Many people have HPV (human papillomavirus), and the infection often clears up on its own, without treatment. And it often doesn’t make people sick.
But if it doesn’t go away by itself, and if it causes problems, your doctor can treat the symptoms of the infection. These may include genital warts linked to low-risk HPV types (which don't generally lead to cancers) and the precancerous changes sometimes linked to certain high risk types of HPV.
If You Have HPV and No Symptoms
You might not need any treatment, at least not immediately. If you have HPV, your doctor will want to make sure you don’t develop any problems from it.
If you’re a woman, your doctor may swab cells from your cervix, just like when you get a Pap test, and send them to a lab for testing. This analysis looks for genetic material, or DNA, of HPV within the body's cells. It can find the HPV types that can cause problems. There’s no similar test for the strains of HPV that cause cancer in men.
If your doctor finds that you have a type of HPV that can lead to cancer, they may suggest you get Pap tests more often to watch for signs of abnormal cell changes in the genital area. Abnormal cell changes in the cervix may be a warning sign cervical cancer. Your doctor may also do a test called a colposcopy, in which they use a special magnifying device called a colposcope to look closely at your cervix, vagina, and vulva as well as take biopsies if needed.
If you’re pregnant or trying to conceive, tell your doctor before you start HPV treatment, which could affect your pregnancy. Your doctor may want to delay treatment until after you have your baby.
What If There Are Changes?
If the HPV infection has caused abnormal cell changes that could lead to cervical cancer, your doctor might want to take wait-and-see approach. Sometimes the cell changes -- called cervical dysplasia, precancerous cell changes, or cervical intraepithelial neoplasia -- will heal on their own.
If your doctor decides to treat the abnormal cells, they may use one of these methods:
- Cryotherapy. This involves freezing the abnormal cells with liquid nitrogen or carbon dioxide.
- Conization. This procedure removes the abnormal areas.
- Laser therapy. This uses light to burn away abnormal cells.
- Loop electrosurgical excision procedure (LEEP). The abnormal cells are removed with an electrical current. The goal is to remove all the abnormal cells, including most or all of the cells with HPV.
If You Have Genital Warts
These growths, which are caused by HPV infection, can be raised or flat. They can be small or large. They may be pink or the color of your skin. Genital warts can appear on the cervix, vulva, scrotum, groin, thigh, anus, or penis.
Treating the warts aggressively right after they appear actually isn’t a good idea. More could grow, and you’ll have to treat them again later on.
HPV types 6 and 11, which are linked to genital warts, tend to grow for about 6 months, then stabilize. Sometimes, visible genital warts go away without treatment.
If you need treatment, your doctor can prescribe a cream that you can use at home. There are two options:
You’d use podofilox for about 4 weeks. It destroys the wart tissue. Research shows that about 45% to 90% of warts clear up, but sometimes the warts come back.
Imiquimod boosts the immune system so it fights off the virus. It often clears the warts, but not always permanently.
Your doctor can also prescribe other types of wart-removal treatments. Among the options:
- Cryotherapy freezes off of the wart with liquid nitrogen.
- Trichloracetic acid is a chemical that’s put on the surface of the wart.
- They can remove the cells surgically, with a scalpel.
- They can burn off warts using an electric current (electrocautery).
- A laser can vaporize the warts.
Having the warts surgically removed may cure the problem in just one visit. Other techniques work about 80% to 90% of the time.
Generally, smaller warts are easier to treat than larger ones. Warts on moist surfaces respond better to treatments that go right on them, compared with warts on drier surfaces.
If your warts don't go away after several treatments, your doctor might have more tests done to see if something else is going on.