STD Facts – Human papillomavirus (HPV)

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Some health effects caused by HPV can be prevented by the HPV vaccines.

What is HPV?

HPV is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV (herpes). There were about 43 million HPV infections in 2018, many among people in their late teens and early 20s. There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening.

How is HPV spread?

You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms.

Anyone who is sexually active can get HPV, even if you have had sex with only one person. You also can develop symptoms years after you have sex with someone who is infected. This makes it hard to know when you first became infected.

Does HPV cause health problems?

In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.

Does HPV cause cancer?

HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).

Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.

There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems (including those with HIV/AIDS) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV.

How can I avoid HPV and the health problems it can cause?

You can do several things to lower your chances of getting HPV.

Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. (See “Who should get vaccinated?” below) CDC recommends HPV vaccination at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already. For more information on the recommendations, please see: https://www.cdc.gov/vaccines/vpd/hpv/public/index.html

Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer.

If you are sexually active

• Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas not covered by a condom – so condoms may not fully protect against getting HPV;
• Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

Who should get vaccinated?

HPV vaccination is recommended at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already.

Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination.

At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.

How do I know if I have HPV?

There is no test to find out a person’s “HPV status.” Also, there is no approved HPV test to find HPV in the mouth or throat.

There are HPV tests that can be used to screen for cervical cancer. These tests are only recommended for screening in women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years.

Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers.

How common is HPV and the health problems caused by HPV?

HPV (the virus): CDC estimates that there were 43 million HPV infections in 2018. In that same year, there were 13 million new infections. HPV is so common that almost every person who is sexually-active will get HPV at some time in their life if they don’t get the HPV vaccine.

Health problems related to HPV include genital warts and cervical cancer.

Genital warts: Before HPV vaccines were introduced, roughly 340,000 to 360,000 women and men were affected by genital warts caused by HPV every year.* Also, about one in 100 sexually active adults in the U.S. has genital warts at any given time.

Cervical cancer: Every year, nearly 12,000 women living in the U.S. will be diagnosed with cervical cancer, and more than 4,000 women die from cervical cancer—even with screening and treatment.

There are other conditions and cancers caused by HPV that occur in people living in the United States. Every year, approximately 19,400 women and 12,100 men are affected by cancers caused by HPV.

*These figures only look at the number of people who sought care for genital warts. This could be an underestimate of the actual number of people who get genital warts.

I’m pregnant. Will having HPV affect my pregnancy?

If you are pregnant and have HPV, you can get genital warts or develop abnormal cell changes on your cervix. Abnormal cell changes can be found with routine cervical cancer screening. You should get routine cervical cancer screening even when you are pregnant.

Can I be treated for HPV or health problems caused by HPV?

There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause:

1. Genital warts can be treated by your healthcare provider or with prescription medication. If left untreated, genital warts may go away, stay the same, or grow in size or number.
2. Cervical precancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment. For more information visit www.cancer.orgexternal icon.
3. Other HPV-related cancers are also more treatable when diagnosed and treated early. For more information visit www.cancer.orgexternal icon.

Where can I get more information?

STD information

HPV Information

HPV Vaccination

Cancer Information

Cervical Cancer Screening

CDC’s National Breast and Cervical Cancer Early Detection Program

STD information and referrals to STD Clinics
CDC-INFO
1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348
In English, en Español

CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
E-mail: [email protected]

American Sexual Health Association (ASHA)external icon
P. O. Box 13827
Research Triangle Park, NC
27709-3827
919-361-8488
E-mail: [email protected]

Human papillomavirus (HPV) and cervical cancer

What is HPV?

Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. Most sexually active women and men will be infected at some point in their lives and some may be repeatedly infected.

The peak time for acquiring infection for both women and men is shortly after becoming sexually active. HPV is sexually transmitted, but penetrative sex is not required for transmission. Skin-to-skin genital contact is a well-recognized mode of transmission.

There are many types of HPV, and many do not cause problems. HPV infections usually clear up without any intervention within a few months after acquisition, and about 90% clear within 2 years. A small proportion of infections with certain types of HPV
can persist and progress to cervical cancer.

Cervical cancer is by far the most common HPV-related disease. Nearly all cases of cervical cancer can be attributable to HPV infection.

The infection with certain HPV types also causes a proportion of  cancers of the anus, vulva, vagina, penis and oropharynx, which are preventable using similar primary prevention strategies as those for cervical cancer.

Non-cancer causing types of HPV (especially types 6 and 11) can cause genital warts and respiratory papillomatosis (a disease in which tumours grow in the air passages leading from the nose and mouth into the lungs). Although these conditions very rarely
result in death, they may cause significant occurrence of disease. Genital warts are very common, highly infectious and affect sexual life.

How HPV infection leads to cervical cancer

Although most HPV infections clear up on their own and most pre-cancerous lesions resolve spontaneously, there is a risk for all women that HPV infection may become chronic and pre-cancerous lesions progress to invasive cervical cancer.

It takes 15 to 20 years for cervical cancer to develop in women with normal immune systems. It can take only 5 to 10 years in women with weakened immune systems, such as those with untreated HIV infection.

Risk factors for HPV persistence and development of cervical cancer

• HPV type – its oncogenicity or cancer-causing strength;
• immune status – people who are immunocompromised, such as those living with HIV, are more likely to have persistent HPV infections and a more rapid progression to pre-cancer and cancer;
• coinfection with other sexually transmitted agents, such as those that cause herpes simplex, chlamydia and gonorrhoea;
• parity (number of babies born) and young age at first birth;
• tobacco smoking 

Global burden of cervical cancer

Worldwide, cervical cancer is the fourth most frequent cancer in women with an estimated 570 000 new cases in 2018 representing 7.5% of all female cancer deaths. Of the estimated more than 311 000 deaths from cervical cancer every year, more than 85%
of these occur in low and middle income countries. Women living with HIV are six times more likely to get cervical cancer compared to women without HIV, and an estimated 5% of all cervical cancer cases are attributable to HIV (2).

In high income countries, programmes are in place which enable girls to be vaccinated against HPV and women to get screened regularly. Screening allows pre-cancerous lesions to be identified at stages when they can easily be treated. 

In low and middle income countries, there is limited access to these preventative measures and cervical cancer is often not identified until it has further advanced and symptoms develop. In addition, access to treatment of such late-stage disease (for
example, cancer surgery, radiotherapy and chemotherapy) may be very limited, resulting in a higher rate of death from cervical cancer in these countries.

The high mortality rate from cervical cancer globally (Age Standardized Rate: 6.9/100,000 in 2018) could be reduced by effective interventions.

Cervical cancer control: A comprehensive approach

The Global strategy towards eliminating cervical cancer as a public health problem adopted by the WHA in 2020, recommends a comprehensive approach to cervical cancer prevention and control. The recommended set of actions includes interventions across
the life course.

The life-course approach to cervical cancer interventions

It should be multidisciplinary, including components from community education, social mobilization, vaccination, screening, treatment and palliative care.

Primary prevention begins with HPV vaccination of girls aged 9-14 years, before they become sexually active. 

Women who are sexually active should be screened for abnormal cervical cells and pre-cancerous lesions, starting from 30 years of age in the general population of women. Screening for sexually active women living with HIV should start at an earlier age,
once they have tested positive for HIV. 

If treatment of pre-cancer is needed to excise abnormal cells or lesions, cryotherapy or thermal ablation both destroy abnormal tissue on the cervix) is recommended and is performed in outpatient clinic.

If signs of cervical cancer are present, treatment options for invasive cancer include surgery, radiotherapy and chemotherapy and patients need to be referred to the right level of services.

HPV vaccination

There are currently 3 vaccines that have been prequalified, all protecting against both HPV 16 and 18, which are known to cause at least 70% of cervical cancers. The third vaccine protects against five additional oncogenic HPV types, which cause a further
20% of cervical cancers. Given that the vaccines which are only protecting against HPV 16 and 18 also have some cross-protection against these other less common HPV types which cause cervical cancer, WHO considers the three vaccines equally protective
against cervical cancer. Two of the vaccines also protect against HPV types 6 and 11, which cause anogenital warts.

Clinical trials and post-marketing surveillance have shown that HPV vaccines are very safe and very effective in preventing infections with HPV infections, high grade precancerous lesions and invasive cancer (3). 

HPV vaccines work best if administered prior to exposure to HPV. Therefore, WHO recommends to vaccinate girls, aged between 9 and 14 years, when most have not started sexual activity. The vaccines cannot treat HPV infection or HPV-associated disease,
such as cancer.

Some countries have started to vaccinate boys as the vaccination prevents genital cancers in males as well as females, and two available vaccines also prevent genital warts in males and females.

WHO recommends vaccination for girls aged between 9 and 14 years, as this is the most cost- effective public health measure against cervical cancer 

HPV vaccination does not replace cervical cancer screening. In countries where HPV vaccine is introduced, screening programmes may still need to be developed or strengthened.

Screening and treatment of pre-cancer lesions

Cervical cancer screening involves testing for pre-cancer and cancer, more and more testing for HPV infection is performed.  Testing is done among women who have no symptoms and may feel perfectly healthy. When screening detects an HPV infection
or pre-cancerous lesions, these can easily be treated, and cancer can be avoided. Screening can also detect cancer at an early stage and treatment has a high potential for cure. 

Because pre-cancerous lesions take many years to develop, screening is recommended for every woman from aged 30 and regularly afterwards (frequency depends on the screening test used). For women living with HIV who are sexually active, screening should
be done earlier, as soon as they know their HIV status. 

Screening has to be linked to treatment and management of positive screening tests. Screening without proper management in place is not ethical.

There are 3 different types of screening tests that are currently recommended by WHO:

• HPV DNA testing for high-risk HPV types
• Visual inspection with Acetic Acid (VIA)
• conventional (Pap) test and liquid-based cytology (LBC) 

For treatment of pre-cancer lesions, WHO recommends the use of cryotherapy or thermal ablation and Loop Electrosurgical Excision Procedure (LEEP) when available. For advanced lesions, women should be referred for further investigations and adequate management.

Management of invasive cervical cancer

When a woman presents symptoms of suspicion for cervical cancer, she must be referred to an appropriate facility for further evaluation, diagnosis and treatment.

Symptoms of early stage cervical cancer may include:

• Irregular blood spotting or light bleeding between periods in women of reproductive age;
• Postmenopausal spotting or bleeding;
• Bleeding after sexual intercourse; and
• Increased vaginal discharge, sometimes foul smelling.

As cervical cancer advances, more severe symptoms may appear including:

• Persistent back, leg and/or pelvic pain;
• Weight loss, fatigue, loss of appetite;
• Foul-smell discharge and vaginal discomfort; and
• Swelling of a leg or both lower extremities.

Other severe symptoms may arise at advanced stages depending on which organs cancer has spread.

Diagnosis of cervical cancer must be made by histopathologic examination. Staging is done based on tumor size and spread of the disease within the pelvis and to distant organs. Treatment depends on the stage of the disease and options include surgery,
radiotherapy and chemotherapy. Palliative care is also an essential element of cancer management to relieve unnecessary pain and suffering due the disease.

WHO response

The World Health Assembly adopted the global strategy to accelerate the elimination of cervical cancer as a public health problem and its associated goals and targets for the period 2020–2030 (WHA 73.2) (4).  The global strategy to
eliminate cervical cancer has set targets to accelerate the elimination: 

• a threshold of 4 per 100,000 women-year for elimination as a public health problem
• 90–70–90 targets that need to be met by 2030 for countries to be on the path towards cervical cancer elimination
• 90% of girls fully vaccinated with the HPV vaccine by age 15.
• 70% of women are screened with a high-performance test by 35, and again by 45 years of age.
• 90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated; 90% of women with invasive cancer managed).

WHO has developed guidance and tools on how to prevent and control cervical cancer through vaccination, screening and management of invasive cancer and a knowledge repository will make them available through a single point. WHO works with countries and
partners to develop and implement comprehensive programmes in line w the global strategy.

References

(1) Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2018). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/today

(2) Stelzle D, Tanaka LF, Lee KK, et al. Estimates of the global burden of cervical cancer associated with HIV. Lancet Glob Health 2020; published online Nov 16. DOI:S2214-109X(20)30459-9 
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30459-9/fulltext 

(3) Lei et al (2020)  HPV Vaccination and the Risk of Invasive Cervical Cancer.  N Engl J Med 2020;383:1340-8. DOI: 10.1056/NEJMoa1917338

(4) World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem https://www.who.int/publications/i/item/9789240014107

HPV: 5 Things All Women Should Know

HPV and Cancer – National Cancer Institute

What is HPV (human papillomavirus)?

HPV is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex. Sexually transmitted HPV types fall into two groups, low risk and high risk.

• Low-risk HPVs mostly cause no disease. However, a few low-risk HPV types can cause warts on or around the genitals, anus, mouth, or throat.
• High-risk HPVs can cause several types of cancer. There are about 14 high-risk HPV types including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68. Two of these, HPV16 and HPV18, are responsible for most HPV-related cancers.

HPV infection is common: Nearly all sexually active people are infected with HPV within months to a few years of becoming sexually active. Around half of these infections are with a high-risk HPV type.

HPV can infect both males and females. Both men and women can become infected with HPV and develop HPV-caused cancers.

Most HPV infections don’t cause cancer: Your immune system usually controls HPV infections so they don’t cause cancer.

High-risk HPV infections that persist can cause cancer: Sometimes HPV infections are not successfully controlled by your immune system. When a high-risk HPV infection persists for many years, it can lead to cell changes that, if untreated, may get worse over time and become cancer.

HPV vaccination can prevent cancer: HPV vaccines can prevent infection with disease-causing HPV types, preventing many HPV-related cancers and cases of genital warts.

What Cancers Are Caused by HPV Infection?

Long-lasting infections with high-risk HPVs can cause cancer in parts of the body where HPV infects cells, such as in the cervix, oropharynx (the part of the throat at the back of the mouth, behind the oral cavity that also includes the back third of the tongue, the soft palate, the side and back walls of the throat, and the tonsils), anus, penis, vagina, and vulva. 

HPV infects the squamous cells that line the inner surfaces of these organs. For this reason, most HPV-related cancers are a type of cancer called squamous cell carcinoma. Some cervical cancers come from HPV infection of gland cells in the cervix and are called adenocarcinomas.

HPV-related cancers include:

In the United States, high-risk HPVs cause 3% of all cancers in women and 2% of all cancers in men. Each year, there are about 45,000 new cases of cancer in parts of the body where HPV is often found, and HPV is estimated to cause about 36,000 of these, according to the Centers for Disease Control (CDC).

Worldwide, the burden of HPV-related cancers is much greater. High-risk HPVs cause about 5% of all cancers worldwide, with an estimated 570,000 women and 60,000 men getting an HPV-related cancer each year. Cervical cancer is among the most common cancers and a leading cause of cancer-related deaths in low- and middle-income countries, where screening tests and treatment of early cervical cell changes are not readily available.

How is HPV Transmitted?

