External Genital Warts Caused by Specific HPV Strains: Key Insights

Human papillomavirus (HPV) is one of the most common sexually transmitted infections, affecting millions of people worldwide. Among the many types of HPV, certain strains are known to cause external genital warts, a condition that can be distressing and uncomfortable. Understanding the causes, symptoms, transmission risks, and available treatments for genital warts is essential for managing this condition effectively.

HPV Strains List

HPV is a diverse group of viruses, with over 200 identified strains. These strains are categorized into high-risk and low-risk types based on their potential to cause cancer. Low-risk HPV strains, such as HPV 6 and 11, are responsible for genital warts but do not lead to cancer. Other low-risk types include HPV 40, 42, 43, and 44, which may also cause mild skin lesions.

High-risk HPV strains, such as HPV 16 and 18, are associated with cervical, anal, and other cancers. Additional high-risk strains include HPV 31, 33, 45, 52, and 58, which have been linked to various precancerous conditions. Some strains, like HPV 1, 2, 4, and 10, cause common warts on non-genital areas, such as hands and feet.

Understanding the specific strain involved in an infection can help determine the best course of action for treatment and prevention.

Which HPV Strains Can Cause Genital Warts?

Genital warts are primarily caused by low-risk HPV strains, most commonly HPV types 6 and 11. These strains are responsible for about 90% of all genital warts cases. Unlike high-risk HPV strains, which are associated with cervical and other cancers, low-risk strains do not lead to malignancy but can still cause persistent and bothersome symptoms.

These warts typically appear as small, flesh-colored or pink growths on the genital and anal regions. They may be flat or raised, single or clustered, and sometimes have a cauliflower-like appearance. Although they are benign, they can cause itching, discomfort, or psychological distress for those affected.

Do HPV 6 and 11 Always Cause Warts?

Not everyone infected with HPV 6 or 11 develops visible genital warts. Many individuals contract these strains but remain asymptomatic, as their immune system effectively suppresses the virus. In some cases, the virus may remain dormant in the body for months or even years before warts appear. This variability in manifestation is why some people unknowingly transmit HPV to their partners without showing any signs of infection themselves.

A strong immune system plays a crucial role in determining whether warts develop. Factors such as stress, other infections, smoking, and immunosuppression can increase the likelihood of warts appearing in those who carry HPV 6 or 11.

What Type of HPV Causes Non-Genital Warts?

While HPV 6 and 11 are associated with genital warts, other strains of HPV cause non-genital warts that appear on different parts of the body. Common warts (verruca vulgaris) found on the hands and fingers are typically caused by HPV types 2 and 4. Plantar warts, which develop on the soles of the feet, are often linked to HPV types 1, 2, and 4. Flat warts, appearing on the face or legs, are commonly caused by HPV types 3, 10, and 28.

These non-genital warts are spread through direct contact with infected skin or contaminated surfaces. Unlike genital warts, which are primarily transmitted through sexual contact, non-genital warts can be acquired in communal environments such as swimming pools, gym floors, or shared personal items.

Early Stage HPV Warts in Females

In women, early-stage genital warts may be difficult to detect as they can develop inside the vagina, on the cervix, or in the perianal area. Many women only become aware of them during routine gynecological exams. When present externally, early-stage genital warts appear as small, soft, painless growths on the vulva, labia, or surrounding skin. They may be flat or slightly raised and can gradually increase in size if left untreated.

Women should seek medical evaluation if they notice any unusual growths, persistent itching, or discomfort in the genital region. Regular Pap smears and HPV tests are recommended to monitor for any potential HPV-related complications, including precancerous changes associated with high-risk HPV strains.

My Partner Has Genital Warts, Will I Get Them?

Having a partner with genital warts does not guarantee transmission, but it does increase the risk. HPV is highly contagious and spreads through direct skin-to-skin contact during sexual activity, including vaginal, anal, and, in some cases, oral sex. Even if warts are not visibly present, the virus can still be transmitted.

Factors that influence the likelihood of transmission include the duration of the relationship, the immune response of the uninfected partner, and whether condoms or other protective methods are used. While condoms reduce the risk, they do not eliminate it completely since HPV can infect areas not covered by protection. If one partner is diagnosed with genital warts, the other should consider getting tested and discussing preventive measures with a healthcare provider.

Treatment of the Condition with Aldara

Aldara (imiquimod) is a topical prescription medication commonly used to treat external genital warts. It works by stimulating the immune system to attack the HPV-infected cells, gradually reducing and eliminating visible warts over time. Unlike treatments that physically remove warts through surgical or chemical methods, Aldara enhances the body's natural defenses, making it an effective option for many patients.

Treatment with Aldara usually involves applying the cream to the affected area three times a week, typically before bedtime. The cream should be left on for about 6 to 10 hours before washing it off. The duration of treatment varies depending on the severity of the warts but generally lasts for several weeks.

Patients using Aldara may experience mild to moderate skin reactions, including redness, itching, swelling, and irritation at the application site. In some cases, flu-like symptoms such as fatigue or fever may occur. These side effects are usually temporary and subside once treatment is completed. However, if severe irritation develops, it is advisable to consult a healthcare provider for alternative options.

Aldara is particularly beneficial for patients with multiple or recurring warts since it not only removes existing lesions but also enhances immune response, potentially reducing the likelihood of future outbreaks. However, it does not eliminate HPV from the body, meaning reinfection or recurrence is still possible.

Final Thoughts

External genital warts, caused by specific HPV strains like types 6 and 11, are a common yet manageable condition. While these warts do not pose a serious health threat, they can cause physical discomfort and emotional distress. Understanding the causes, symptoms, and transmission risks of HPV is crucial for effective prevention and treatment.

For those diagnosed with genital warts, various treatment options are available, including Aldara, which helps boost the body's immune response to eliminate warts. Safe sexual practices, regular screenings, and maintaining a strong immune system can also play a significant role in managing and reducing the impact of HPV-related conditions.

If you or your partner has been diagnosed with HPV or genital warts, consulting a healthcare provider for proper diagnosis and treatment is the best course of action. Early intervention and appropriate management can help individuals lead a healthy and confident life despite an HPV diagnosis.

Medically Reviewed by Dr. Faride Ramos, MD