What is human papillomavirus (HPV)?
What is human papillomavirus (HPV)?
The human papillomavirus (HPV) is responsible for a common sexually transmitted infection that shares the same name. Most sexually active people are exposed to it at some point.
There are different types of HPV, and some can increase the risk of cancer. Each year, around 19,400 females and 12,100 males in the U.S. develop cancers that stem from HPV.
Treatments
There is no way no way to cure HPV, to remove the virus from the body.
However, a person can take various steps to remove the warts that HPV can cause. It is also worth noting that these warts often go away without treatment.
Common warts
Over-the-counter salicylic acid products can treat common warts. Do not use these products on warts in the genital area, however.
For some people, a doctor may prescribe one of the following medications:
- imiquimod (Aldara, Zyclara)
- podofilox (Condylox)
- trichloroacetic acid
- podophyllin
Also, surgical intervention may be necessary.
Genital warts
Do not use over-the-counter products on genital warts. A doctor may recommend :
- Cryotherapy: This involves using liquid nitrogen to freeze off warts.
- Electrocautery: This involves using an electrical current to burn away the warts.
- Laser or light therapy: This involves using a high-powered, targeted beam to remove the unwanted tissue.
- Surgical removal: A surgeon can cut away warts in an outpatient procedure that involves a local anaesthetic.
The best option will depend upon the type and location of the wart. Treatments can remove warts, but the virus will remain in the body and remain transmissible.
A person may have one small skin bump, a cluster of bumps, or stem-like protrusions. These warts can range in size and appearance, and they may be:
- large or small
- flat or cauliflower-shaped
- white, pink, red, purplish-brown, or skin-coloured
They can form on the:
- vulva
- cervix
- penis or scrotum
- anus
- groin area
These warts can cause itching, burning, and other discomfort.
Other types of warts
HPV can also cause common warts, plantar warts, and flat warts.
Common warts are rough, raised bumps that tend to form on the hands, fingers, and elbows.
Plantar warts are hard, grainy growths that often form on the feet, usually on the heels or balls of the feet.
Flat warts, meanwhile, are flat-topped, slightly raised lesions that are darker than the surrounding skin and often appear on the face or neck.
How HPV can lead to cancer
Most people with HPV do not develop cancer, but the infection can increase the risk, especially in people with weakened immune systems.
A high-risk strain of HPV can change the way that cells communicate with each other, and this can cause them to grow in an uncontrolled way.
In many people, the immune system defeats the unwanted cells. However, if the immune system is unable to do this, the cells can stay in the body and continue to grow. In time, this can lead to cancer.
It may take 10–20 years for a tumour to develop, according to the National Cancer Institute (NCI).
In the U.S., around 3% of all cancers in females and 2% of all cancers in males stem from HPV.
The infection can increase the risk of developing cancer of the:
- cervix
- vulva
- vagina
- penis
- anus
- oropharynx, includng the base of the tongue and the tonsils
Routine screening can lead to an early diagnosis, and receiving prompt treatment can prevent the cancer from spreading.
The best course of treatment will depend on the type of cancer, its stage, and the age and overall health of the person.
Causes
HPV is a virus that transmits through skin-to-skin contact often sexual contact. The infection can develop in anyone who is sexually active.
There may be no symptoms, or the symptoms may appear and disappear. HPV can pass from person to person regardless of whether symptoms are present.
The strains of HPV that cause warts are different from those that increase the risk of cancer.
Risk factors
Factors that increase the risk of HPV include:
- having several sexual partners
- having sex with someone who has had several sexual partners
- having sex without using barrier protection, such as a condom
- having areas of broken or damaged skin
- having contact with warts or surfaces where HPV exposure has occurred
- not having the HPV vaccination
The risk of cancer is higher if a person has HPV and:
- has other sexually transmitted infections, such as chlamydia
- delivered their first baby at a young age
- has given birth to many children
- smokes tobacco products
- has a weakened immune system
Diagnosis
If warts or lesions are visible, a doctor can usually diagnose HPV with a visual examination. Also, tests can confirm the presence of the virus.
When to get tested for HPV?
Tests for HPV or related cervical cellular changes include:
- a Pap smear
- a DNA test
- a biopsy
A Pap smear, also called a cervical smear, involves collecting and testing cells from the surface of the cervix or vagina. It can reveal any cellular abnormalities that may lead to cancer.
A DNA test can evaluate for high-risk types of HPV, and a doctor may use it alongside a Pap smear.
A biopsy, which involves taking a sample of affected skin, may be necessary if a test reveals unusual cell changes.
There is currently no routine screening for HPV in males, and the range of testing options is limited. Some experts have called for more testing, especially for men who have sex with men.
Prevention
To reduce the risk of contracting HPV, a person can:
- Get the HPV vaccine.
- Use barrier protection every time they have sex.
- Limit their number of sexual partners.
- Not have sex while genital warts are present.
To help prevent the warts from spreading:
- Avoid touching the wart unnecessarily.
- Wash the hands after touching a wart.
- Avoid shaving over a wart.
- Use footwear in public areas, such as pools and locker rooms, if warts are present on the feet.
- Treat and cover a wart until it disappears.
- Avoid sharing towels and other personal items.
Vaccination
The Centers for Disease Control and Prevention (CDC) recommend vaccination at the age of 11–12 years to reduce the risk of cervical and other forms of cancer.
Currently, three HPV vaccines available:
- Gardasil
- Cervarix (available in South Africa)
- Gardasil 9
People aged up to 26 years who have not received the vaccine should ask their doctors about it.
Speak with a doctor to see whether vaccination is appropriate. Anyone who is pregnant should wait until after delivery to have the vaccination.
Medically reviewed by Meredith Goodwin, MD, FAAFP — Written by Lori Smith, MSN, BSN, WHNP-BC — Updated on October 13, 2020