HPV passes easily between sexual partners. It can be transmitted through any intimate skin-to-skin contact, including vaginal–penile sex, penile–anal sex, penile–oral sex, vaginal–oral sex, and use of sex toys or other objects. The infection passes easily between sexual partners. Condoms and dental dams can lower the chance of HPV transmission but do not prevent it completely.

Does HPV Infection Cause Symptoms?

Infection with high-risk HPV does not usually cause symptoms. The precancerous cell changes caused by a persistent HPV infection at the cervix rarely cause symptoms, which is why regular cervical cancer screening is important. Precancerous lesions at other sites in the body may cause symptoms like itching or bleeding. And if an HPV infection develops into cancer, the cancer may cause symptoms like bleeding, pain, or swollen glands. Learn more about signs and symptoms of cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers.

HPV Vaccination: Preventing HPV Infection

The HPV vaccine Gardasil 9® protects against infection from nine HPV types: the two low-risk HPV types that cause most genital warts, plus the seven high-risk HPV types that cause most HPV-related cancers.

HPV vaccination is recommended by the Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunizations Practices (ACIP) to prevent new HPV infections and HPV-associated cancers and other diseases.

HPV vaccination provides strong protection against new HPV infections. Vaccination is prevention and does not cure an infection once you have it. The HPV vaccine is not used to treat HPV infections or diseases caused by HPV. HPV vaccination offers the most protection when given at ages 9-12. HPV vaccination is estimated to prevent up to 90% of HPV-related cancers.

Who should get the HPV vaccine?

The HPV vaccine series is recommended for girls and boys, at the age of 11 or 12, and the series can be started at age 9. It is important for males as well as females to get vaccinated, because both men and women can develop cancers of the mouth and throat, anal cancers, and genital warts. Women are also at risk for cervical cancer, and men for penile cancer. Vaccination can also reduce the spread of HPV that causes cancer to other people. 

Children who start the vaccine series before age 15 need two doses to be protected. For young people who weren’t vaccinated within the age recommendations, HPV vaccination is recommended up to age 26. Those who receive their first dose at age 15 or older need three doses to be protected.

Can the HPV vaccine be given at older ages?

Yes, the vaccine can be given to adults between the ages of 27 and 45 who didn’t receive all vaccine doses earlier. Adults in this age group benefit less from the vaccine because they are more likely to have been exposed to HPV already. Therefore vaccination is not routinely recommended for people in this age group. If you are concerned that you are at risk for a new HPV infection, talk with your health care provider about whether HPV vaccination may be right for you.

Learn more about the human papillomavirus (HPV) vaccine.

Screening for HPV and Cell Changes Caused by HPV

Screening tests are used to check for disease when there are no symptoms. The goal of screening for cervical cancer is to find precancerous cell changes at an early stage, before they become cancer and when treatment can prevent cancer from developing.

Currently, cervical cancer is the only HPV-caused cancer for which FDA-approved screening tests are available. Screening for cervical cancer is an important part of routine health care for people who have a cervix. This includes women and transgender men who still have a cervix. Cervical cancer screening tests include the HPV test that checks cervical cells for high-risk HPV, the Pap test that checks for cervical cell changes that can be caused by high-risk HPV, and the HPV/Pap cotest that checks for both high-risk HPV and cervical cell changes. 

Learn more about HPV and Pap testing and find out about next steps after an abnormal Pap test or positive HPV test. 

Sometimes an HPV infection can become active again after many years. Learn more about what it means if a woman has a positive HPV test after many years of negative tests.

Screening for Other HPV-Related Cancers

There are no Food and Drug Administration (FDA) approved tests to detect HPV infections or HPV-caused cell changes in anal, vulvar, vaginal, penile, or oropharyngeal tissues. Research studies are ongoing to identify tests that can detect precancers in these areas or find cancer in an earlier, more treatable stage. 

Anal cancer screening: Among populations that are at higher risk for HPV infection, such as men who have sex with men or men who are HIV positive, some research has found that an anal Pap test (also called an anal Pap smear) may help to detect early cell changes or precancerous cells. Research is ongoing to see if treating anal precancer prevents anal cancer.

Learn more about Anal Cancer Prevention (PDQ®).

Oral cancer screening: Currently, there are no standard screening tests for oral cancer. The United States Preventive Services Task Force (USPSTF) has found that the current evidence is insufficient to assess the balance of benefits and harms of screening for oral cancer in asymptomatic adults. However, the American Dental Association (ADA) recommends dentists check for signs of oral and oropharyngeal cancer as part of a routine dental check-up in all patients.

Learn more about Oral Cavity, Pharyngeal, and Laryngeal Cancer Screening (PDQ®) and about symptoms in Oropharyngeal Cancer Treatment (Adult) (PDQ®).

Treatment for Cell Changes Caused by HPV Infection

Although HPV infection itself cannot be treated, there are treatments for the precancerous cell changes caused by infection with high-risk HPV.

Precancerous cervical cell changes: Most women who have precancerous cervical cell changes are treated with the loop electrosurgical excision procedure (LEEP), which is a method to remove the abnormal tissue.

Learn more about treatments for abnormal cervical cell changes.

Precancerous vaginal, vulvar, penile, and anal lesions and genital warts: Treatment methods include topical medicines, surgical excision, cryosurgery, and laser therapy.

HPV-related cancers: Individuals who develop an HPV-related cancer generally receive the same treatment as patients with tumors at the same site that are not related to HPV infection. However, patients with HPV-positive oropharyngeal cancer may receive different treatments than patients whose oropharyngeal cancers are not caused by HPV.

Learn more about treatment options for oropharyngeal cancer, including targeted therapy and new types of treatment such as immunotherapy being tested in clinical trials.

How Does HPV Cause Cancer?

HPV infection causes cells to undergo changes. If not treated these cells can, over time, become cancer cells.

Credit: National Cancer Institute

Once high-risk HPV infects cells, it interferes with the ways in which these cells communicate with one another, causing infected cells to multiply in an uncontrolled manner. These infected cells are usually recognized and controlled by the immune system. However, sometimes the infected cells remain and continue to grow, eventually forming an area of precancerous cells that, if not treated, can become cancer. Research has found that it can take 10 to 20 years, or even longer, for HPV-infected cervical cells to develop into a cancerous tumor.

Among women whose cervical cells are infected with high-risk HPV, several factors increase the chance that the infection will be long lasting and lead to precancerous cervical cells. These include:

• Having a very aggressive HPV type, particularly HPV 16 or HPV 18. If you have either of these HPV types, make sure you receive diagnostic testing with a colposcopy. 
• Smoking cigarettes. Quitting smoking can help your body to fight HPV. 
• Having a weakened immune system. If you have HIV or are taking medicines that suppress your immune system, talk to your health care provider about diagnostic testing and follow-up.

NCI and HPV-Related Research

Clinical trials are an important step in learning about better ways to prevent, diagnose, and treat diseases, such as cancers caused by HPV. NCI’s Cancer Information Service can help you learn about HPV-related trials in the United States.

The National Cancer Institute is conducting and funding research to learn more about HPV:

• The Division of Cancer Epidemiology and Genetics (DCEG) conducts research into cervical and other HPV-related cancers to advance our understanding of how HPV causes cancer, evaluates screening practices to determine the most effective methods to detect precancerous changes early, develops and tests new approaches to screening that may be easier to use in low-resource settings, and refines tools for risk assessment in the clinic to help health care providers follow up on abnormal screening test results. Investigators in DCEG conducted the first population-based clinical trial of HPV vaccines.
• The Division of Cancer Prevention (DCP) conducts and fosters the development of research on the prevention and early detection of human papillomavirus (HPV)-related cancers and related conditions.
• The Division of Cancer Control and Population Sciences (DCCPS) supports research-tested intervention programs related to HPV and the investigation of implementation strategies to promote the HPV vaccine in regions with low HPV vaccine rates.
• The Center for Cancer Research (CCR) is home to scientists and clinicians who are exploring the cutting-edge of cancer-related research. CCR scientists work on a wide spectrum of biological and biomedical problems, including HPV. Investigators in CCR conducted the research that led to the initial development and characterization of the human papillomavirus (HPV) vaccines.

Causes, Testing, Treatment & Prevention

Overview

Female pelvic anatomy

What is human papillpoma virus (HPV)?

HPV stands for human papilloma virus. It is a very common virus. There are about 100 types of HPV that affect different parts of the body. About 30 types of HPV can affect the genitals — including the vulva, vagina, cervix, penis and scrotum — as well as the rectum and anus. Of those, about 14 types are considered “high risk,” for leading to cervical cancer.

Male pelvic anatomy

How common is HPV?

HPV that affects the genitals is very common. Approximately 79 million Americans are currently infected with HPV, with roughly 14 million people becoming newly infected each year. Most men and women — about 80 percent of sexually active people — are infected with HPV at some point in their lives, but most people never know they have the virus.

Can men get HPV?

Yes. In men, genital warts most often appear on the penis, on the scrotum, in or around the anus, or on the groin. For men, HPV infection — including those that can cause cellular changes — cause no symptoms, so diagnosing HPV in men is difficult. The diagnosis of HPV in men is made when external genital warts are seen.

Since there is no treatment for HPV that has no symptoms, most men with the infection are not treated. Sometimes, a healthcare provider can see small warts that might have otherwise gone unnoticed. In general, HPV infection does not place a man at a much higher risk for health problems. However, HPV prevention is still important for men, as the virus has been linked to uncommon cancers such as penile, anal, and head and neck.

How is HPV related to cervical cancer?

Certain strains of HPV can cause changes in the cells of the cervix, a condition called cervical dysplasia. If it is not treated, dysplasia can advance to cervical cancer. HPV is almost always the cause of cervical cancer. However, just because a woman has HPV or cervical dysplasia does not necessarily mean she will get cervical cancer.

Regular Pap tests are the best protection against cervical cancer. The test detects pre-cancerous changes and cervical cancer. Cervical cancer is almost always preventable or cured if pre-cancerous changes are detected and treated early, before cancer develops.

Before age 30, HPV infection is usually transient (gets better on its own). By age 30, finding HPV during Pap screening can help determine how often to be screened. The absence of high-risk HPV types usually means that a woman is at low risk for developing cervical changes related to the risk of cervical cancer. In this case, the period between Pap test screenings is usually five years for most women.

If a woman tests positive for high-risk HPV types, her healthcare provider will perform more frequent Pap tests to check for any cell changes that might be pre-cancerous or that need to be treated .

What is cervical cancer?

Cervical cancer is a condition in which the cells in the lining of the cervix — the narrow, outer end of the uterus — change and grow very fast, producing a grouping of cells called a tumor. This condition usually develops over time. It can affect women of any age, but it is most common in women in their mid-40s. A type of virus, called HPV, is the cause of most cases of cervical cancer.

Symptoms and Causes

How do you get human papilloma virus (HPV)?

Genital HPV is spread through contact with (touching) the skin of someone who has an HPV infection. Contact includes vaginal, anal, and oral sex. Some types of HPV cause genital warts, which are hard, rough lumps that grow on the skin. Anyone who is sexually active can get HPV and genital warts.

In women, genital warts most often appear in the following areas of the body:

• On the vulva (the outer female genital area)
• In or around the vagina
• In or around the anus
• On the groin (where the genital area meets the inner thigh)
• On the cervix

What are the symptoms of HPV?

In many cases, HPV causes no symptoms. When they do occur, the most common symptom is warts in the genital area. Signs of infection can appear weeks, months, or even years after the person has been infected with the virus.

Diagnosis and Tests

How is human papilloma virus (HPV) diagnosed?

There are no blood tests for HPV, but some tests can help your healthcare provider diagnose the infection:

• Pap test: During this test, the healthcare provider removes a sample of cells from the cervix. The cells are then examined under a microscope to look for any changes in the cells, even if the patient does not have genital warts.
• Colposcopy: For this test, a healthcare provider uses an instrument — called a colposcope — that shines a light and enlarges the view of the cervix. A vinegar solution is placed on the cervix. The solution turns abnormal cells that are infected with HPV white, so they can be seen more easily.
• HPV DNA test: This test looks directly for the genetic material (DNA) of the HPV within a sample of cells. The test can detect the type of HPV connected to cervical cancer. The sample used for this test is generally collected at the same time as a Pap test.

Management and Treatment

How is human papilloma virus (HPV) treated?

There is no cure for the virus itself, but many HPV infections go away on their own. In fact, about 70 to 90 percent of cases of HPV infection are cleared from the body by the immune system.

When treatment is needed, the goal is to relieve symptoms by removing any visible warts and abnormal cells in the cervix. Treatments might include:

• Cryosurgery: Freezing the warts off with liquid nitrogen.
• Loop electrosurgical excision procedure (LEEP): Using a special wire loop to remove the abnormal cells.
• Electrocautery: Burning the warts off with an electrical current.
• Laser therapy: Using an intense light to destroy the warts and any abnormal cells.
• Prescription cream: Applying medicated cream directly to the warts. (Do not use over-the-counter wart treatments on the genital area.)

In some cases, no treatment is needed. However, your doctor will closely watch any cell changes during your regular screening appointments.

Only a small number of women infected with HPV will develop cellular changes that need to be treated.

Prevention

Can human papilloma virus (HPV) be prevented?

Using condoms correctly every time you have sex can help reduce the risk of HPV. You should be aware, however, that condoms do not cover all of the genital skin, so they are not 100 percent effective in protecting against the spread of HPV. A person with genital warts should not have sex until the warts are removed. This might help reduce the risk of spreading HPV.

Here are some other ways of reducing the risk of HPV:

• Women should have regular Pap tests to look for abnormal changes in the cervix that might be pre-cancer.
• Men and women should stop having sexual contact as soon as they know or think they have genital warts, and they should seek treatment immediately.
• Get vaccinated with one of the three available HPV vaccines. Gardasil® and Gardasil9® protect against the development of cervical cancer and genital warts. They are approved for girls and women ages 9 to 26, as well as for boys and men ages 9 to 26 to protect against genital warts. The third vaccine, called Cervarix®, is approved for women only to protect against cervical cancer (does not protect against several of the HPV strains that cause warts).

It is best to get the vaccine before the start of sexual activity. The vaccine consists of a series of three shots, with the second shot coming two months after the first, and the third coming six months after the first. If you already have HPV, the vaccine does not treat or cure, but can still help protect against other types of HPV infections.

Resources

Glossary of terms

• Cervical dysplasia: A pre-cancerous condition that occurs when the human papilloma virus (HPV) leads to changes in the cells of the cervix
• Cervix: The tip of the uterus, where the vagina meets the uterus
• Genital warts: Hard, rough lumps that develop on the skin
• Groin: Where the genital area meets the inner thigh
• Vulva: The outer female genital area

What You Need to know about HPV

New guidelines, issued in February by the Centers for Disease Control and Prevention, urge vaccination against the human papilloma virus for all boys aged 11-12. Vaccination for girls aged 11-12 has been recommended since 2006. We offer this review of the facts about HPV to help parents make an informed decision for their children.

