or anal intercourse. When an infected site of a person’s skin come into direct contact with a mucous membrane (such as genitals and anus) of an uninfected person, HPV virus will transmit and does not necessarily have to have an opening in the skin.
As genital HPV are transmitted through body fluids and mucous membranes, these genital HPV strains can spread through oral sex when the infected skin cell contacts with moist surface layers inside the mouth of an uninfected person.
Other low risk HPV strains that cause non-genital warts on other body area, such as foot and hand, can transmit through non-sexual direct contact with the warts. These warts HPV can be transmitted within the same person when the infected skin contact with an area of uninfected skin, usually by scratching the warts and bringing the virus to a new location.
And how long does HPV live outside the body?
HPV, like other virus, cannot live by itself. HPV requires a host cell to reproduce and function, with the duration that the virus survives outside the body depends on the surrounding environmental temperature and humidity.
There are claims that HPV cannot survive outside of the body long enough to transmit the infection, but researches do show HPV virus particles can be found on inanimate objects and dry surfaces, with some presence up to 24 hours till 7 days of lifespan, with below findings:
- U.S. National Cancer Institute revealed HPV-16 still demonstrated 30% of infectivity after dehydrated on a surface for 7 days at room temperature.
- Research by Jewish General Hospital of Canada shows HPV DNA detected on 50% of surgical gloves and 37% of biopsy forceps used for managing patients with genital HPV infections.
- Study published in Sexually Transmitted Infections – BMJ Journals shows HPV found on vibrator immediately after use in women with vaginal HPV, continued the presence up to 24 hours after the sex toy was cleaned.
While the wart-causing HPV transmission through indirect contact is not common and remain debatable, this transmission route cannot be ruled out especially if there is a break in the skin when the person’s skin is scratched or cut, increasing the risk for HPV to enter the body and attach to the host cells to start replicate.
As such, warts HPV can be spread through sharing of items like contaminated sex toys and razors, and transmitted indirectly from contaminated objects or surfaces such as the surrounding area of swimming pool, according to UK National Health Service.
HPV transmission to the baby during pregnancy and delivery is rare but possible, that potentially cause Recurrent Respiratory Papillomatosis (RRP) that grow tumors in the baby’s respiratory tract, like throat.
Remember: HPV can be passed on even if you do not see the warts or any wart symptoms.
The US National Library of Medicine estimated genital warts incubation period (from HPV infection to genital wart development) is 2 weeks to 8 months, with the majority of genital warts appearing 2–3 months after an HPV infection.
Is HPV a STD?
HPV is a very common STI (sexually transmitted infection), but not all HPV are STD (sexually transmitted disease).
The HPV types (e.g. HPV 2 and HPV 3) that infect non-genital body parts such as foot and hands are not sexually transmitted, and they are not the same strains as the sexually transmitted HPVs (e.g. HPV 16 and HPV 11) that infect the genital areas.
Besides, people with STI may not have had the infection show symptoms or turn into a disease, as over 90% of the HPV infection will go away without treatment. When these infections show HPV symptoms and cause warts or other effects such as HPV related cancer (e.g. cervical, anal and penile) that affect the genitals, then they are sexually transmitted diseases (STDs).
Difference between HPV and Herpes
While genital wart is caused by Human Papillomavirus (HPV), genital herpes is caused by the Herpes Simplex Virus (HSV). Hence, although both HPV and HSV are common sexually transmitted infection (STI), HPV is different virus than HSV.
Just as Dr Peter Leone added – ‘Warts are not a form of herpes, and HPV will not cause genital herpes. Conversely, genital herpes does not cause cervical cancer or anal cancer’.
Is HPV Curable?
There is no cure for HPV virus itself, but HPV treatment is available for the health effect and cell changes that HPV can cause, such as:
- Wart treatment with options like wart removal surgery, wart removal products, and natural home remedies.
- HPV incurred cervical cells change detected in abnormal Pap smear can be thoroughly diagnosed with colposcopy and treated before further development into Cervical cancer. Similar applied to other HPV-related cancers.
Nonetheless, recent study by The University of Texas Health Science Center (UTHealth) indicates the extract from Japanese Shiitake mushrooms called Active Hexose Correlated Compound (AHCC) shows initial promise in treating HPV.
As prevention is better than cure – practice safer sex with condom, and boost your immune system with healthy lifestyle habits like getting enough sleep and avoid smoking are among the warts and HPV prevention steps.
Does HPV Go Away?
According to U.S. Centers for Disease Control and Prevention (CDC):
“More than 90% of new HPV infections, including those with high-risk types, clear or become undetectable within 2 years, and clearance usually occurs in the first 6 months after infection”.
When HPV does not go away in men and females, the virus can live in a dormant state in the skin, whereby low risk HPV virus may cause recurring wart growth. Maintaining a healthy lifestyle to boost immune system will help reduce the chances of recurrences.
Warts and HPV Statistics
Warts and HPV are very common. According to American Sexual Health Association, The National Center for Biotechnology Information, and U.S. CDC:
- About 79 million people are thought to have an active HPV infection at any given time.
- About 14 million Americans become newly infected with HPV each year.
- About 6 million new cases of HPV are sexually transmitted annually in the United States.
- About 2 million people in England and Wales see general practitioner for cutaneous warts treatment yearly.
- About 80 percent of sexually active people contracting HPV at some point in their lives.
While below depict relation of HPV and cancer:
- Cervical cancer: Almost all cervical cancer is caused by HPV.
- Vulvar cancer: About 50% are linked to HPV.
- Vaginal cancer: About 65% are linked to HPV.
- Penile cancer: About 35% are linked to HPV.
- Anal cancer: About 95% are linked to HPV.
- Oropharyngeal cancers (cancers of the back of the throat, including the base of the tongue and tonsils): About 60% are linked to HPV, though many of these cancers may be related to tobacco and alcohol use.
The Takeaway… What Next?
Wart is a rough bump on the surface of skin caused by Human Papillomavirus, in which the HPV strains are categorized into low-risk HPV strains that can cause warts, and high-risk HPV strains that may cause cancer in men and women.
People often have no HPV symptoms when infected, while more than 90% of HPV infection will be cleared by the immune system and disappear by itself without treatment within 2 years, with clearance usually occurs in the first 6 months after infection.
HPV and warts are very common, with HPV wart virus is highly contagious that can spread through sexual contact, transmitted to one’s self when direct contact with wart, and even through indirect contact (though not common and remain debatable).
By now you have the basic understanding on HPV and warts. To win the war of warts, below are highly recommended reads for you to learn more:
- How to Identify All 8 Types of Wart
- 13 Actionable Tips to Prevent Embarrassing Warts
- Can HPV Warts on Hand Spread to Genitals: Ask The Experts
Always consult the doctor if you are not sure if you have HPV or warts. Nowadays you can even get medical consultations from licensed and board certified physicians from anywhere by going online or calling, to decide on next move.
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Hi Kousuke, thanks for sharing your thoughts!