GENITAL WARTS – HUMAN PAPILLOMAVIRUS (HPV)
By Dr. Nektarios Logaras – Dermatologist/Venereologist
HPV is the most common sexually transmitted disease (STD) affecting a large number of men and women, with an increasing tendency of transmission.
The infection is due to the Human Papillomavirus (HPV). Human papillomavirus (HPV) is a group of viruses that are extremely common worldwide.
There are more than 100 types of HPV viruses and they are divided into low and high risk, according to their ability through their action on healthy cells to turn them into cancerous cells. The “High Risk” Types are 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 82 and they can cause cancer. The “Low Risk” Types are 6, 11, 40, 42, 43, 44, 53, 54, 61, 72, 73 and 81. The most common “Low Risk” Types are 6 and 11.
Genital Warts appear as painless growths or lumps on the skin and mucous membranes of the vagina, penis, anus and perianal areas.
The first and most important step is to identify each and every lesion and recording them in order to monitor the progress and the effectiveness of the treatment. At Athens South Dermatology & Laser Clinic, Genital Warts are identified and recorded with the most reliable Digital Dermatoscope the Fotofinder ATBM System.
High resolution and high magnification, up to 140 times, allows us to identify even the smallest lesions that are not yet visible to the naked eye. Then, all the lesions are removed using the state-of-the-art CO2 Laser. At the same time a sample of lesions is taken to detect and identify the one or more of the types of HPV viruses and to find out the responsible type of HPV virus(es) in order to know from the beginning of the infection, the future course of the disease
If the procedure of detecting the Genital Warts is incomplete, i.e. if small genital warts that are not visible to the naked eye, are left behind without clearing them, the infection will persist and their appearance will become a vicious circle. We will see them growing, giving us a new generation of lesions, perpetuating the infection. Therefore, their diagnosis and treatment should be done by a specialized Dermatologist-Venereologist.
The identification of HPV type will determine:
The degree of risk, regarding the future transformation of healthy cells into cancer cells, depends upon the type of HPV virus causes the infection. For example, if they are high or low-risk types. More than 90% of cases are low-risk types, more specific, the types 6 and 11.
We recommend that both girls and boys are immunized against the HPV viruses that cause Genital Warts in order to prevent infection against types of viruses to which they have not yet been exposed and to help prevent further spread of the disease.
In order to reduce the rates of genital warts recurrence, after removing the lesions that are caused by the HPV virus, the treatment is continued at home with the use of a topical immunostimulatory cream in the affected area.
Our Lifestyle should be as friendly as possible to our immune system, because the ‘battle’ will be given between the immune system and the virus. When our immune system is strong then the virus can be defeated
THE TREATMENT IN ATHENS SOUTH DERMATOLOGY CLINIC
The treatment of genital warts at Athens South Dermatology-Venereology Clinic is in accordance with the international standards and protocols.
One of the most important reasons of high clearance rate in our clinic is the identification of all the lesions, even those ones that are not yet visible to the naked eye. This is achieved by the use of the advance technology, of Digital Dermoscopy Imaging System.
Then it follows the appropriate treatment, which is the complete destruction – evaporation of all lesions, even the smallest ones, with the advance technology of Laser CO2.
At Athens South, it is performed a detailed examination and the specialist Doctor devotes a lot of time without hurry, discreetly, with delicate handling, individualizing each examination and treatment. The procedure of digital dermoscopy for their detection followed by the treatment of genital warts is always performed by the specialist in Dermatology and Venereology Dr. Nektarios Logaras. This gives the patient the advantage that the doctor remembers the history, since he/she will need a follow-up reassessment, with possible future recurrences of the lesions. The instructions are clear without confusion, as it can happen if the same patient is examined and treated by different doctors each time.Thanks to many years of experience and specialization, we also provide the necessary support as it will require patience until the virus is cleared.
FREQUENT ASKED QUESTIONS ON Genital Warts
If I see something like a painless lump that looks like a small cauliflower or something new on my skin of vagina, penis, anus and in the perianal areas that protrudes or has a different color.
The most common areas are in the pubic area, the shaft, the glans and the prepuce of the penis, in men, the groins, on and around the genital area in women, in the urethra, or in the rectum or anus in both sexes, i.e. where the condom does not protect, especially if the sexual partners man – woman, man – man or woman to woman are freshly shaved in the pubic-perianal areas, due the friction causes minor injuries and the virus is inoculated into the skin and it does not pass into the blood.
The condom, however, is necessary, especially when it comes to having sex with a new partner, as it provides great protection from the genital warts being transmitted internally. Also the condom can provide protection from other STDs.
No. They are asymptomatic, they have been rarely reports of itching.
They can be transmitted through skin-to-skin contact.
The main way of transmission is sexual intercourse (from person to person). But, also, they may spread to the same person by the shaving or scratching with the nails in the area.
HPVs are curable, but….
If they are not treated properly and in time, they are more likely to continue to grow and spread but also to cause cancer in the rectogenital area and in the mouth.
Δεν έχουν επίπτωση στην εγκυμοσύνη και την γονιμότητα.