Genital human papillomavirus (HPV) is currently the most common sexually transmitted infection in the United States. Approximately 20 million Americans are already infected with HPV and each year another 6 million become newly infected. It’s estimated that at least 50 percent of sexually active men and women will get HPV at some point in their lives.

HPV used to be thought of simply as the cause of common skin and genital-area warts. In the late 1970s, however, studies began linking HPV infection to cervical cancer. These studies, which earned their author the Nobel Prize in Medicine, led to further research into the potential dangers of HPV infection. We now know that HPV is responsible for many of the cancers affecting the sexual organs and for oropharyngeal cancers, that is, cancer at the back of the throat, base of the tongue, or of the tonsils.

Signs and Symptoms 

Since most people with HPV do not experience noticeable symptoms or health problems, they are unaware that they have the infection, and unaware that they are transmitting it. In 90 percent of cases, the virus will be naturally cleared by the body’s immune system within about two years. However, when the HPV infection lingers, symptoms and health risks can develop.

Genital warts are the most noticeable symptom, and can appear within weeks or months of contact with an infected partner, even if he or she showed no signs. These warts are caused by a “low-risk” type of HPV, one that does not develop into cancer. Without treatment, some genital warts will go away, some will remain unchanged, while others will grow in size and number. It is not possible to predict the development of individual cases, and the longer genital warts go untreated, the more likely they are to return.

Health Risks

Almost all cases of cervical cancer are caused by HPV. More than 50 percent of vulvar or vaginal cancer, and 95 percent of anal cancers are linked to HPV. A study published this January reveals that HPV is responsible for more oropharyngeal cancers than is tobacco use and estimates that”by 2020, there will be more HPV-positive oral cancers among men than cervical cancers among women in the US.”

Why Vaccinate ? 

There is currently no cure for HPV, just treatment for symptoms. The FDA has approved two HPV vaccines, Gardasil and Cervarix, both highly effective in preventing persistent infection with the “high-risk” HPV types that cause 70 percent of cervical cancers and also effective with HPV-linked cancers at other sites. Gardasil, the only vaccine available to men, is also effective against the HPV types that cause nearly all (90 percent) of genital warts.

To be fully effective, the HPV vaccine must be given before any HPV infection. That’s why public health experts recommend it be given in the pre-teen years of 11 or 12.

The Dangers of Untreated HPV: Asia Mohsin, MD: OBGYN

Did you know that almost 80 million Americans have the human papillomavirus (HPV), and 6 million more contract it each year? These numbers make HPV the most common sexually transmitted disease in America. 

Multiple types of HPV exist, and not all of them have symptoms. In fact, many people with HPV don’t know they have it and let it go untreated. This leads to the virus spreading to more people who may also go untreated. 

At Progressive Women’s Health in Friendswood, Texas, Asia Mohsin, MD, and our entire team are dedicated to giving patients the best in comprehensive clinical care in a welcoming environment. Our compassionate team respects your privacy and offers confidential STD screenings to ensure your optimal health and treatment.  

What is HPV?

The human papillomavirus, or HPV, is a group of 150 related viruses. The different strains have different symptoms, and some have no symptoms at all. Some of the viruses can cause genital warts, some can cause cancer, but all are transmitted sexually. 

Fortunately, there’s now a vaccine available for the cancer-causing strains of HPV. This vaccine is recommended for people under age 26, and Dr. Mohsin is able to administer it at your appointment.

How does HPV spread?

The human papillomavirus spreads through skin-to-skin contact. The most common way it’s transmitted is through vaginal, anal, or oral intercourse. Other than abstaining, there is no way to completely eliminate getting or transmitting the virus. You can, however, minimize your risk by using condoms and other barriers during sexual contact. 

Factors that lead to an increased risk of contracting or spreading HPV include:

• Skipping regular OB/GYN appointments 
• Lacking access to health insurance or education 
• Being asymptomatic and not knowing you need treatment
• Having multiple sexual partners 
• Not using a barrier method when having sexual intercourse

It’s possible to have more than one type of HPV and still be symptom-free. Sometimes symptoms won’t appear for years after you’ve been infected, meaning you could spread the disease to multiple people without knowing it. 

What are the dangers of untreated HPV?

Fortunately, most strains of HPV aren’t deadly. In many cases, HPV resolves on its own without any treatment. However, some types of HPV can cause a number of health conditions, such as genital warts and cancer. 

Genital warts can be removed by a doctor. Cancer is the most serious threat posed by untreated HPV. Without treatment, HPV can lead to anal, vaginal, penile, and throat cancer. 

It’s important that you maintain regular OB/GYN exams with Dr. Mohsin. During your regular visit, Dr. Mohsin will check for signs of cancer and will run any necessary lab work. This can ensure an early diagnosis of cancer, which can improve your chances of successful treatment.

At Progressive Women’s Health, your health is our top priority. To learn more about HPV screenings and treatment, book an appointment online or over the phone today.

90,000 Human papillomavirus (HPV) and cervical cancer

What is HPV?

Human papillomavirus (HPV) is the most common viral infection of the genital tract. Most sexually active women and men acquire the infection at some point in their lives, and some may be reinfected.

The peak infection period for both women and men begins shortly after they become sexually active. HPV is sexually transmitted, but penetrative sex is not required to transmit the virus.Bodily genital contact is a well established route of transmission.

Many types of HPV do not cause problems. HPV infections usually go away on their own, without any intervention, a few months after infection, and about 90% go away within 2 years. A small proportion of infections with certain types of HPV can persist and lead to the development of cervical cancer.

Cervical cancer is by far the most common HPV-related disease.Almost all cases of cervical cancer can be attributed to HPV infections.

Infection with some types of HPV can also lead to cancers of the anus, vulva, vagina, penis and oropharynx, which can be prevented using the same primary prevention strategies as for cervical cancer.

HPV types that do not cause cancer (especially types 6 and 11) can lead to genital warts and respiratory papillomatosis (a disease in which tumors grow in the airways leading from the nose and mouth to the lungs).Although these conditions very rarely lead to death, they can often lead to illness. Genital warts are widespread, highly infectious, and have a negative impact on sex.

How does HPV infection lead to cervical cancer?

Although most HPV infections and precancerous lesions go away on their own, there is a risk for all women that HPV infection can become chronic and precancerous lesions develop into invasive cervical cancer.

Women with normal immune systems develop cervical cancer within 15–20 years. In women with weakened immune systems, such as those with HIV infection if untreated, it may take as little as 5-10 years to develop.

Risk factors for the persistence of HPV and the development of cervical cancer

• HPV type – its carcinogenicity, or the ability to cause cancer;
• immune status – people with weakened immune systems, such as people with HIV infection, are more likely to have persistent HPV infections that develop more rapidly into precancer and cancer;
• co-infection with other sexually transmitted pathogens such as herpes simplex, chlamydia and gonorrhea pathogens; 90,033 90,032 number of births (number of children born) and early first births;
• tobacco use.

Global burden of cervical cancer

Cervical cancer is the fourth most common cancer among women globally, with an estimated 570,000 new cases in 2018, accounting for 7.5 % of all female deaths from cancer. It is estimated that more than 85% of the more than 311,000 annual deaths from cervical cancer occur in low- and middle-income countries. Women with HIV are six times more likely to develop cervical cancer than women who are not HIV infected, and an estimated 5% of all cervical cancer cases are HIV-related (2) .

High-income countries have programs that provide opportunities for girls to get the HPV vaccine and women for regular screening. Screening detects precancerous lesions at stages where they can be easily treated.

In low- and middle-income countries, access to such preventive measures is limited, and cervical cancer is often only diagnosed late, when symptoms develop. In addition, access to treatment for the disease at such advanced stages (eg, surgery, radiation therapy and chemotherapy) can be very limited, resulting in high mortality rates from cervical cancer in these countries.

High global mortality from cervical cancer (age-standardized rate: 6.9 / 100,000 in 2018) can be reduced through effective interventions.

Tackling cervical cancer: an integrated approach

The WHA’s Global Strategy to Accelerate Elimination of Cervical Cancer as a Public Health Issue in 2020 recommends a comprehensive approach to the prevention and control of cervical cancer. The recommended set of measures includes activities covering the entire life cycle.

should be multidisciplinary and include components of community education, social mobilization, vaccination, screening, treatment and palliative care.

Primary prevention begins with HPV vaccination of girls aged 9-14, that is, before they become sexually active.

Sexually active women should be screened for abnormal cervical cells and precancerous lesions from the age of 30. Screening for sexually active women with HIV infection should begin at an earlier age, immediately after a positive HIV test result.

For the treatment of precancerous lesions, removal of abnormal cells or lesions is recommended on an outpatient basis (abnormal cervical tissue can be destroyed with cryotherapy or thermal ablation).

If there are signs of cervical cancer, treatment options for invasive cancer include surgery, radiation therapy, and chemotherapy, and patients should be referred to the correct level of care.

HPV vaccination

There are currently 3 prequalified vaccines that protect against HPV
16 and 18, which are known to cause at least 70% of cervical cancers.A third vaccine protects against five more carcinogenic HPV types, which cause an additional 20% of cervical cancers. Given that vaccines that only protect against HPV 16 and 18 also have some cross-protection against these less common HPV types that cause cervical cancer, WHO believes the three vaccines protect against cervical cancer equally. Two of these vaccines also protect against HPV types 6 and 11, which lead to the development of anogenital warts.

Results from clinical trials and post-marketing surveillance indicate that HPV vaccines are highly safe and effective in preventing HPV infections, serious precancerous lesions and invasive cancers (3) .

HPV vaccines are most effective when given before exposure to HPV. Therefore, WHO recommends vaccinating girls between the ages of 9 and 14, when most of them are not yet sexually active. Vaccines cannot treat HPV infections or HPV-related diseases such as cancer.

Some countries have introduced the vaccination of boys, given that vaccination prevents the development of genital cancer in both men and women, and the two available vaccines also prevent the development of genital warts in men and women.

WHO recommends vaccinating girls aged 9-14 years as this is the most cost-effective public health measure against cervical cancer.

HPV vaccination is not a substitute for cervical cancer screening. In countries where HPV vaccination is introduced, screening programs may still need to be developed or strengthened.

Screening for precancerous lesions and their treatment

Screening for cervical cancer includes testing for precancer and cancer, and more and more tests for HPV infection are being performed.Testing is performed in women who are asymptomatic and who are feeling perfectly healthy. If screening detects HPV infection or precancerous lesions, they can be easily treated and thereby prevent the development of cancer. Screening can also detect cancer at an early stage with a high likelihood of a cure.

Given the fact that precancerous lesions develop over the years, every woman is recommended to undergo screening from the age of 30 and then regularly (depending on the test used).For sexually active women with HIV infection, screening should be done as early as possible once they become aware of their HIV status.

Screening should be linked to the treatment and management of patients with positive screening results. Screening without proper patient management is not ethical.

WHO currently recommends 3 different screening types:

• DNA testing for high-risk HPV types
• visual inspection with acetic acid
• conventional Pap test ( ) and liquid cytology

For the treatment of precancerous lesions, WHO recommends the use of cryotherapy or thermal ablation, and electrosurgical loop excision if available.For advanced lesions, women should be referred for further research and appropriate treatment.

Treatment of invasive cervical cancer

Women with symptoms suggestive of cervical cancer should be referred to appropriate health facilities for further evaluation, diagnosis and treatment.

Symptoms of early stage cervical cancer may include:

• Irregular spotting or minor bleeding between periods in women of reproductive age;
• Spotting or bleeding in the postmenopausal period;
• bleeding after intercourse; and
• profuse vaginal discharge, sometimes with an unpleasant odor.

As cervical cancer progresses, more serious symptoms may appear, including:

• persistent back, leg and / or pelvic pain;
• weight loss, fatigue, loss of appetite;
• discharge with an unpleasant odor and discomfort in the vagina; and
• edema of the leg or both lower extremities.

Other severe symptoms may occur in later stages, depending on which organs the cancer has spread to.

The diagnosis of cervical cancer should be made on the basis of histopathological findings. Determination of the stage is based on the size of the tumor and the spread of the disease within the pelvis and to distant organs. Treatment depends on the stage of the disease and includes surgery, radiation therapy, and chemotherapy. Palliative care is also an important element in the management of cancer patients to relieve excessive pain and suffering.

WHO activities

The World Health Assembly adopted a global strategy to accelerate the elimination of cervical cancer as a public health problem and its goals and targets for the period 2020-2030.(WHA73.2) (4) . The global strategy sets targets to accelerate the elimination of cervical cancer:

• the threshold for elimination as a public health problem set at 4 per 100,000 women per year; 90,033 90,091 For countries to be on the path to eliminating cervical cancer by 2030, the 90-70-90 targets below must be met; 90,033 90,091 90% of girls should be fully vaccinated against HPV by age 15;
• 70% of women should be screened with a high-performance test at age 35 and then at age 45;
• 90% of women with diagnosed cervical disease should receive treatment (provide treatment for 90% of women with precancerous cancer; ensure 90% of women with invasive cancer are managed).

WHO has developed guidelines and tools for the prevention and control of cervical cancer through vaccination, screening and treatment for invasive cancer, which are hosted in a knowledge repository. WHO works with countries and partners to develop and implement comprehensive programs in line with the global strategy.

References

(1) Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2018).Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/today

(2) Stelzle D, Tanaka LF, Lee KK, et al. Estimates of the global burden of cervical cancer associated with HIV. Lancet Glob Health 2020; published online Nov 16. DOI: S2214-109X (20) 30459-9 https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30459-9/fulltext

(3) Lei et al (2020) HPV Vaccination and the Risk of Invasive Cervical Cancer.N Engl J Med 2020; 383: 1340-8. DOI: 10.1056 / NEJMoa1917338

(4) World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem https://www.who.int/publications/i/item/9789240014107

The whole truth about the papilloma virus (HPV). What is HPV? HPV treatment methods.

In the structure of the incidence of malignant neoplasms in the population of the Russian Federation in 2015, 10% were neoplasms associated with HPV (human papillomavirus), and these numbers are growing.[1]

Therefore, it is very important to know the whole truth about HPV and methods of its prevention. Questions about HPV will be answered by a doctor obstetrician-gynecologist of the highest category of the network of multidisciplinary clinics “DIALINE” Evseeva Nadezhda Ivanovna.

What is HPV?

– HPV is the most common sexually transmitted infection according to the WHO. Currently, more than 100 types of HPV are known, each type of HPV affects its own tissue in the human body.Diseases of the genitals are directly related to the types of viruses of high oncogenic risk (causing cancer) and there are about 13 types of them. Not many people know that HPV manifests itself, including in the form of various formations on the skin and mucous membranes: warts, condylomas and papillomas. But the most insidious feature of this virus is the lack of overt symptoms.

– How is HPV transmitted?

