The most common questions about HPV Condylomas
Condylomas are lesions, which occur in the genital and perinatal regions and are transmitted through sexual contact. Condylomas is the ancient name and HPV is the modern medical terminology and means Human Pappiloma Virus. Condylomas are benign tumors of varying sizes that appear on the skin from very small – the size of a small mole or skin tag – to sizeable ones and from simple single tumors to multiple ones, varying in sizes. Their color is mainly that of the skin and they appear mainly in the perinatal region of both women and men. However, there are also condylomas that are not easily visible and that primarily affect the uterine cervix where they are difficult to recognize with simple observation. Here’s where the PAP smear comes, as it helps us identify condylomas and their consequences. There are about 100 different genotypes of the virus, of which 35 concern the genitals. The latter according to their “behavior” are classified into four categories: Low Risk, High Risk, Intermediate Risk and Uncertain Outcome. Transmission can also be made through intense friction with infected fingers or sex toys.
Incubation time is undefined. Condylomas appear within a few weeks (at the earliest one month) and up to 3 months after contact, whereas in some cases it may take years. It is also possible for someone to be infected with the virus, but never develop condylomas. This depends on the status of the immune system. Condylomas can occur in times when the immune system is weakened and cannot suppress the virus. Factors that can trigger their appearance (from a previous infection) are:
- Psychological pressure, stress.
- Hormonal disorders due to pregnancy or contraceptives.
- Immunosuppressants.
- HIV infection (the virus that causes AIDS).
However, it is estimated that condylomas only occur in 1-2% of those infected with the strains causing condylomas. Dysplasia occurs only in 3-5% of those affected by the dysplasia-causing strains. Most of those infected remain asymptomatic carriers.
The condom only covers the penis area. Therefore, both the penis base and the area around the genitalia (perinatal area) remain exposed. This make it very easy to transmit condylomas during sexual intercourse from one partner to another.
In theory, yes. It all depends on your immune system. It can keep the infection under control and prevent the further development of problems. However, there are cases of women who got infected with condylomas and after a while their immune system has managed to suppress the virus without relapses. There are, of course, those cases where, despite treatment, the lesions reappear or new ones form. So far, there is no drug or other treatment that kills the virus. The treatment is meant to treat the symptoms and involves the removal of condylomas and dysplasia in the cervix by the following techniques:
- Laser
- Cauterization
- Cryotherapy (cryosurgery)
- Surgical excision
The method is decided depending on the symptoms, the extent of the disease and the degree of dysplasia that has been developed.
The Pap smear can provide a diagnosis of the virus in about 90% of cases, and can detect in a timely manner the malformations that are caused to the uterine cervix due to it. Of course, the way and the person performing the test are important. If the PAP smear comes out negative but the doctor still suspects the presence of infection, he may suggest a test called a colposcopy. This doctor examines the vulva, the vagina and the cervix with a “magnifying lens”, the colposcope, so he can detect any lesions. During the examination certain solutions are applied to the cervix to help highlight abnormal areas and take biopsies where necessary.
During treatment you should be very careful where sexual contacts and depilation methods are concerned. In addition, you should carefully follow any instructions given to you by your gynecologist.
HPV is transmitted by direct contact with the affected area, and is therefore considered a sexually transmitted disease. That is, with any sexual practice there can be transmission of the virus and any part of the body that comes into contact with the infected partner’s area will also get infected. But it is not contracted from the toilet, kissing on the mouth, sharing cookware, or swimming pools or bathtubs.
Yes, when a condom is not used. In fact, it has been shown that the HPV virus may be responsible for the onset of cancer in areas such as the larynx, the pharynx and the oral cavity. Recent studies claim that the development of cancers in the oropharyngeal cavity in recent years has been raised by 40%.
Skin condylomas are low risk HPV strains, i.e. non-carcinogenic strains. Practically, there is no risk of cancer by skin condylomas. However, thorough testing is recommended because together with low-risk strains of the virus, high risk HPV strains which may cause cancer (e.g. cervical, rectum) may coexist.