In most cases, they look like small cauliflowers or small strawberries, but there are also lesions that have the colour of skin and that’s why it is required experience and specialization in digital dermoscopy to be differentiated from nevi (moles), pimples (infection), molluscum contagiosum, seborrheic keratosis, pearly penile papules (PPP), cysts, haemorrhoids, angiokeratomas, freckles, hair follicle hyperplasia, skin folds as well as other Sexually Transmitted Diseases or other dermatological findings that do not necessarily need treatment.
This is not the case as someone can have the virus without ever developing genital wart lesions and someone else can develop genital warts lesions long after he/she has been infected.
This means that there should be no psychological strain between the couple as there is no precise examination to find out when was the first contact with the virus.
On the contrary, one partner should support the other, since it is a disease that they will overcome together.
Factors that increase the chances of frequent relapses are:
-Poor Diet (Nutrition)
-Shaving – Injury to the area
The available treatments are:
-Cryotherapy with liquid nitrogen
-Evaporation withCO2 Laser
Cryotherapy with liquid nitrogen is a cost-effective treatment but may leave scars and may be needed more than one treatment as there is no absolute control of the treated depth of the lesions. Diathermy cauterization is an old method that may leave scars and moist wounds with slow healing progress.
THE EVAPORATION WITH CO2 LASER IS THE MOST APPROPRIATE TREATMENT
There are many factors that play a key role for the rapid recovery. Such as the appropriate Laser treatment, the proper team cooperation, the accurate patient information, a well-organized place as well as the compliance with health and safety protocols. Furthermore, at the Athens South Dermatology Clinic, we have the appropriate smoke evacuator system in order to prevent the entrance of smoke due to the treatment process entering into the lungs through the respiratory system. Evaporation is the conversion of a lesion-tissue directly from the solid phase to the gaseous phase, without passing through an intermediate liquid phase. As a result, the HPV lesions are converted from solids to gas without leaving a wound, so they are healed in three to four days without leaving a scar. Another important advantage of the CO2 Laser is that the specialist doctor has full control over how much it will remove in depth and width, in order to completely destroy the lesion leaving the healthy skin intact. The procedure is short, simple, painless, bloodless and is applied in the doctor’s office under local anesthesia.
GENITAL WARTS ARE CURED.
THE THERAPEUTIC PROTOCOL.
- All lesions should be detected and treated at the first treatment appointment.
- To schedule a follow-up with digital dermoscopy for eight months with a visit once a month, as eight months is their incubation time.
- Our sexual partner has to be examined and treated also.
- To stimulate and strengthen our Immune system in order to fight infection (Multivitamins, Exercise, Adequate Sleep, Balanced Diet, Stress Avoidance, correct any Vitamin D3 deficiency.) Detection and Treatment of other diseases that may coexist.
- Home treatment with immunostimulatory topical treatment (ointment)..
- Avoid reinfection by a new partner.
Prevention is better than cure.
The HPV vaccine along with the condom is the most effective way of prevention.
The most common areas of genital warts are on the pubic area, around the genital area for both sexes, where the condom does not protect.
ΤThe HPV vaccine is prescribed at the doctor’s office and It is free for girls, and for boys up to 26 years old. A screening for all Sexually Transmitted Diseases (STDs) is also prescribed.
However, the vaccine is also given to older sexually active people because they may come in contact with the virus at any age. People who have been exposed to the virus can also be vaccinated in order to avoid being infected by other types that they do not have. Although the vaccination does not cure the current infection, it may reduce the risk of recurrence. The vaccination at the Athens South Dermatology – Venereology Clinic is performed by Dr. N. Logaras at no extra charge.
The Doctor’s experience
Dr. N. Logaras MD
Laser Dermatologic Surgeon
Graduate of Nottingham and Birmingham Universities of England.
- Specialization in Dermatologic Surgery, Department of Plastic Surgery, Hospital of Dermatology & Venereal Diseases “Andreas Syggros”
- Specialization in Digital Dermoscopy – Mole Mapping, at the Department of Dermoscopy and Melanoma, Hospital of Dermatology & Venereal Diseases “Andreas Syggros”
- Degree in Medicine, Bachelor of Medicine and Bachelor of Surgery, The University of Nottingham, UK.
- Bachelor of Medical Sciences STDs, Sexually Transmitted Diseases,The University of Nottigham, UK.
CAREER AND PROFESSIONAL EXPERIENCE
Dermatologist – Venereologist, Private Clinic – Athens South Dermatology & Laser Center, Alimos
-Dermatology – Venereology Specialty, Hospital of Dermatologic & Venereal Diseases “Andreas Syggros”
-Former Doctor, Royal Derby | Derby Teaching Hospitals NHS Foundation Trust, England
-Former Doctor, Taunton and Somerset Hospital NHS Trust-Musgrove Park, England
-Former Doctor, Worthing and Southlands Hospitals NHS Trust, England
-Former Doctor, Queen Alexandra Hospital, England
-Former Doctor, Portsmouth Hospital NHS Trust, England
-Former Doctor, Brighton and Sussex University Hospitals NHS Trust, England
19 years of medical experience
Phone No. for Appointment: +302109821431
I had an early and correct diagnosis which was vital in my case, my gynecologist didn’t have an electronic dermoscope, he wasn’t sure if they were warts, or papillomas, and he couldn’t find the very small ones. In ATHENS SOUTH with Mr. Lagaras, everything went well, because he found them all, and removed them with a Laser and they never came back.