– The route of transmission of HPV is predominantly sexual. Infection of partners occurs both during traditional sexual intercourse and not (homosexual, anal-genital, oral-genital).The route of transmission of HPV by the contact-household route and infection of the fetus during childbirth are not excluded.
In recent years, there has been an increase in malignant lesions of the anal and oral cavity, including in men, which is associated with HPV. Many infected people self-remove HPV without treatment and clinical symptoms due to their own immunity. About 10% of patients present with clinical manifestations, including those with cervical cancer.

The following factors increase the likelihood of HPV infection:
– early onset of sexual activity and frequent change of sexual partners with neglect of the method of contraception – a condom;
– the presence of other infections and chronic inflammatory diseases of the genital organs;
– bad habits that reduce immunity;
– abortion;
– burdened heredity in oncology.

– How to determine if there is HPV or not?

Various methods are used in the diagnosis of HPV-associated diseases. But the most important: examination, colposcopy, PCR smear for HPV, PAP test – smear for oncocytology and biopsy. All examination data are carried out in the network of DIALINE multidisciplinary clinics and are appointed by a gynecologist or urologist.
HPV testing is subject to:
– women and men who are sexually active;
– patients with chronic genital infections or complaints of discharge, women with vaginitis and cervicitis and any formations on the cervix;

– patients with formations on the external genital organs and with any unclear pathological processes of the external genital organs;
– all women after 30 years of age when taking a smear for cytology.

– Is HPV treated and, if so, how?

– The tactics of treating HPV infection depends on the type and amount of the virus, changes in PAP smears (cytology), and clinical manifestations. Currently, specific drugs against HPV have not yet been created, the development of vaccines has not been completed. In the presence of HPV in a latent form and with vestibular papillomatosis, it is necessary to observe a specialist once every 6 months. Treatment includes medical and destructive (destruction or removal of tissue, altered HPV) methods.Treatment is carried out with a sexual partner. When planning a pregnancy, examination and treatment before pregnancy is mandatory.

– Are there vaccines for HPV?

Currently there is a vaccine against 2 types (16,18) and 4 types (16, 18, 6,11) viruses. There is no expediency in vaccinating adult women, since most are already infected. Vaccination before the onset of sexual activity showed insufficient effectiveness, possible side reactions. In our country, HPV immunization is not included in the National Vaccination Schedule.Screening (annual examination for HPV) remains the main method of preventing cervical cancer. The most effective method of preventing HPV is with condoms.

– How to properly prepare for the HPV diagnosis?

– Before a smear for HPV and PAP test, sexual abstinence is recommended and the exclusion of vaginal sprays and other medications in the vagina for 2-3 days, do not drink alcohol on the eve, for men do not urinate 3 hours before the analysis.

And most importantly, remember that a timely visit to a doctor will help identify the disease in the early stages, which increases the likelihood of helping the body cope with HPV.Better yet, follow all precautions: have only your own hygiene items, protect yourself with condoms and avoid promiscuous sexual intercourse.

[1] Gretsova OP, Kostin AA, Samsonov Yu.V., Petrova G.V., Prostov M.Yu., Prostov Yu.I .: “Morbidity and mortality from malignant neoplasms associated with human papillomavirus “// Research and practice in medicine, 2017, vol. 4, no. 3, p. 33-50

90,000 What if you have Human Papillomavirus (HPV)? Diagnostics, treatment, prevention.

Now they often began to diagnose human papillomavirus (HPV) in patients and after that the eternal question began to arise, what to do?

To begin with, I would like to tell you a little about it: the definition of the human papillomavirus.

Generally speaking, HPV infection can be in the following forms:

1. Latent course is defined as persistence of papillomavirus in the basal layer of the epithelium.In this case, the virus is in episomal form (the DNA molecule of the virus is not incorporated into the DNA molecule of the cell) and does not lead to pathological changes in the cells. The latent course of infection is characterized by the absence of clinical manifestations, colposcopic, cytological and histological norm. The presence of HPV infection is determined by DNA methods (PCR).
2. Productive infection involves clinical manifestations of infection (papillomas, warts, condylomas). In this case, the virus, existing in episomal form, is copied in the infected cells.At the same time, there is an increased multiplication of cells of the basal layer of the epithelium, which leads to the progression of infection and the appearance of vegetation (growths). A clinically productive infection is defined as warts or papillomas. The virus is detected by PCR. Histological examination determines the phenomenon of hyperkeratosis (increased keratinization, i.e. aging of cells).
3. Dysplasia (neoplasia) develops when the viral DNA is integrated (inserted) into the cell genome. With neoplasia, changes occur in the structure of epithelial cells.Most often, lesions are localized in the transition zone of the cervix. At the junction of stratified squamous and columnar epithelium, basal cells sensitive to viral infection are in close proximity to the surface layers, which facilitates contact with the virus during infection. HPV infection is confirmed by histological examination and colposcopy.
4. In the case of invasive tumor carcinoma, the virus exists in the cell in an integrated form. In this case, altered, “atypical” cells are revealed, indicating the malignancy of the process.The most common localization is the transitional zone of the cervix. Revealed by colposcopic and histological examination.

How is HPV infection manifested?

The main symptom of human papillomavirus infection is the formation of so-called genital warts.

Externally, genital warts are similar to common warts. They can be small in size (from a few millimeters to a centimeter), pinkish or flesh-colored, smooth or slightly bumpy surface.

Most often, genital warts are formed in the area of ​​the external genital organs.

In women, genital warts can occur near the clitoris, on the labia minora and majora, in the vagina and on the cervix. In case of irritation of genital warts located close to the entrance to the vagina, itching and minor bleeding may occur during intercourse.

In men, genital warts form on the penis and scrotum.

Warts can also form in the anus, in the urethra, or anywhere else on the skin (neck skin, armpits). Several adjacent genital warts can merge into one large “wart”.

As a rule, genital warts are painless. In some cases, there is slight itching and discomfort in the genital warts.

When to see a doctor?

Be sure to consult a doctor if you notice formations (warts, outgrowths) on your skin that look like genital warts. The doctor will prescribe the necessary examinations for you to help determine the exact cause of the disease and exclude other sexually transmitted diseases.

Diagnosis of HPV?

To confirm the diagnosis of human papillomavirus infection, the PCR (polymerase chain reaction) method is used, which allows you to determine the DNA of the virus and determine exactly what type of virus a person is infected with.

In modern diagnostic laboratories, the type of virus, its amount (viral load) and the integration of the virus into the genome are determined.At the beginning of the article, information is provided that shows that the most dangerous HPVs of high oncogenic risk (VOR). Apart from the type of virus, the definition and its quantity are important. The tactics of treatment depend on this. The integration of the virus into the cell genome, unfortunately, is not determined in our laboratories. This analysis is important in the early diagnosis of cervical epithelial dysplasia and non-invasive carcinoma.

It is very important that everyone understands, even if PCR analysis reveals oncogenic forms of HPV in you, this does not mean that you already have cervical cancer or that you will inevitably get sick with it in the near future, since not in all cases HPV leads to the development of cancer.It can take years from the moment of infection to the appearance of precancer.

In order to determine whether HPV has caused a change in the cells of the cervix and whether there is a risk of developing cancer, it is imperative to undergo a thorough gynecological examination, which must include:

• Colposcopy (examination of the cervix with an apparatus that resembles a microscope and allows examination under magnification from 8 to 20 times).
• Cytological smear (PAP test), which is used to determine dysplastic changes in the cells of the cervix.
• Bacterioscopic examination of vaginal discharge. Often HPV infection is combined with other sexually transmitted infections (in about 20% of cases), so additional examination may be necessary to determine chlamydia, mycoplasmosis, ureaplasmosis and trichomoniasis.
• Targeted biopsy – taking a piece of tissue from the cervix in cases of dysplasia or suspicion of a malignant tumor of the cervix.

HPV treatment

Since a complete cure for human papillomavirus infection is currently impossible to achieve (along with this, spontaneous, spontaneous cure is often observed), the manifestations of HPV are treated, and not the presence of the virus in the body.At the same time, the effectiveness of various methods of treatment is 50-70%, and in a quarter of cases the disease reappears already several months after the end of treatment. The question of the appropriateness of the treatment of each patient is decided by the doctor individually. At the same time, it is necessary to avoid factors that reduce immunity (hypothermia, severe emotional stress, chronic overwork, vitamin deficiency). There are studies that show the preventive effect of retinoids (beta-carotene and vitamin A), vitamin C and trace minerals such as folate on HPV-related diseases.

Among the methods of treating the manifestations of HPV infection (genital warts and papillomas), the most commonly used are:

1. Destructive methods is a local treatment aimed at removing genital warts. There are physical ( cryodestruction, laser therapy, diathermocoagulation, electrosurgical excision ) and chemical ( trichloroacetic acid, feresol, solcoderm ) destructive methods, as well as surgical removal of genital warts . Cytotoxic drugs – podophyllin, podophyllotoxin ( condilin ), 5-fluorouracil . For women of childbearing age, reliable contraception or refusal to have sex is recommended during treatment.
2. Immunological methods The most commonly used for the treatment of HPV infection are interferons ( Laferon, Laferobion, Alfarekin, Reaferon, Viferon ) . They are a family of proteins that are produced by cells of the immune system in response to viral stimulation.Separately, there is the drug Alokin-alpha, which stimulates the production of its own interferon and activates cellular immunity.
3. Specific antiviral drugs ( cidofovir, panavir, alpirazine ). The well-known antiviral drug acyclovir (zovirax) has no effect on HPV. Of the local (vaginal) drugs, Epigen intim spray and Betadine have an antiviral effect.

Prevention of HPV

It can be non-specific and specific.

Nonspecific includes prevention of sexual transmission of HPV, a healthy lifestyle to strengthen the immune system, and a balanced diet that includes beta-carotene, vitamin A, vitamin C and folic acid.

Specific prophylaxis – vaccination.

HPV vaccines contain organic matter similar in structure to live HPV viruses. These substances can in no way cause illness.

After the introduction of the vaccine, cells of the immune system begin to be produced in the human body, which prevent the introduction of HPV into the body.

There are currently two types of HPV vaccines: quadrivalent Gardasil and bivalent Cervarix.

Cervarix prevents infections with HPV 16 and 18, which cause 70% of all cervical and anal cancers.

Gardasil, in addition to protection against HPV types 16 and 18, also provides protection against HPV types 6 and 11, which cause 90% of cases of genital warts.

Gardasil and Cervarix protect against infection in people who are not yet infected with the corresponding HPV type. They cannot eliminate the virus from the human body if it has already entered it and cannot cure diseases (for example, genital warts or cervical dysplasia) that the virus has already provoked. It is for this reason that HPV vaccinations are recommended during childhood and adolescence, prior to the onset of sexual activity.

Thus, the Gardasil vaccine protects against infection with HPV types 6, 11, 16 and 18 and is recommended for the prevention of cervical cancer and dysplasia, cancer of the vagina and external genital organs in women, as well as for the prevention of anal cancer and genital warts in men and women. …The Cervarix vaccine protects against infection with HPV types 16 and 18 and is recommended for the prevention of cervical cancer and dysplasia in women and anal cancer in men and women.

In 2014, a nine-valent vaccine was released, which eliminated the shortcomings of the previous ones. The nine-valent Gardasil 9 vaccine covers an additional five high-risk virus types: 31, 33, 45, 52 and 58. In December 2014, Gardasil 9 was approved by the US Food and Drug Administration (FDA) …

As of 2013, vaccines are registered in more than 125 countries of the world, almost 20 countries are included in national vaccination schedules, 111 million doses of the drug are distributed worldwide.

Author:
Dmitry G. Sumtsov

Treatment of cervical pathology and diagnostics

What is “cervical cancer”?

Why, speaking about the prevention of this type of female oncology, doctors often use “cervical pathology”, and this will be more accurate? How can this problem be detected, and how has the approach to its treatment changed around the world? The head of the obstetric and gynecological department of the Health Territory Galina Vladimirovna Ovsyannikova explains in detail and in an accessible manner:

“At present, all over the world,“ cervical pathology ”(and cervical cancer is the result of a neglected pathological process) is one of the most common problems among women of reproductive age.This problem causes a lot of controversy, but everywhere the tactics of managing such patients are becoming more and more gentle. Let’s try to figure out what is the reason, and how to protect ourselves in terms of cervical oncology.

The culprit of the most “dangerous conditions” from the cervix is ​​the human papillomavirus (HPV). Only he, in his active state, can cause changes in the epithelium of the cervix, which, without treatment, can lead to oncology in a few years. It is very important to remember that a condom does not always protect against HPV, and in men, the virus is most often asymptomatic (and it is completely safe for their health!).Therefore, it is now very common. When we did not yet know about HPV, it was customary to cauterize (coagulate) any visual pathology. Roughly speaking, a woman came to the appointment, the doctor saw a red spot with his eye, and immediately a decision was made about the need to remove it mechanically, that is, to burn it. There was no talk of any conservative treatment.

But later it turned out that cervical cancer is more common in women who had a history of moxibustion. Why? Because the “joint zone” (the area between the inner part of the cervix and the outer part, where HPV lives), a 2 mm zone, after cauterization goes into the cervical canal and becomes inaccessible to visual inspection.This means that with an external picture of well-being inside, everything may not be so good at all. Therefore, such tactics are now being abandoned.

What to do about it?

First, to understand that the cervix, like the tonsils in the mouth, for example, is the most accessible organ for examination. You do not need any additional equipment to understand that the cervix is ​​healthy (or not healthy). Any attentive doctor will be able to assess this immediately on examination, and additional research will only allow him to be convinced of his correctness.I must say right away that HPV on the cervix does not cause unpleasant symptoms in a woman. This is the insidiousness of the virus. Therefore, it is so important to have a regular check-up with a doctor! The doctor will never rely on a woman’s complaints. He will be able to see everything for himself: for this he has objective examination data. We will talk about them.

So, you’ve come for a consultation. When examined in a chair, the doctor assesses the condition of the vaginal mucosa and cervix. It should be pale pink (like the inside of the cheek).Condylomas on the external genital organs are a reliable sign of the presence of HPV, but there is no danger in them. Condylomas are removed if they cause itching or discomfort in the growth zone (this often happens) or cause aesthetic discontent. In any case, one must understand that the removal of genital warts is a symptomatic treatment and does not affect the cause. But it also takes place.

But back to the cervix. With an outwardly healthy neck, you just need to take a cytological scraping (epithelial cells) and after 2 – 3 days, having received the result, live peacefully on.You will no longer need this scraping for at least a year.

But if the doctor saw with his eye a red or white spot, changes in the structure of the mucous membrane or some formations on the cervix, then a more detailed and in-depth study is needed. For example, samples with vinegar and iodine, examination under a microscope and extended smears. What tactics we choose after – depends on the results obtained.

In the Health Territory, we always try to find the cause of the disease

In this case, we are talking about any pathology of the cervix and help a person cope with it on their own.Only this approach will have a long-term positive result. Think about why some have the human papillomavirus (sometimes a woman comes with a smear and different types of HPV detected there), but there are no problems, and they do not need treatment, while in others we do not even detect HPV (it is not always easily detected in smear), but there is a pathology on the cervix that needs to be treated because it is a precancerous condition?