When the treatment of this lesion is done with the excision method, painlessly, bloodlessly, without incisions and stitches with a flexible CO2 laser, it does not leave any scarring.
Condylomas can be transmitted to various parts of the body that come in direct or indirect contact with existing outbreaks of infection.
If you suspect that your partner has condylomas, he should contact a doctor (for men a dermatologist-aphrodisiologist), who, by using the so-called pendulum, something that corresponds to the colposcope will suggest the appropriate treatment. If this happens, the transmission risk is noticeably reduced. But in no case should you neglect to take all precautionary and protective measures and check your perinatal health periodically.
Shaving the perinatal areas quite often causes scratches but waxing also causes minor injuries, resulting in outbreaks of possible virus entry. On the other hand, laser depilation, is not at all considered as an aggravating medium, if it is properly applied, of course. It remains the safest depilation method during the post-treatment period of the condylomas. It is also essential for the perinatal area to be depilated to allow easy self-examination for early detection of lesions.
The vaccine against is now included in Greece’s primary vaccination program, and it is suitable for girls from 12 to 26 years of age. It is a key shield to HPV protection with a protection rate of 90%. In our country there are two types of vaccines.
No, because the vaccine only immunizes against some strains of the virus, particularly the serotypes 6,11,16 and 18 that are the most “aggressive” and responsible for 70% of the cases of cancer.
You should still have a PAP smear once a year even after vaccination, because as we have already mentioned, the vaccine offers 70% protection. However, for the timely diagnosis of conditions for which vaccination does not provide coverage, a full gynecological check and a PAP smear should be performed once a year.
HPV has 100 different strains. So if you continue to apply risky sex tactics, it is possible to contract another strain of the virus. For example, the cervix may have been affected by more than one strain of the virus, or a patient may present both acuminate condylomas and HPV infection or dysplasia in her cervix.
HPV does not threaten the fertility of a woman unless it is not diagnosed early and the lesions have developed into malignancy, thus affecting the entire reproductive system of the woman. In an infected woman, the pregnancy can progress normally without the risk of transmitting the virus to the child. During childbirth, however, there is a risk of a 4% transmission of the virus to the child upon delivery, which would cause in its early years of life papilloma in the larynx. Therefore, the delivery method should be discussed between the patient and the doctor and after going over all the possible complications, they should decide upon the most appropriate method of delivery.
First of all, it should be made clear that the “treatment” of HPV lesions, especially when condylomas have manifested, is not always assured, regardless of whether clinical alterations were immediately detected. This is because often the tissues surrounding the damaged area (lesion) continue to contain the virus, therefore the emerging condylomas are not due to reinfection but to a delayed manifestation of HPV.
Moreover, after frequent contact of the host with the same strain of the virus, the immune mechanism of the first against the carrier’s antigens has been activated and the immune response is not affected by continuous contact with the same viral antigens. So new condylomas may occur, which are not due to infection by your partner but to a delayed development of the condyloma.
After the complete removal treatment of precancerous cervical lesions, the inability of clinical detection of viral DNA as early as in the first trimester after surgery was confirmed – this negative “HPV test” is also considered as indicative of the success of the treatment. The absence of virus detection in most of these women remains stable for a long time, regardless of whether sexual contacts resume with the initial partner (and possibly a viral carrier) or another (and possibly carrier of a different viral strain) partner. Somehow the “protection” of these women is due to the whole process of tissue wound healing after removal of the damaged part of the cervix and local activation of the immune mechanism.
New vaccines against cervical cancer come to save lives, as this particular disease is the second cause of death in women. In addition, it stops the transmission and appearance of condylomas from the female genitalia system, thus immediately improving quality of life.
Gardasil contains (protects from) 4 HPV types:
- Types 16 and 18, the cause of 75% of cervical cancers in Europe.
- Types 6 and 11 are responsible for 90% of genital condylomas.
Cervarix contains (protects from) 2 HPV subtypes, 16 and 18.