Genital bumps: What we should know
One of the most common skin bumps that can develop in the genital area are genital warts. These are a sexually transmitted infection caused by Human Papillomavirus (HPV), the same virus that can cause cervical as well as vulvar, penile and anal cancer. Genital warts may be skin-colored to pale pinkish and may be located anywhere in the male or female genital area. They may also appear in other areas including the anus or even the mouth, tongue or throat that was involved in sexual activity. The bumps may be small and barely noticeable or can merge to form a larger mass that look like a cauliflower at the top. Although there are usually no symptoms of genital warts other than the bumps, they may also cause pain, itching and discomfort depending on the size and location of the warts.
There are more than a hundred HPV strains or types, but according to several studies, HPV 6 and HPV 11 cause 90% of benign (non-cancerous) genital warts. HPV 16 and HPV 18 on the other hand, predispose these benign lesions to become malignant (cancerous). Genital warts are caused by HPV types that are different from the ones that cause warts on your hands or other parts of the body.
Genital warts can be transmitted to others even when there are no visible warts or symptoms present. HPV can spread from person to person through contact with infected genital skin, mucous membranes, or bodily fluids during sexual activity. The incubation period of the virus is variable but it can take weeks, months or even years before you develop genital warts after infection.
Diagnosis of genital warts is mostly by visual inspection. Your doctor will conduct a physical examination in areas where genital warts may occur. In some cases however, wherein a diagnosis needs further confirmation, a skin biopsy may be performed. Your doctor can also do a Pap smear, where cells from the cervix are obtained by swabbing then tested for presence of HPV. If abnormalities in the cervix are detected in a Pap smear, and if you are concerned that you may have an HPV type that cause cervical cancer, a DNA test called HPV genotyping may be performed. This test will identify the HPV strain present in your body. HPV genotyping is especially useful in cases where you need to monitor specific HPV types in pre-malignant lesions.
Although there is no cure for HPV infection, there are different treatment options available that will reduce infectivity and remove visible warts. These include topical, immunological and surgical techniques. Despite successful removal of visible warts, recurrence of genital warts is still very likely over the course of your life. Recurrence may be attributed to several factors including persistency of the virus, immune status and behavior of the patient and surgical technique of the provider. The use of combination or continuous treatment may be needed to reduce recurrence.
Prevention, as they say, is still better than cure. An HPV vaccine is available to provide protection from the most common HPV strains that cause genital warts. Such vaccine can also provide protection against HPV strains that may cause cancer. It is most effective if given to a young person (as young as 9 years old) who is not yet sexually active and thus, has not yet been exposed to HPV. Certain types of HPV vaccines can be given to both male and female based on the recommendation of the doctor. As in other sexually transmitted infections (STI), genital warts can also be prevented to a great extent by proper and consistent use of condoms during sexual activity and avoiding risky sexual practices like having multiple sexual partners, etc.
The Centers for Disease Control and Prevention (CDC) estimates 79 million people to be infected with HPV in the United States alone. In the Philippines, local data from the Philippine Dermatological Society estimates more than a thousand infected cases since 2011. With preventive measures, early detection and prompt treatment, the number of genital wart cases can significantly be reduced.
Do you have suspicious skin bumps in your genital area? Have you checked? It is best that you start checking on a regular basis. If you find bumps in your genital skin, don’t think twice. Consult your doctor (perhaps a dermatologist) right away.
Dr. EMMERSON GALE SILVERIO VISTA is both consultant and faculty member at St. Luke’s Medical Center- Global City and the Research Institute for Tropical Medicine (RITM) Department of Dermatology. He graduated in medicine at the University of Santo Tomas and finished his Dermatology Residency Training at RITM. He continued his training with a fellowship observership program at the National Skin Center in Singapore and Dermatology Mentorship Training on STD-HIV at the Ludwig Maximilian University of Munich Department of Dermatology and Allergy in Germany. Currently, he is the head of the STI Unit at RITM Department of Dermatology and assistant residency training officer and member of the Training committee of the Department of Dermatology St. Luke’s-Global and Quezon City.