The answer is simple. Each organism is unique, and the “oncogenicity” of the virus is also a very conditional concept.In other words, there may be a carrier of HPV, which is usually attributed to a high oncogenic risk, but the woman will not need treatment. Or it may be that of those types of virus that we have learned to look for, there are no or no oncogenic, but there are signs of the activity of this virus on the cervix. And then the woman will need treatment. Every woman always has her own story …

One important nuance – the treatment will always be complex. No matter how trite it sounds, but the normalization of sleep and rest, healthy eating and strengthening the body through exercise, the absence of stress is no less important than drug treatment.

And more. “Erosion of the cervix” (“pathology of the cervix”) is a collective concept. It means any visual deviation of the epithelium from the norm. Ectopia of the cervix (“pseudo-erosion”, non-standard location of the cervical epithelium), for example, is an absolute norm, although it looks like dysplasia on normal examination. But real dysplasia (an altered state of epithelial cells, which is called “precancerous”) should always be treated. In our Center, we try to assess a woman’s condition in the context of threats to her health, reproductive function, and life.Treat not the symptoms, but the cause of the disease. At the same time, our doctors will give the most complete information about the state of health and possible options for tactics. ”

Doctor gynecologist Minkevich Konstantin Vladimirovich answers to questions

Questions and answers

Author’s spelling and punctuation retained

Question: What are condylomas? and why do they appear?

Answer of Minkevich K.Q: Condylomas are a consequence of infection with the human papillomavirus and are sexually transmitted. Condylomas are in the form of scallop or mucous growths.

Question: Good afternoon! Help me figure out how condylomas differ from warts and papillomas? Or is it all the same, just the name depends on where these things appear?

Answer of K.V. Minkevich : Condylomas are also called genital warts, that is, their localization is the genital area from the name.In other areas, these are not warts. Papillomas are papillary growths and they can be localized anywhere.

Question: Good afternoon. The papilloma on the labia was removed using the radio wave method. 3 days passed – the path from the wound was covered with a white-yellow crust, similar to pus. I wash with a solution of potassium permanganate, using an epigen spray. It should be?

Answer of K.V. Minkevich : Don’t worry, the epithelialization (healing) process is exactly how it goes. The “white-yellow crust” you describe is called a scab.It is better to use not potassium permanganate, but powder “Baneocin” 2 times a day (morning-evening).

Question: Good afternoon! Found oncogenic HPV, prescribed treatment with Polyoxidonium suppositories, sent for laser removal of genital warts and testing for viral load. After going through all these procedures, how best to protect yourself and what is the chance of your partner contracting this virus after treatment? during treatment is it worth having sex at all or is it better to abstain? Thanks for the answer.

Answer of K.V. Minkevich : No need to worry, HPV has a high prevalence and in most cases the immune system copes with it on its own, even without treatment. The presence of genital warts must be removed, and after that, sexual activity is not recommended until the epithelialization of the wound surface, about 2 to 3 weeks. In the future, there is no restriction in sexual activity, if the sexual partner does not have genital warts on the penis, if so, then they must also be removed.Therefore, the presence of HPV according to analyzes, without genital warts, is not a refusal to have sex. There is no effective method of protection (100%) from the transmission of HPV; a condom is considered the most rational method against transmission of infection. After removal of genital warts, there is no need to be afraid of the risk of HPV transmission.

Question: There was an itching in the anus. Then I felt the formation of a thickening between the anus and the vagina. It was this area that itched. What is it? Which doctor should I go to?

Answer of Minkevich K.Q.: Consult a gynecologist with complaints about the appearance of a possible formation with itching in the perineal region.

Question: Hello. I had a radio wave excision of the cervix within healthy tissues. I am currently undergoing treatment with candles. But an analysis came for histology and a pathomorphological diagnosis: flat warts. L-SIL. Allokin alfa injections were prescribed six injections every other day. The injections are expensive. Tell me if there is a similar drug and whether it is worth pricking them.Thank you.

Answer of K.V. Minkevich : The main treatment for cervical disease (flat warts) is PEE (radio wave excision). Antiviral drugs, which include Allokin-alpha, are drugs with no proven effectiveness. The diagnosis of flat warts is a consequence of the influence of the human papillomavirus (HPV), therefore, after removing the altered mucosa, doctors prescribe various antiviral drugs to prevent relapse. The injections that have been prescribed for you must still be performed correctly – subcutaneously, at home (with the help of relatives), this cannot be done, so you will have to go to the procedures, and this is an additional expense.In my practice, many years ago, I did not get a good result in the treatment of genital warts, so I refused this drug. For the purpose of prevention, I prescribe antiviral drugs, but I warn patients that drugs are without proven effectiveness. There are a lot of drugs produced in our country, I recommend table. inosine pranobex, spray with glycyrrhizic acid.

Question: Hello! My name is Tatiana, I am 24 years old. Please tell me how to get rid of genital warts? How can this be done.Is there a clinic in Chita where you can remove warts with a laser. Help, I’m really looking forward to an answer

Answer of K.V. Minkevich : From the city of Chita, I did not have any doctors studying on the use of laser in gynecology, so I cannot recommend a doctor or a clinic. If you do not know where to turn, start your treatment with a home treatment method. The international recommendations for the treatment of genital warts include the use of imiquimod cream (not of Indian origin). This antiviral cream is applied to the skin and warts on it 3 times a week (for example: Monday-Wednesday-Friday) at night.This area should be washed with soap and water in the morning. During treatment, exclude sexual activity. The course of treatment until the disappearance of genital warts, but not more than 16 weeks. The effect of the treatment after 4 weeks, but maybe even later.

Question: hello. I have genital candidiasis. I removed them, but I’m very afraid of a relapse. Is it necessary to treat just the surface of the skin with Aldara cream, where they were, so that there is no relapse? what time? and do the candidalomas inside the vagina disappear if only the outer labia is treated?

Answer of Minkevich K.V.: After removing genital warts, apply Aldara cream to the skin, if they are absent, it is not necessary. In case of new warts (genital warts recurrence) it is necessary to start treatment with Aldara cream. This is the correct approach with excellent results that do not lead to relapse. As for genital warts on the vaginal mucosa, in this case, the most effective approach is laser removal.

Question: Good afternoon! Warts were found and removed from me about three months ago. They have not appeared since then.But I read a lot about them and I know that they often recur. How long does it take for them to appear again? How often do you need to visit a gynecologist? And what can be done to avoid relapse? Thanks in advance!

Answer of K.V. Minkevich : Katya, there is no effective remedy for the prevention of recurrence of genital warts. Many doctors in our country, and I in particular, recommend taking antiviral drugs. Their effectiveness has not been proven, in some cases there is a positive result, and patients have a relapse-free course.There are a lot of these drugs, it is impossible to predict what will work. In these cases, one must rely on the experience of the gynecologist who is being observed. Recurrence of genital warts depends on the activity of HPV (human papillomavirus) more often genotypes 6 or 11 and occurs within 6 months.

Question: Tell me, please, read that you recommend imiquimod for the treatment of genital warts. I was diagnosed with HPV 2 years ago. I smeared condylomas on the skin in the groin, as well as on the urethra, with Aldara, almost all of them went away, and the viral load decreased.The remaining at the urethra were cauterized with solcoderm 2 times. After 3 months, condylomas reappeared, in the same place near the urethra, on the skin in the groin and now inside the vagina. Will a repeated course of Aldara help? And could they grow again, due to burning with solcoderm? Thanks

Answer of K.V. Minkevich : Julia, if the first treatment was effective, then the second course should also be effective. Only this time extend the course of treatment, but no more than 16 weeks. Solkoderm does not cause recurrence of genital warts. If you have had a sexual relationship, pay attention to whether there are similar growths on the partner’s penis, if any, then it is necessary to undergo joint treatment.

Question: Hello! please tell me if there is something in common between the husband’s genital warts and the wife’s candidiasis?

Answer of K.V. Minkevich : Maria, a connection may appear if, against the background of vulvovaginal candidiasis, you also have these formations. Sexual relations, if one of the partners has condylomas, must be interrupted before they are cured. This viral disease is most often sexually transmitted. It is necessary to undergo an examination by a gynecologist and, if you do not have genital warts, take a course of antifungal treatment.

Question: Good afternoon! I am 27 years old, did not give birth, there were no turns and misses. In 2012. I was diagnosed with HPV type 11, which at that time did not manifest itself in any way. Before that, I was always diagnosed with cervical erosion, there were no other diseases. But this year there were cervical warts, it turned out during examination. I think so because of the greatly reduced immunity, I have been treating kidney inflammation for a long time. Cytology showed nothing, as I was told the result is good. I was prescribed cycloferon intramuscularly and in the vagina.I did 2 courses with a break of 10 days. After the next examination, the doctor said that the warts were less and the erosion was not so strong. Now I was prescribed a sprinkling with a thousand-leaf plant, celandine and tampons with aloe and honey, and oblepik tampons. Please tell me how effective is this treatment? Is laser removal of genital warts necessary or can it still be treated with medication? Can papillomas appear on the face, body now? Can the virus fall asleep again and not manifest itself and what else needs to be done for this?

Answer of Minkevich K.Q: Human papillomavirus (HPV) type 6 or 11 most commonly causes genital warts to grow in the anogenital area. The most effective and gentle way of treating genital warts in nulliparous girls is laser exposure. Conservative treatment, like yours (cycloferon), is also effective. A further course of therapy, douching with yarrow, celandine and tampons with aloe and honey, sea buckthorn tampons, can hardly be considered a fight against condylomatosis. The course of treatment is prescribed by the doctor, after the examination and the results of the examination.Therefore, it is impossible to predict the result of your treatment without a concrete understanding of the problem. Cutaneous papillomas have no connection with genital warts. The best prevention of genital warts is to remove them and if they recur, imiquimod cream (not made in India).

Question: Good afternoon! I came for an examination to a gynecologist, just came to get checked, the doctor discovered that I had condylomas on both walls of the vagina, I didn’t even know what the HPV virus was, I passed tests for type, ureaplasmosis, mycoplasmosis, and for some other infections; I am waiting for the results, I am very afraid of where my husband and I live for 11 years, wanted to plan a second child, how to be now, what to do! I read it on the forums, I don’t know what to think!

Answer of Minkevich K.Q: For starters, do not be nervous and wait for the test results. Sometimes doctors confuse the wavy structure of the vaginal mucosa and growths in the form of genital warts. More often, condylomas are formed on the external genital organs. If you doubt that these are condylomas, go to see another gynecologist to confirm this diagnosis.

Question: How to get rid of kandil in the intimate area?

Answer of K.V. Minkevich : It is necessary to consult a gynecologist and, depending on their number, he will recommend a method of treatment.This can be laser removal, chemical cauterization (feresol or condilin), you can apply imiquimod cream at home. It is applied to the skin 3 times a week, every other day at night and only to the skin. The effect of the treatment occurs in about 4 weeks.

Question: Hello! I have warts on the outer and inner labia. I don’t know if it’s inside. Can you please tell me if you are treating patients for papilloma virus, by what method and at what cost is it possible to remove them from you? Thank you in advance.City Novosibirsk.

Answer of K.V. Minkevich : Yes, I am engaged in the treatment of pathology of the cervix, vagina and vulva on an outpatient and inpatient basis. In particular, laser, radio wave with argon plasma ablation treatment of diseases, and genital warts too, these localizations. Patients come for treatment from other regions, but the decision is made after examination and it is wrong to promise something in advance. The cost of removal can be found on the website of the medical center “MedLab” St. Petersburg, where I accept.

Question: Good afternoon! For genital warts, I use Aladra cream as a prescription doctor.But so far, no results. 2 weeks have passed. How long should I wait to see progress in treatment?

Answer of K.V. Minkevich : The effect of the use of Aldara cream (not of Indian origin) in each patient occurs at different times from 4 weeks to 8 weeks from the start of application, depending on the size and number of genital warts. Final deliverance can occur after the completion of the full course of treatment – 16 weeks.

Question: Hello, my daughter has just such a problem, which is written about in the article, she removed many times the candidiasis with a laser, but they appear again and again, the child is in despair, she has wounds at the sites of removal, the doctor advised the next removal to be carried out with nitrogen.I don’t know anything about this, how can I help my daughter? What advice do you have?

Answer of K.V. Minkevich : Cryotherapy, nitrogen removal, I do not recommend, as after the laser there may be relapses. In your case, imiquimod cream (not of Indian production) gives you more chances to get rid of genital warts without removing them at home. The cream (1 sachet-bag) is completely applied to the skin in the area of ​​warts, if warts are localized on the skin, then treat them too. The application of the cream is carried out in the evening, before going to bed, 3 times a week (for example: Monday-Wednesday-Friday).The course of treatment is 16 weeks, the first positive reaction may appear 4 weeks after the start of treatment. Be sure to read the instructions in addition.

Question: Hello! Which doctor should you contact with the problem of genital warts in the groin? Thank you!

Answer of K.V. Minkevich : You should consult a gynecologist and if the doctor has doubts about the diagnosis, the next specialist will be a dermatovenerologist.

Question: Hello! My neoplasm is already ten years old, it is outside on the large lip, on a thin leg, 1.5 centimeters in diameter – papilloma? or condyloma? , there are no other neoplasms nearby.One of my chronic diseases is 2nd stage hypothyroidism. I am 48 years old. What advice would you give me? Can I use imiquimod cream for treatment?

Answer of K.V. Minkevich : No, you cannot use imiquimod cream on your own. Consultation with a dermatologist is necessary, because it can be a dermatological disease – a nevus. With this disease, the cream will not help.

Question: Hello. I have treated condylomas of the anal canal. From the beginning with a laser, then the operation, i.e.because they were deep. Now they have appeared again. Is endoscopic treatment possible without surgery? Thank you!

Answer of K.V. Minkevich : Warts often recur after removal. Do not worry, since there has already been laser removal and surgical treatment, I recommend imiquimod cream. This is an antiviral drug with a good effect, it is the first line of treatment for genital warts in the world. The cream should be applied to the skin in the anus 3 times a week, at night. Follow the instructions before use.The effect occurs in 4-8 weeks, and the condylomas disappear.

Question: hello, please tell me how warts can be treated, they appeared in intimate places, there is no discomfort, but a little in a panic. I can’t go to the hospital yet, it’s not cheap. I tried to burn it out with iodine, it seemed to pass, maybe there are still any therapeutic drugs !? Please tell me! Thank you in advance.

Answer of K.V. Minkevich : If you do not have the opportunity to consult a gynecologist and you are sure that these are condylomas of the anogenital area, then there is a home treatment.If this formation is not condyloma, then treatment will not help. Treatment of genital warts with chemical solutions (condilin or feresol) or imiquimod cream. Warts themselves (warts) are treated with warts or feresol. The cream is applied to the skin where the condylomas are located (you can also apply the condylomas themselves, if they are located on the skin) 3 times a week, at night. In any case, it is better not to start treatment without consulting a doctor.

