Anal warts commonly spread from person to person through sexual contact, although they may also spread from inanimate objects such as a shared bath towel. Around two-thirds of people who have sexual contact with a person who has genital warts will develop them, often within three months of the time of contact. Medical science estimates as many as one-million new cases of anal and genital warts are diagnosed each year in the United States alone.
There are two types of venereal warts - condyloma latum, and condyloma accuminatum.
Condyloma latum are moist and reddish warts. They are a sign of secondary syphilis. The warts are treated by treatment of the underlying syphilis infection through administration of antibiotics.
Conyloma accuminatum are white to pink warts that occur on a person's anus and genitalia due to an infection with the papilloma virus. The Human Papilloma Virus (HPV) is one of the more common viral sexually-transmitted diseases (STD's) in America. Approximately one out of every five adults in America has a genital HPV infection.
HPV's occur on a person's penis, vagina, anus or, on rare occasion, mouth.
Condyloma accuminatum in a person's anal area might be mistaken for hemorrhoids and are spread by contact with the wart which actively sheds viral particles. The warts grow geometrically and can become extensive. Warts that occur on other parts of a person's body such as the hands are caused by different forms of HPV. Contact with these warts does not appear to cause genital warts.
Anal warts can first appear as tiny spots or growths, maybe as small as the head of a pin, then potentially grow to be larger than the size of a pea.
The warts usually do not cause either pain or discomfort to those affected. Because of this, people may be unaware of the warts.
Some people experience symptoms that include itching, mucus discharge, bleeding, or a feeling of a mass or lump in their anal area. Anal warts should be removed or they will usually grow and multiply. If anal warts remain untreated, they may lead to an increased risk of cancer in the affected area.
Treatment using immunotherapy and a commercial preparation of alpha interferon is available.
The alpha interferon is injected into the anal or genital wart, stimulating an immune response that causes the wart to disappear. The problem with this form of therapy is that alpha interferon is expensive and does not always work. Imiquimod cream is another form of treatment that is applied by the person. The cream is an immune response modifier that induces local production of interferon in people with external genital warts.
While genital warts can be treated, none of the treatments that are available provide a cure for HPV itself. The virus can remain in nearby skin, even after treatment. The virus can remain dormant in a person's cells. In some cases, the warts may return months or even years after the person has received treatment for them. In other cases, the warts never return.
The more reliable form of treatment involves destruction of the wart:
The treatment can be accomplished chemically with liquid nitrogen, an acid compound, or surgically. The acid compounds are chemical cauterants that burn the wart off. Cryotherapy is the application of liquid nitrogen, which destroys the wart by freezing it off. The warts can also be destroyed by vaporization with a CO2 laser or electrocautery.
The procedures can be performed on an outpatient basis at an outpatient surgical facility or a hospital. At the time of the surgery, all of the visible warts are destroyed, although it can take up to thirty days before infected tissue presents signs of wart development. What this means is that it is important for the person to pursue prolonged follow-up care.
If the warts the person's has are very small and isolated to the skin around their anus, they might be treated only with a topical medication. They may also be treated by a doctor who can destroy them with liquid nitrogen. The warts can also be removed surgically. While surgery provides the person with immediate results, it does require the use of a local anesthetic such as Novocaine or a general or spinal anesthetic, depending upon the number and location of the warts. Warts located inside of the person's anal canal are commonly unsuitable for treatment through medications; they need to be treated surgically.
People who are treated for anal warts usually do not need to be hospitalized:
Surgical treatment of anal warts is commonly performed on an outpatient basis. The majority of people who received treatment experience mild discomfort for a few days after receiving treatment and may be prescribed pain medication. Depending upon the extent of the disease, some people return to work the following day; others might return after several days.
Recurrence of warts is common:
The virus that causes them may live in a person's tissues for many months before another wart develops. As new warts develop they can usually be treated in a doctor's office. At times new warts develop rapidly enough that treatment in an office would be uncomfortable. When this happens, a second or perhaps third outpatient surgical visit may be recommended. Follow-up visits are needed at regular intervals for several months after the last wart is observed in order to be sure that no new warts occur.
People who have experienced anal warts need to discuss with their doctor how often they should be evaluated for recurrent warts.
It is important to abstain from having sexual contact with people who have anal or genital warts.
The fact that many people can be unaware that they have the condition should be reason for everyone to practice safe sex habits.
Condom use, sexual abstinence, or limiting sexual contact to a single partner will reduce potential exposure to the contagious virus that causes anal and genital warts.
Sexual partners should be checked, even if they do not present with any symptoms.