HPV

What Is HPV?

HPV is a sexually transmitted infection. HPV stands for human papillomavirus. It’s very common. Many people don't have any symptoms, and the infection might go away on its own. But some types of HPV can lead to cervical cancer, head and neck cancer, or cancer of the anus or penis.

HPV isn’t just one virus. There are more than 100 kinds, and some are riskier than others.

Types of HPV

Each human papillomavirus has its own number or type. The term "papilloma" refers to a kind of wart that results from some HPV types.

HPV lives in thin, flat cells called epithelial cells. These are found on the skin's surface. They’re also found on the surface of the vagina, anus, vulva, cervix and head of the penis. They’re also found inside the mouth and throat.

About 60 of the 100 HPV types cause warts on areas like the hands or feet. The other 40 or so enter the body during sexual contact. They’re drawn to the body's mucous membranes, such as the moist layers around the anus and genitals.

Not all of the 40 sexually transmitted human papillomaviruses cause serious health problems.

High-risk

High-risk HPV strains include HPV 16 and 18, which cause about 70% of cervical cancers. Other high-risk human papillomaviruses include 31, 33, 45, 52, 58, and a few others.

Low-risk

Low-risk HPV strains, such as HPV 6 and 11, cause about 90% of genital warts, which rarely develop into cancer. These growths can look like bumps. Sometimes, they’re shaped like cauliflower. The warts can show up weeks or months after you’ve had sex with an infected partner.

HPV Symptoms

Often, HPV infections cause no symptoms, and the body clears the infection on its own in a few years. Many people never know they were infected with HPV.

But sometimes an infection with high-risk types of HPV will last longer. This can cause changes in the cells of the cervix that could lead to cancer, including vulvar cancer. The same thing could cause abnormal changes in cells of the penis and anus, but this is rare.

The symptoms of a low-risk HPV infection are warts. The kind of warts you get will depend on which kind of HPV you have.

• Genital warts. These are either flat spots or raised bumps. In women, they usually grow on the vulva, but can also show up on the anus, cervix, or vagina. Men get them on the penis, scrotum, or anus.
• Common warts. These rough bumps typically show up on the hands and fingers.
• Plantar warts. Plantar warts are hard, grainy, painful bumps that affect the bottom of your feet.
• Flat warts. These are slightly raised spots with a flat top. You can get them anywhere, but they’re common on the face and legs.

HPV Causes and Risk Factors

The human papillomavirus infects you by entering your body through a cut, scrape, or tear in your skin. You get it from skin-to-skin contact, or vaginal, anal, or oral sex. You can pass HPV to your baby if you have genital warts when you’re pregnant. In rare cases, this can cause a noncancerous growth in your baby’s voice box (larynx).

The warts are contagious. You can get them by touching someone else’s wart, or by touching a surface that came into contact with one.

Certain things make your chances of getting HPV go up. They include:

• Damaged skin. Places on your skin that have been cut a lot or have holes are more likely to get common warts.
• Direct contact. If you touch someone’s warts or come into contact with surfaces warts have touched, you can get HPV.
• Number of sexual partners. The more sexual partners you have, the higher your risk of getting HPV. If you have sex with someone who has many partners, that increases your risk, too.
• Age. Children are more likely to get common warts. Genital warts are more common in adolescents and young adults.
• Weak immune system. If you have a condition such as HIV or AIDS, or are on treatment that weakens your immune system, you’re more likely to get HPV.

HPV Diagnosis

Your doctor may be able to tell you have HPV just by examining your warts. But there are also several tests they can use if you don’t have symptoms you can see.

• Vinegar solution test. This test uses a vinegar (acetic acid) solution. Your doctor applies it to your genital area. If you have lesions in the area, they’ll turn white.
• Pap test. Your doctor uses a swab to collect samples from your cervix or vagina. They send the samples to a lab to see if you have abnormal cells. Abnormal cells can lead to cancer.
• DNA test. If you’re a woman over 30, your doctor may recommend this test along with a Pap test. They look at the DNA of the cells of your cervix to see if you have the type of HPV that can lead to cancer.

HPV Treatments

Warts may go away without treatment, especially in kids. But there are also medications that treat them, including:

• Salicylic acid. You put treatments with this ingredient directly on the wart. They destroy the wart one layer at a time. You shouldn’t use it on your face.
• Imiquimod. This is a prescription cream that helps your immune system get rid of HPV. It can cause some redness and swelling around the area you apply it.
• Podofilox. You apply this gel directly to genital warts to destroy their tissue. You may get some burning and itching from it.

Trichloroacetic acid. This burns off warts on your palms, soles of your feet, and genitals. It may irritate your skin.

Usually your doctor will recommend medication first. If that doesn’t work, they can remove them with:

• Cryotherapy (freezing with liquid nitrogen)
• Electrocautery (burning with an electric current)
• Surgery
• Laser surgery (using intense light to destroy warts and abnormal cells)

For HPV on your cervix, your doctor may use a procedure called colposcopy to find and remove cells that look abnormal. They’ll use an instrument called a colposcope to magnify your cervix and take samples of (biopsy) these areas.

To remove any precancerous cells on your cervix, your doctor may use:

• Loop electrosurgical excision procedure (LEEP). This uses a thin wire loop with an electric current to remove a layer of cervical tissue.
• Cold knife conization (cone biopsy). A doctor removes a cone-shaped piece of tissue from your cervix and sends it to a lab to look for abnormal cells.
• Cryosurgery. Your doctor uses extreme cold to destroy abnormal tissue.
• Surgery
• Laser surgery

There aren’t any FDA-approved tests to screen for HPV-caused cell changes in the anus, penis, or head and neck. But Pap tests for the anus may help your doctor see early cell changes or precancerous cells. Your doctor may suggest you get one if you are in a high-risk category for HPV.

HPV Complications

When HPV doesn’t go away, it can lead to other problems. Some HPV infections cause lesions, or abnormal areas on your tongue, tonsils, soft palate, or in your nose or larynx.

HPV can also cause cancer. Certain strains of HPV can lead to cancer of the:

• Genitals
Anus
• Mouth and upper respiratory tract

HPV Prevention

You can get HPV through sex (vaginal, anal, or oral). It spreads through skin- to-skin contact.

HPV can infect skin not normally covered by a condom, so using one won’t fully protect you.

You can’t get HPV from a toilet seat, swimming pools, or from an infected person’s blood.

The only way to avoid all risk of any type of HPV infection is to never be sexually active -- no vaginal, anal, or oral sex.

To lower your risk, you can also limit the number of sex partners you have. And you can choose partners who've had few or no sex partners before you.

Three vaccines -- Cervarix, Gardasil, and Gardasil-9 -- protect against HPV. They’re available to boys and girls as young as 9 and adults up to age 26.

The vaccines focus on some of the higher-risk types of HPV. All three guard against HPV 16 and 18. Gardasil and Gardasil-9 are also effective against HPV 6 and 11, which cause most genital warts. Gardasil-9 also covers against the high- risk strains 31, 33, 45, 52, and 58.

While you can’t completely avoid the low-risk HPV infections that cause common or plantar warts, you can reduce your chances if you:

• Don’t pick at warts you already have.
• Don’t bite your nails.
• Wear shoes or sandals in locker rooms or public pools.

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