Question: Is it possible to remove genital warts not by surgical methods, but with the help of drugs

Answer of Minkevich K.Q: Possibly. By the chemical method, treatment with genital warts with condilin or feresol. A more effective method is the treatment of the skin where the warts are located (it is possible on the warts themselves, if they are located on the skin) with imiquimod cream. The cream is applied 3 times a week, at night and condylomas disappear after 4-8 weeks. The instructions must be read before use.

Question: Is it possible to get genital warts during oral sex? how can they look in the mouth?

Answer of Minkevich K.Q: If during oral sex the sexual partner had warts (condylomas) on the penis, then the chance of infection is high. Growths (warts) appear on the oral mucosa. Infection with the human papillomavirus during oral sex does not always occur, therefore, if no formations appear in the mouth, you should not worry. In this situation, it is necessary to consult a dentist.

Question: Vaginal warts were removed with a laser. The doctor said to wash with chlorhexidine is it like a regular wash? And how to use bepanten?

Answer of Minkevich K.B.: after removal of genital warts with a laser, it is not necessary to treat the vagina with chlorhexidine and bepanten. For epithelialization of the wound surface of the vagina, vaginal suppositories Gynoflor-E are better suited or do not treat with anything.

Question: Hello! Can you please tell me effective remedies for the treatment of genital warts?

Answer of K.V. Minkevich : Fast and cosmetic way to remove genital warts, this is laser removal. The slow method is treatment with chemical solutions (condilin, feresol).Long-lasting, but the most effective (less recurrence of genital warts) imiquimod cream.

Question: Hello! A year ago, I was diagnosed with HPV 16 and 18 types and genital warts (on the labia minora), but the doctor is in no hurry to remove them: he says, you must first deal with the erosion of the cervix, and then solve the warts. Over the past month, condylomas have increased in size, and there are more of them. It scares me a lot. Moreover, as I was told, these types of HPV can cause cancer.Tell me, are warts really connected somehow with oncology? Are they dangerous? Thanks in advance!

Answer of K.V. Minkevich : Condylomas very rarely become malignant. If you have a cytological smear from the cervix without atypia, you should start removing genital warts as soon as possible. Warts grow very quickly and increase in size.

Question: Hello, I have no warts, but my sexual partner (the first sex was a month ago) was found and removed the warts.What should I do? get tested? What is the likelihood that I also became infected? Can this virus be treated before genital warts appear?

Answer of K.V. Minkevich : Human papillomavirus (HPV) is not always sexually transmitted. There is no need to be treated in advance. Take a PCR smear for HPV and, even if a virus is found, you do not need to be treated. Your immune system will fight it, and in most people it will eliminate (kill) it without any treatment. Treatment should be started if warts (condylomas) appear on the genitals.

Question: Good afternoon. Tell me where you can buy a cream, Imichimod! I live in Moscow. Thanks in advance everyone.

Answer of K.V. Minkevich : I do not know. I live in St. Petersburg and my patients buy from pharmacies. Probably, they will find out about the presence of the cream in the reference pharmacies or on the Internet (where to buy imichimod in Moscow).

Question: Hello. I was diagnosed with genital warts. My doctor obliges me to pass tests for chlamydia and ureaplasma, arguing that without them he cannot begin treatment.Do I have to take them?

Answer of K.V. Minkevich : To treat condylomas of the anogenital area, it is not necessary to be tested for latent infections, which include chlamydia trachomatis and ureaplasma urealiticum. Maybe the doctor diagnosed you with an inflammatory process and wants to rule it out. If you remove condylomas against the background of inflammation, then the process of epithelialization (healing) will be long.

Question: How to remove warts on the tongue? Is there any treatment?

Answer of Minkevich K.V.: On the tongue, condylomas are located on the side and on its root (lower surface), where there is a delicate mucous membrane. See a dental surgeon who is proficient in laser removal.

Question: Hello. Recently, I found small formations similar to warts on my mucous membrane near the labia. The fact is that my partner has two warts on the pubic area, could I get them from him? We have been together for a year, and I have only recently, can we continue to have sex?

Answer of Minkevich K.V.: Without examination, it is difficult to assess what kind of education appeared, and you have a sexual partner. You need to consult a gynecologist, because these may not be condylomas, but atheroma or inflammation of the hair follicle or molluscum contagiosum. Any education requires diagnostics, and there may be not one specialist, but several (also a dermatologist). First, take a smear by PCR for HPV (human papillomavirus), which is the source of the growth of genital warts. If the doctor confirms the diagnosis of genital warts, they must be removed

to you and your sexual partner.Sexual life at this time must be interrupted.

Question: Hello. She treated genital warts 6 years ago, they were near the urethra and vagina. Why did they appear again?

Answer of K.V. Minkevich : Possibly 2 options for relapse. The first option: the visible warts were removed last time, but the papilloma virus (HPV) remained. Weakening of the immune system (stress, pregnancy and other factors) contribute to the activity of the virus and the beginning of the growth of new genital warts. Therefore, after treatment, it was necessary to monitor once a year for the presence of HPV in the body (HPV PCR smear).Option two: You have contracted the virus again.

Question: Good afternoon. A couple of months ago, a couple of pimples appeared in the lower part of the buttocks (not in the perineum, but on the skin, approximately in the place where we sit). At first I thought, ordinary pustules, smeared with brilliant green, cauterized with potassium permanganate, alcohol solution. Did not help. They do not itch, do not bother in any way, the only thing is that they have increased in size and have become as if keratinized. And a month later, three more such things appeared on the pubis.I didn’t go to the doctor, I’m terribly shy. I panic if the infection occurred when changing a sexual partner. Please advise what it can be and how to get rid of it?

Answer of K.V. Minkevich : You need to consult a dermatologist. Judging by your description, this disease is called molluscum contagiosum, but without examination I am afraid to be mistaken. It has nothing to do with the sexual partner, and there is no need to be ashamed of examining a doctor. This is a viral disease, infection occurs in a household way, for example, through the sand on the beach.Treatment: laser removal of formations or their extrusion in combination with the reception of decaris. To have the effect of treatment, first consult a specialist.

Question: hello. I found in myself some kind of growths in intimate places. Which doctor should I go to ???

Answer of K.V. Minkevich : You need an initial consultation with a gynecologist, if the doctor does not understand the disease, then contact a dermatovenerologist.

Question: Hello, I have condyloma, the gynecologist said that it could go away on its own, as if it was formed due to thrush, is it worth believing this or is it better to contact a dermatovenerologist? Thanks

Answer of Minkevich K.Q: The appearance of genital warts is the result of infection with the human papillomavirus (HPV). This virus is usually sexually transmitted. Yeast colpitis (thrush) is a consequence of a violation of the vaginal microflora, which can occur as a result of HPV infection. Yeast colpitis is treated with the appointment of antifungal suppositories, and warts must be removed. In intimate places, gynecologists are mainly involved in treating genital warts, but you can also be treated by a dermatovenerologist. Whichever doctor you trust is the one who is treated.Indeed, in some cases, condylomas disappear on their own, but in any case, doctors recommend antiviral treatment (local or general or combined), more often insist on removing genital warts.

Question: The girl is 20 years old, she has genital warts, we were told to remove them, we are very afraid of their reappearance and of course scars. We live in St. Petersburg. Advise what to do

Answer of K.V. Minkevich : Vaginal warts are best removed with a laser.Then there will be no scars, this is an effective cosmetic operation. Relapse is not guaranteed by any method of removal. You can apply for inspection, I advise in St. Petersburg.

Question: Hello! If condylomas are only on the mucous membrane, then how will the cream help if it is applied only to the skin nearby? And can the cream help to get rid of the papillomavirus itself or only from genital warts? I also heard that it is better to buy Aldar cream from Israel, which is not sold in Russia. What is the difference from ours? And where can you order it?

Answer of Minkevich K.Q: Imiquimod cream acts on the receptors of natural immunity, stimulating the production of interferon and attracting other cells of the immune system to this zone. This leads to a decrease and disappearance of genital warts not only at the site of application of the cream, but in a significant area surrounding this place. Also, the cream helps to reduce the amount of virus DNA in the cells, which eliminates the HPV from the body. Imiquimod cream of Swedish and Indian companies is sold in our country (do not buy Indian production). The Swedish cream works well (I have known and used for a long time), I don’t know about the Israeli one.

Question: I had sexual intercourse with a man who had a small papilloma on his penis below the head, we did not use contraception, tell me if there are any concerns for me 2 months have passed, can I get some kind of analysis?

Answer of K.V. Minkevich : Get tested from the cervix and vulva for human papillomavirus (HPV) by polymerase chain reaction (PCR). Having a papilloma virus, which is indeed sexually transmitted, should not cause you to panic.It is very common, and the immune system of the person himself fights the virus, and in 80% of cases it copes with it without taking medication. The manifestation of the virus after sexual intercourse is not predictable, on average up to 6 months.

Question: Good afternoon, Konstantin Vladimirovich! I am 23 years old and have recently developed genital masses. I went to the doctor, they said it was genital warts. They offered to have an operation. But I’m terribly afraid. Surgical methods are extreme for me. Has read through Questions and your answers about Aldar cream.In your opinion, Aldara ointment is a fairly effective way to remove genital warts and can serve as an alternative to a destructive method of treatment? Or is it better to go to a surgeon who cuts everything out in one go? I also read that after operations, there are quite frequent cases of recurrence of warts. Maybe there are some statistics on the percentage of relapses after different methods of treatment? I don’t want to go under the knife, but even less want to be a walking infection. Thank you in advance for your answer and sorry for so many Questions.It’s just very important to me.

Answer of K.V. Minkevich : Indeed, there are patients who refrain from destructive treatment of genital warts. Aldara cream is an effective drug and I would recommend starting with it, because after surgical removal, at least 50% of cases relapse. If there is no effect, then surgery.

Question: There can be warts on the head, how to treat?

Answer of K.V. Minkevich : Warts on the head cannot be.Consultation with a dermatologist is necessary, as this may be another skin growth, and is probably associated with another type of viral disease.

Question: I’m only 14, but I looked and it seems to me that I have candidiasis, but I don’t know for sure. I am a virgin, that is, there was no natural sexual intercourse. I am afraid to tell my mother even about suspicions, because physically I am no longer a virgin. and she may not think so. help me.

Answer of K.V. Minkevich : Lena, warts, is a disease associated with the human papillomavirus (HPV) and is transmitted only sexually through sexual contact.Until you are sexually active, you cannot have genital warts. There are other viral skin diseases such as molluscum contagiosum that can be contracted on the beach while lying on the sand. There are skin rashes of a different nature, you need to contact a dermatologist to clarify the diagnosis.

Question: Hello, I had a lot of warts, even near the anus, and they suddenly began to disappear, even at the entrance to the vagina they became very small, and I felt a lump in the vagina at a distance of 8 cm below, at the floor.unpleasant sensations, what could it be? I’m very afraid, I can’t find a place for myself (((

Answer of K.V. Minkevich : Ale, it is difficult to say without examination what kind of education you have in your vagina. It is necessary to go to a specialist gynecologist, and after the examination, draw a conclusion and make a diagnosis. From sexual activity, I would advise to abstain for now.

Question: Hello. During pregnancy, I developed condylomas. The doctor prescribed medication and prescribed treatment for me and my future husband.But I read that if they are cured, they can still reappear and the virus will always be in the body. I would like to know if I cure them, will the childbirth be difficult and what is the probability of infecting the child and by how much?

Answer of K.V. Minkevich : During pregnancy, the human papillomavirus is indeed activated, resulting in genital warts. Unfortunately, conservative treatment during pregnancy is ineffective. It is necessary to remove them until they have grown.The removal method depends on the availability of equipment (laser, radio wave), it can be treated with chemicals (vagotil or others). The presence of genital warts is not an indication for surgical delivery, but it depends on their number. If there is a giant confluent warts, then birth through the birth canal will be impossible. Therefore, do not bring to this state and delete while they are small. The route of transmission of the virus to a child during childbirth has not been proven. In rare cases, it is transmitted, but this cannot be predicted.It is necessary to abstain from sexual activity during pregnancy if warts have appeared and the husband must be treated if he has the same warts on his penis. In the absence of genital warts on the penis, treatment is not necessary.

Question: Hello. I was found to have condylomas of the oncogenic type 33,35,56. Itching is very disturbing, they are small but there are many of them. What do you recommend to do? I want to make an appointment with a dermatovenerologist for laser removal, but I think it will be very expensive and God forbid there will be a relapse.

Answer of K.V. Minkevich : The types of genital warts detected in you have a greater effect on changes in the cervix. Therefore, it is necessary to pass a smear for oncocytology from the cervix (Pap test). Genital warts cause types 6 and 11. Itching does not cause warts, the virus can cause dysbiosis and a violation of microflora. Itching is usually caused by a fungal infection (thrush), it is necessary to prescribe local antifungal drugs. Small growths at the entrance to the vagina are called papillomas, and do not require removal, only for cosmetic purposes, if it bothers you.Without inspection, I do not know to say definitively what it is impossible and should be removed from you or not. For my patients, if they have papillomas and want to get rid of them, I prescribe imichimod cream. Treatment of only the skin in the external genital area for 4 – 8 weeks. Processing 3 times a week, at night, after 1 day.

Question: Hello. Today I was on an ultrasound scan for pregnancy, after the consultation I found out that I have condyloma. I wanted to know if this could pass from me to my husband? And is it not dangerous to cauterize warts during pregnancy?

Answer of Minkevich K.V.: In the presence of genital warts, it is necessary to abstain from sexual activity. The husband does not need to be treated, if he does not have growths on the penis, if there is, then contact a urologist or dermatologist. You need to remove warts, the sooner the better. Warts grow very quickly during pregnancy. Removal of genital warts is carried out by the method used by the medical institution in which you are being observed or you will be referred. Removal is carried out with a laser or radio wave, it is not dangerous during pregnancy.

Question: Good afternoon! Tell me please…. visiting a gynecologist, he had to pay attention and say that I have .. condyloma on one of the labia minora ….?! I noticed a change … after the first childbirth … but did not know what it was and what it was connected with … and now I would very much like to consult and get rid of this ailment !!!!!

Answer of K.V. Minkevich : Svetlana, to say that you have on the labia, an examination is necessary and only after it can a diagnosis be made and treatment recommended. After childbirth, warts that appear during pregnancy usually disappear on their own.If there is a condyloma on one labia, then the same formation should appear on the opposite lip (mirror image). If this is not the case, then it is hardly a warts.

Question: Hello, doctor. Today I have found papillomas near the vagina on the mucous membrane. They offered to remove them immediately, I agreed. They smeared them with solcoderm for me, they said that this is the most effective remedy. They said that there should be no relapse if the virus was blocked. Licopid 10mg was prescribed once a day for 10 days and as a prophylaxis epigenes before contact with a partner.Questions: can they really be removed with solcoderm? Will he help against papillomas in the palm of your hand? Is it really possible to block the virus with drugs? What is the likelihood of our partner getting infected if we have always protected ourselves with condoms?

Answer of K.V. Minkevich : Papillomas are tender papillary growths on the mucous membrane. These growths on the mucous membrane of the vulva (at the entrance to the vagina) do not need to be removed for medical reasons, they are removed at the request of the patient for cosmetic purposes. Sometimes doctors have confusion between papillomas (it is not necessary to remove) and warts – rough scallop growths, they must be removed.Solcoderm is used to remove single warts or papillomas. Antiviral drugs Likopid and Epigen-spray are used in combination with the removal of genital warts, in particular solcoderm, to prevent recurrence of the disease. During treatment with solcoderm, it is necessary to refrain from sexual activity. Any antiviral medications do not guarantee you will get rid of the human papillomavirus (HPV). Growths on the skin of the palms are not associated with papillomas of the vulvar mucosa. This is also a viral lesion, but of a different type.The antiviral drugs prescribed for you (lycopid and epigen) are inappropriate to use to treat growths on the skin of the palms, this is unlikely to help. In this case, it is necessary to consult a dermatologist, sometimes they are also treated with solcoderm. The presence of papillomas, but not genital warts, cannot serve as a refusal to have sex, even without treatment.

Question: Hello. I have genital warts near the entrance to the vagina .. the gynecologist prescribed Elok ointment for me. AND EVERYTHING .. Do you think this is a normal treatment? Thanks

Answer of Minkevich K.Q: I believe that Elokom ointment in the presence of genital warts is the wrong vector of treatment. If these are indeed condylomas, then they must be removed surgically or prescribe local medications that have an antiviral effect, such as imiquimod cream.

Question: if warts and erosion of the cervix are found. what to treat first?

Answer of K.V. Minkevich : Warts should be treated first as they spread and cause discomfort.For cervical erosion, consult another doctor, because erosion is taken to be the normal state of the cervix, which is called ectopia.

Question: I developed 1 genital warts on the labia, and then disappeared by itself. Is it possible?

Answer of K.V. Minkevich : Yes, this is possible. The body (immune system) independently fights the human papillomavirus. Warts are the result of this virus. When the immunity copes with the virus, without treatment, then the elimination (disappearance) of genital warts is also possible.This does not happen 100% of the time, but it is possible.

Question: how to cure candidiasis?

Answer of K.V. Minkevich : Approaches to the treatment of genital warts: surgical in a medical facility and therapy at home. All methods have drawbacks, these are the recurrence of genital warts. The surgical method involves laser removal; it has an excellent cosmetic effect on the skin. Removal with argon plasma can be applied, it is also very beneficial from a cosmetic point of view. Cryosurgery, the method is good, but after it there are many relapses.At home, you can apply imiquimod cream, with a good effect. This cream is applied only to the skin where there are condylomas for 4 weeks. Processing 3 times a week at night.

Question: Hello, two days ago, genital warts were surgically removed in the vagina. (cut with a hot knife, I don’t understand the details). Now there is severe itching in this area. This is normal? And how to deal with it? Maybe this is somehow connected with thrush, which I periodically get?

Answer of Minkevich K.Q: This is a reaction of the mucous membrane to exposure. Burn wounds hurt, unfortunately, this is a consequence of the operation. You need to take pain relievers, such as rectal suppositories with indomethacin.

Question: flat warts-sil?

Answer of K.V. Minkevich : Yes, it’s LSIL. Lesion of stratified squamous epithelium of low severity or dysplasia of 1 degree.

Question: Hello! I am 20 years old. I went to the doctor and they told me that I have condyloma.Is this a dangerous disease and does it affect pregnancy?

Answer of K.V. Minkevich : The presence of condyloma is not a dangerous disease, but an unpleasant one. Having genital warts affects sexual behavior, lowers quality of life, and raises concerns about future pregnancy. Warts themselves do not affect the fetus, but their presence during pregnancy causes problems. Warts during pregnancy begin to grow actively, which can cause discomfort in the genital area and difficulty walking.Removal of genital warts during pregnancy can be repeated and only by a surgical method. Therefore, genital warts should be healed and preferably as soon as possible before their number increases.

Question: Good evening! I use Aldara cream to remove genital warts and then I have a question – is this enough? Maybe what vitamins to drink or in parallel with some other means to anoint? What do you advise?

Answer of K.V. Minkevich : Treatment with Aldara cream is the right choice of therapy.No additional medication (such as vitamins) is required. If the treatment with the cream does not cause any local reactions on the skin, then there is no need to take a break from the treatment or to treat the skin with other ointments or sprays.

Question: 3 weeks ago I was in the KVD. The doctor removed my genital warts (vaginal) with liquid nitrogen. 10 days ago I went to the reception again – the doctor cauterized the condylomas again. Now in the vagina (in places of genital warts) there is a strong burning sensation, as with a burn.And I see that the warts have remained. And the vagina hurts. What can be done now? The doctor went on vacation. Thank you!

Answer of K.V. Minkevich : Cryotherapy, which was performed by a doctor, is one of the methods of treating genital warts. The main disadvantage of all existing treatment methods is that none of them guarantees complete elimination of genital warts. After cryotherapy, the effect of the treatment does not come immediately, but after a while. Therefore, at present, do not perform any repeated operations, but it is necessary to wait for the healing of the wound surface.For the purpose of anesthesia, rectal suppositories (into the rectum) with indomethacin at night. If, after epithelialization of the vaginal mucosa, condylomas remain, it is necessary to apply another method of their treatment.

Question: Good afternoon! Tell me how genital warts are treated? How many tests need to be taken (or determined only visually). Is it necessary to treat a partner if he has no visible manifestations?

Answer of K.V. Minkevich : The presence of newly emerging genital warts in the anogenital region is an indication for therapy at home.This treatment is carried out in consultation with your attending physician and under his supervision. The first line therapy at home is the use of imiquimod cream (not made in India), and leads to the disappearance of genital warts in most patients. Establishing the type of human papillomavirus (HPV) before starting treatment is not necessary, and does not provide additional clinical information if the doctor has no doubts that the data of the formation of condyloma. Treatment of a sexual partner is not required if he does not have warts (genital warts) on the penis.

Question: A year ago, my husband had genital warts removed in the groin area, cryodestruction was used. Then he underwent a course of immunotherapy, and a month ago he noticed a new warts, but in a different place. What to do, is it really impossible to remove this infection completely? What could have influenced the emergence of a new entity?

Answer of K.V. Minkevich : The disadvantage of any method of treatment is that none of them guarantees the appearance of new genital warts. Relapses occur at the treatment site or new sites.Removal treatment must be repeated. The rate of relapse depends on the immunity of a particular person, and taking immune drugs without evidence, in terms of fighting the virus.

Question: During pregnancy, 2 condylomas appeared in the perianal region, one too “long”, constantly touches. Also later I noticed how many pieces are in the décolleté area and near the neck. Now 4 months have passed after giving birth, I would like to get rid of them completely. She took metronidazole for 10 days and put Polygynax in parallel.There are no shifts. What to do?

Answer of K.V. Minkevich : Consultation on the treatment of genital warts is carried out by a gynecologist, and formations on the skin in the neck and décolleté are carried out by a dermatologist. Treatment can vary. Basic approaches: surgical removal – laser; electrosurgical, including radio wave; with a scalpel, this is a quick release. The second approach is chemical treatment of warts. The third, long-term approach is imiquimod cream (not made in India), it is used at home and the least relapses occur after this treatment.

Question: Hello! Tell me, is the treatment of warts in intimate places so fundamentally different from the treatment of warts on the hands or feet? Can one product be used? And if so, which one is better to use?

Answer of K.V. Minkevich : Treatment of warts in the anogenital area and in other places with a surgical method, for example with a laser, does not differ, but is carried out by doctors of different specialties. There are nuances in the use of local drugs (for example, imichimod cream), in the treatment of genital warts of different localizations.Therefore, it is necessary to consult a specialized specialist.

Question: Hello! I am pregnant, and, of course, the breasts are constantly increasing, changing shape and appearance. Recently I noticed that on the nipple (at the very top, it was always a little cracked) something very similar to genital warts appeared – one of the miniature “balls” on the nipple increased and began to stick out like a drop. Could it be a warts on the chest? Or are these changes normal during pregnancy?

Answer of Minkevich K.Q: This Question cannot be answered without examination. During pregnancy, changes in the skin structure occur in the areola, and this may be a variant of the norm. It is enough to consult a doctor at the reception in the antenatal clinic.

Question: Good afternoon! If I have warts on my hands, can I transfer them to intimate places? More precisely infecting yourself? Or a partner, if I touch the organ with my hand?

Answer of K.V. Minkevich : Warts on hands are also viral formations.The spread of these warts can indeed occur through contact. Infection occurs when this contact occurs between the wart and an injured (damaged) area of ​​the skin or mucous membrane. This damage may not be visible to the eye. Therefore, it is better to get rid of warts not only from an aesthetic point of view, but also from a medical point of view.

Question: Y I have three warts on the inner sides of the legs next to the groin areas, they do not interfere, but are simply psychologically perceived as a time bomb, yesterday I read that in 1 out of 100 patients, warts can degenerate into malignant formations.Should I be treated for them?

Answer of K.V. Minkevich : Formations on the inner surfaces of the thigh, not a typical localization for genital warts. Therefore, consult a dermatologist about these formations. True single condylomas practically do not become malignant.

Question: Hello! I have HPV type 39, genital warts. I am undergoing a course of treatment. The partner has not found a virus. How can this be, if there was oral sex and somehow for a long time (but already with signs of HPV I have) an unprotected act.Does he still need to take the course? Thank you.

Answer of K.V. Minkevich : In the absence of genital warts (genital warts) on the genitals, the sexual partner does not need treatment (medication). This means that the partner’s immunity copes with HPV on its own.

Question: Good afternoon! The doctor prescribed a remedy for genital warts, but I can’t really make out the name. There is a word either imiquimod or imiquimod. And there is another short word ahead.I can’t understand him. A search on the Internet did not give anything, or I do not know how to search ((Can you tell me what kind of tool it can be?

Answer of K.V. Minkevich : The doctor has prescribed imiquimod cream for you. This is a drug that is prescribed in the presence of genital warts in the anogenital area.

Question: Dear Konstantin Vladimirovich! I have a question for you. I have extensions on my small lips, similar to saws, How could I have them? I discovered them already 2 months ago, but I am afraid to go to the doctor.because I have never been there. What do you advise me? Can I take any medications?

Answer of K.V. Minkevich : Without inspection, I can not advise you anything. This may be the norm, just before they did not pay attention to it, or it may be a benign formation. It is necessary to go to an appointment with a gynecologist.

Question: It is clear that it is not curable. But if the operation is performed, they will disappear, or will they continue to appear all my life? I have candidiasis in the area of ​​the genitals.Cauterized, they appear again. What to do. Thank you.

Answer of K.V. Minkevich : Warts are not forever. The human papillomavirus (HPV), which causes the growth of genital warts, is fought by the human immune system, and in 80% of cases this virus wins. Any destructive (surgical) treatment does not always lead to complete elimination of the virus, but removes only visible warts, and the virus can be located nearby in a neighboring area of ​​the skin or mucous membrane. After removal, new warts begin to grow, in new places, therefore, antiviral drugs are used to prevent the recurrence of new warts.These drugs also do not have sufficient effectiveness, and which drug will help, and there is a varied number of them in our country, it is not known. An effective antiviral drug, which has long been successfully used abroad, and now in our country, is imichimod cream (only not of Indian production). If, after removing genital warts, they recur, then no more need to be removed, but apply this cream and there will be a good result. It is applied only to the skin 3 times a week, every other day, at night, for 4 weeks.

Question: Good afternoon. I have the following problem: in the month of April, I turned to my gynecologist with the fact that condylomas grew in the area of ​​the vagina and anus. The doctor took my tests, HPV was not found, on May 18, they prescribed a removal. According to the agreement, on the appointed day, everything was removed, one warts were sent for histology. According to the results of histology, nothing dangerous was found. For a month, I treated the place where there were condylomas with Epigen spray, plus I also injected antiviral injections.But after the first menstruation after the removal procedure, I noticed that I had warts again in the same places. And less than a month later, a relapse happened, and now there are much more of them than last time, and they are growing very quickly. My gynecologist prescribed a second removal of genital warts after the next menstruation. I have a Question, maybe I need to go not to a gynecologist, but to a dermatologist, and for what reason there was such a quick relapse.

Answer of K.V. Minkevich : Warts can be treated by a gynecologist or dermatologist, the main thing is that the doctor is a specialist and understands this problem.Antiviral injections do not always (rarely) help in this situation. In a situation where genital warts have recurred after surgery, and they grow rapidly, it is necessary to remove them again with a prescription, preferably before removing the imiquimod cream again. Continue it after removal for 4 weeks. Ask your doctor how to use it or read the instructions carefully.

Question: Hello, doctor. Today I have found papillomas near the vagina on the mucous membrane.They offered to remove them immediately, I agreed. They smeared them with solcoderm for me, they said that this is the most effective remedy. They said that there should be no relapse if the virus was blocked. Licopid 10mg was prescribed once a day for 10 days and as a prophylaxis epigenes before contact with a partner. Questions: can they really be removed with solcoderm? Will he help against papillomas in the palm of your hand? Is it really possible to block the virus with drugs? What is the likelihood of our partner getting infected if we have always protected ourselves with condoms?

Answer of Minkevich K.V.: Papillomas should not be confused with warts. Condylomas must be removed, but papillomas do not require removal, only at the request of the patient. Papillomas are not always a problem with the virus, but a feature of the structure of the mucous membrane.

Question: Will Aldara cream help cure candidiasis?

Answer of K.V. Minkevich : Good conservative treatment for genital warts. It is applied to the skin 3 times a week (for example: Monday-Wednesday-Friday), at night, for 4 weeks (minimum).

Question: Hello, can genital candidiasis appear immediately a few days after unprotected sex with an infected partner?

Answer of Minkevich K.Q: Genital warts may appear several days after having unprotected sex with a sexual partner who has genital warts on the penis. Carriage of the papilloma virus by a sexual partner, without visible warts, is unlikely to lead to their growth in the partner after a few days. In this case, it is difficult to say when and from whom you were infected, if before that you had sexual intercourse with other partners, and even in a condom. Sexual contact can provoke a virus that was already in the mucous membranes of the genital tract.

Question: Good afternoon! Tell me, please, I had warts on the labia and in the vagina. Deleted in 3 months already three times. With a laser and twice with electrocoagulation, but still, at the next examination, the gynecologist finds more and more. After removal, I put candles Genferon or Viferon 5000-10 days, twice a day. I use Epigen spray. Cycloferon injected injections. Tell me what else you can do? How to get rid of them? Is it possible to plan a pregnancy (we really want to) and what is the probability that they will reappear during pregnancy?

Answer of Minkevich K.V.: Lack of effect from physiosurgical methods of treatment (laser, electrocoagulation) is not uncommon. Relapse after these occurs> 50% of cases. Therefore, it is best to combine one of these methods with topical application of imiquimod cream. In this case, there are practically no relapses. In your case, you need to apply this cream, which is applied only to the skin. The cream is applied once every 3 days (for example: Monday-Wednesday-Friday) at night. One package contains 12 sachets (sachets) for 4 weeks, this is quite enough. If not all were eliminated, then the maximum duration is 16 weeks.Carefully read the instructions and the drug with a good effect. Despite the fact that it is applied to the skin, warts on the mucous membrane will also go away. It is not necessary to combine this method with other symptomatic therapy. It is not possible to predict warts will appear during pregnancy, but you should not be afraid of this. The effect of this therapy, I think, ensures that they do not show up during pregnancy.

Question: Hello. A year ago, during pregnancy, I developed condylomas. I was treated with genital warts, sent to another hospital to be removed while I wait, but why can’t I get pregnant, is it because of genital warts? Thanks for attention.

Answer of K.V. Minkevich : If you have genital warts, you do not need to get pregnant. They grow very quickly during pregnancy. There is imiquimod cream, which effectively removes warts. This dosage form is designed for home treatment by the patient himself. Good effect and safe application. Enough 1 package, where there are 12 sachets (sachets) of the cream, which is applied to the skin, every other day, at night.

Question: Good afternoon !! condyloma skin and perforation may appear inside the genital tract or only outside

Answer of Minkevich K.V.: Condylomas are rough scallop growths, papillomas are delicate papillary formations. Examination by a gynecologist is required because they affect the cervix, vagina, external genitalia.

Question: Hello! For half a year already, I had acute intestinal candidiasis in the anus, I didn’t know what it was and didn’t go to the village until today I decided to search the Internet, after reading a couple of sites I’m horrified, I don’t know what to do, I’m 23 years old I am in position almost seventh month.On the first site I saw that you can burn with iodine and immediately burned it, did I do the right thing? Can you advise me what to do? how to be It is very scary after seeing videos about kandilomas.

Answer of K.V. Minkevich : Treatment of condyloma with iodine is not indicated. You are 28 weeks pregnant, so there is still a lot of time ahead and condyloma can grow significantly before delivery. Therefore, you need to consult a GI doctor and apply the method of removing condyloma, the method that the doctor owns or he will send to the hospital, where it will be removed.There are various methods of treatment during pregnancy: conservative – condilinum or surgical – laser or radio wave removal.

Question: Hello. I have had warts for 3 months on the labia (only outside). The doctor said to remove (remove by radio waves). Is this a mandatory procedure or can a cream replace laser, radio waves or cryo removal? And are imichimod and aldara the same thing or not?

Answer of K.V. Minkevich : Imichimod is the active ingredient in Aldara cream (trade name).I do not advise removing the radio wave, it turns out roughly. The laser is good, cryo is ineffective. Imichimod is the golden mean, he recommended starting treatment with him.

Question: I live in the Kaliningrad region, in which pharmacy I didn’t ask for such an Aldar cream. They don’t even know how and where can I buy it?

Answer of K.V. Minkevich : I don’t know where you can buy it in the Kaliningrad region. In the pharmacies of St. Petersburg it is, I think, and in the pharmacies of Kaliningrad it should be. Type on the Internet search imiquimod cream, this is the active ingredient of Aldara cream.

Question: Hello. I would like to consult a specialist regarding the treatment of genital warts. I discovered them about 3 weeks ago in the vaginal area and on the outside of the penis. At that time I was pregnant, but soon I had a fading pregnancy. Please tell me which method is better to start treatment and should I take any medications? Thanks a lot in advance.

Answer of K.V. Minkevich : Getting warts during pregnancy means that you are infected with the human papillomavirus (HPV).Pregnancy reduces the immune defense of the woman’s body, and the virus is activated when the pregnancy ends, in your case it is interrupted, the immune system is restored. The body itself begins to actively fight the virus, and in a large number of cases, condylomas disappear without any treatment. If the number of genital warts increases or you want to get rid of them faster, I recommend imiquimod cream. Apply to the skin in the area of ​​warts growth 3 times a week at night for 4 weeks. The vaginal mucosa does not need to be processed, the therapeutic effect will be from application to the skin.

Question: Hello! I heard many reviews that after removing genital warts in intimate places in women with the help of Surgitron, it is impossible to have a full sex life (meaning after several months and even years after removal), because it hurts very much !!!! Why are there such consequences?

Answer of K.V. Minkevich : Surgitron is a radio wave removal of warts (electrical impact). After any electrical action, scars remain, which can disrupt the trophism (nutrition) of tissues.Therefore, there may be areas of the skin or mucous membranes with increased sensitivity, but over time, the tissue nutrition is somewhat restored, and the discomfort gradually disappears.

Question: papillomas are everywhere: they are large under the arms, small along the chest, and now they have grown on the neck. How to get rid of them, because where they are sometimes itches very much.

Answer of K.V. Minkevich : This is a viral influence. In these places, the most effective method of treatment is laser removal.Effective and good cosmetic result. Unfortunately, over time, new papillomas will appear on the skin, which will require new removals. These are cosmetic laser procedures.

Question: Good evening! I have been suffering from diabetes for four years (on insulin) and recently experienced a coma (five days). After these events, condylomas appeared and began to grow very quickly and spread to all genitals, forming whole growths, it suffers from terrible itching, but it may be associated with high sugar.I tried to treat with Kondilin, but it was very painful. As I understand it, after a coma and drugs, the immunity was gone. I took medications to boost the immune system. How can and in general it is possible to get rid of a kandil in my illness without resorting to surgical intervention and uterine cancer is possible, if the risk of oncogenicity is revealed, and is it high?

Answer of K.V. Minkevich : Firstly, in diabetes mellitus, you need to regulate blood sugar, then the immune system will recover a little. Secondly, in order to understand you are at risk for cervical cancer, you need to pass a scraping for the human papillomavirus (HPV).The presence of an oncogenic type of HPV does not necessarily cause cancer, but in this case, once a year, it is necessary to take a smear from a gynecologist for cytology from the cervix in combination with an HPV test. Immunity can cope with the virus on its own without any treatment. Warts are caused by a non-oncogenic type of virus that does not cause cancer, only the growth of warts. Considering the presence of diabetes mellitus, try starting treatment for genital warts with imiquimod cream. It should only be applied to the skin 3 times a week (Monday-Wednesday-Friday).Before starting treatment, read the instructions in order to use it correctly and how to react if there is a reaction to it.

Question: Hello! I had several problems at once. Cystitis, violation of microflora and HPV with warts near the vagina. The doctor prescribed pills to restore microflora, cystitis is generally ignored, and condyloma is taken lightly. And they said that I could not infect a partner, but I read that it is easily tolerated. Most of the time, everything itches and itches for me, I can’t wait to be prescribed something.What should I do next?

Answer of K.V. Minkevich : Before starting treatment, it is necessary to pass tests for latent infection – chlamydia, mycoplasma genitalium, in the presence of cystitis, urealiticum for ureaplasma. Treatment for cystitis is antibacterial drugs that need to be clarified with a urologist. Burning and itching at the entrance to the vagina and in the vagina is a manifestation of vulvovaginal candidiasis (thrush), it is necessary to use antifungal drugs (suppositories and ointment). When the acute phase of inflammation subsides a little, warts must be removed.If warts begin to grow before the acute inflammation subsides, they must be removed immediately. Removal methods are better than laser or argon plasma ablation. In the absence of inflammation, imiquimod cream can be applied.

90,000 Human papillomavirus and head and neck cancer: what you need to know?

This information will help you understand what human papillomavirus is and how it can cause head and neck cancer.

to come back to the beginning

What is human papillomavirus?

Human Papilloma Virus (HPV) is a virus that can infect the skin and mucous membranes of the mouth, throat, genitals and anal area.HPV infection is widespread. Most people with HPV do not develop any symptoms and their immune systems get rid of the virus without any treatment. In some cases, HPV can lead to cancer. We do not know why some people manage to get rid of HPV before it causes cancer, while others do not.

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Are there different types of HPV?

Yes, there are different types of HPV. Some types of this virus cause warts to grow on the skin, mouth, or genitals.Other types can lead to cancer. These are called high risk types. High-risk HPV can cause a variety of cancers, including cancers of the cervix and genital organs in women, the penis in men, and the anus. The most common type is cervical cancer. This is why a cervical swab (also called a Pap smear to check for cervical cancer) is taken from women, which includes testing for HPV.

High-risk HPV can also cause head and neck cancer in men and women.

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How do people get HPV?

HPV can enter your body if your skin or mucous membrane comes in contact with the skin or mucous membrane of an infected person. This usually happens during vaginal, anal, or oral sex with someone who has the virus. Because HPV is so widespread, it is difficult to establish when the infection entered the body and who transmitted it. Moreover, your first symptoms of HPV may appear several years after having sex with an infected person.For this reason, it is difficult to find out when you were first infected.

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Am I infected?

HPV is not spread through physical contact (such as touching and kissing on the cheek or lips), but you can get HPV during vaginal, anal and oral sex. This means that if you have HPV, then your sex partners may also have this virus. Since most people get rid of the infection on their own, it is very unlikely that your partner will have HPV-related cancer, even with a high-risk type.If you are diagnosed with HPV cancer, you do not need to change your sexual behavior in any way.

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Can HPV be cured?

There is currently no cure for HPV. Most people infected with HPV get rid of the virus without any treatment.

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Should my partner get tested for HPV?

• Women should follow normal women’s health guidelines, which include regular cervical swabs.
• Men are not required to undergo any special check-ups or examinations as they do not have any routine or routine HPV testing.

Your partner is very unlikely to develop cancer due to HPV. If you have symptoms or concerns, your partner should discuss this with your doctor.

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What can I do to avoid getting HPV and infecting another person?

Condoms and rubber dams (a thin, rectangular sheet of latex or silicone that covers the genitals of a woman who has oral sex) are not as effective against HPV as against other sexually transmitted infections (STIs), such as chlamydia and the virus human immunodeficiency (HIV), but their use can reduce the likelihood of transmission of HPV.Always use condoms or rubber dams during vaginal, anal, or oral sex.

You should also get the HPV vaccine and tell your partner to do the same.

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Should I get the HPV vaccine?

Anyone between the ages of 9 and 26 can be vaccinated against HPV to protect against genital warts and various types of HPV that can cause cancer.Children are encouraged to get vaccinated at the age of 11–12 so that they are protected several years before they have sex.

This vaccine is not usually given to people over 26 years of age. However, regardless of your age, talk to your doctor to see if the HPV vaccine might be beneficial for you.

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If I am already infected with HPV, can I be cured with the vaccine?

If you are already infected with HPV, vaccination will not cure you, but it may protect you against other types of HPV.

If you are infected with HPV, talk to your doctor or nurse to find out what tests or treatment you need.

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How does HPV cause head and neck cancers?

We do not know for sure how HPV causes head and neck cancers. Most people with high risk HPV will not have cancer. However, some people fail to get rid of HPV. In this case, the virus can cause damage, which ultimately will lead to the development of a tumor.It often takes many years for HPV-infected cells to turn into cancer cells. It is impossible to predict who will clear the infection and who will develop cancer. Most cancers of the head and neck caused by HPV form in the part of the throat where the root of the tongue and tonsils are located.

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How do I know if HPV is the cause of my cancer?

During the diagnosis of head and neck cancer, it is possible to check the tumor for the presence of HPV.This is currently the only way to know if the cancer is caused by HPV.

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Can I get another type of cancer due to HPV?

The risk of developing a second type of cancer from HPV is low, but your doctor will continue to check you regularly. Be sure to report any new symptoms or concerns to your doctor.

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Does having HPV affect my treatment or my chances of being cured?

People who have HPV-related head and neck cancers respond better to treatment than people who do not have HPV as the cause of head and neck cancers.However, both types of cancer are treated in the same way. Treatment-related decisions are made based on the size and location of the tumor, the stage of the disease, and the person’s general health. Scientists are currently investigating whether there should be a change in cancer treatment if it is associated with HPV.

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What about tobacco and alcohol?

People who smoke and alcohol are more likely to develop head and neck cancer.However, cancers caused by HPV can develop regardless of whether you drink alcohol or use tobacco products. People with cancer, nonsmokers and non-alcoholic people have a longer life expectancy and are less likely to develop new cancers. For this reason, people with head and neck cancer should quit smoking and limit their alcohol intake. If you need help breaking these habits, MSK can help you. Ask your doctor or nurse for more information about our programs, or call the Counseling Center at 646-888-0200.

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Resources

There is a lot of information on the Internet about HPV and cancer, but sometimes it is contradictory and unreliable. We recommend that you contact the following organizations for additional information:

American Cancer Society (ACS)
www.cancer.org
800-ACS-2345 (800-227-2345)

Centers for Disease Control and Prevention
www.cdc.gov/std/hpv/default.htm

Support for People with Oral and Head and Neck Cancer (SPOHNC)
www.spohnc.org
800-377-0928

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90,000 HPV treatment in women and men

HPV treatment

Human papillomavirus (HPV) is an infection that leads to the formation of neoplasms on the skin and mucous membrane of internal organs – warts, papillomas and condylomas.Currently, there are more than 100 varieties of HPV that differ at the genetic level.

Gynecology deals with such manifestations of HPV as genital warts and flat warts of the cervix. They are caused by different types of HPV virus.

Genital warts are nipple-like outgrowths of a flesh or reddish color, resembling a cockscomb or cauliflower in shape. They occur in places that are most often injured during sexual intercourse.The degeneration of genital warts into malignant tumors is unlikely. However, condylomas can grow rapidly; during an exacerbation of the disease, their number can increase sharply.

Flat warts can lead to dysplasia, that is, a change in the cellular structure of the mucous membrane of the cervix. In the case of dysplasia, there is a risk of developing cervical cancer. The highest cancer risk is in the case of the appearance of formations caused by the HPV virus of 16 and 18 types.

HPV treatment (in both women and men) involves the destruction and removal of the masses caused by the virus.Such formations are a source of infection, and can facilitate the transmission of the virus to a sexual partner or child during childbirth. Modern drugs are able to suppress the activity of the virus and exclude the re-formation of genital warts and papillomas. If the virus is absent in a woman’s body, it is recommended to undergo a course of HPV vaccination in order to exclude infection, which is very likely during sexual activity.

In the polyclinics of JSC “Family Doctor” you can do the tests necessary for the diagnosis of HPV.Experienced obstetricians-gynecologists will remove papillomas and genital warts, treat with the most effective antiviral drugs, and carry out vaccine prophylaxis with imported vaccines (the course consists of three HPV vaccinations per year). Below you can check the prices for services and make an appointment with a doctor.

Dear patients!
Please note that the cost of a visit to a doctor does not always coincide with the indicated admission price.