Condylomas are specific growths on the surface of the skin. Their appearance is caused by the presence of the papilloma virus in the human body. Many people ask the question: can condylomas go away on their own? Answer: yes, in most cases of HPV infection, genital warts go away on their own within 2 years. But, even if the condylomas go away on their own, the virus remains in your body. In some cases, without treatment, condylomas grow into large cluster formations.
Rice. 1. Condylomas are caused by the papilloma virus
What is HPV?
The human papillomavirus (HPV) is known to cause flat and pointed warts on the skin and mucous membranes. In medicine, such neoplasms are called papillomas and condylomas, respectively. But the most dangerous thing about HPV is that it is a common cause of cervical cancer.
How is HPV transmitted?
“HPV infection occurs through contact of mucous membranes and skin. The main route of infection is sexual, but it occurs through contact of the surfaces of the skin and mucous membranes with an HPV carrier, and not through sperm and other biological fluids. This is why condoms do not prevent HPV infection. It is almost impossible to become infected with HPV in public toilets, locker rooms of fitness clubs, and saunas.”
Nosov Vladimir Borisovich
expert
Head of the Department of Obstetrics, Gynecology and Gynecological Oncology, European Medical Center (EMC), Gynecological Oncologist, Obstetrician-Gynecologist
HPV is very common, with approximately 14 million people becoming infected each year. During their lifetime, almost every sexually active unvaccinated person (80% of people by the age of 50) gets it, but very few people learn about the disease. Even if you have been tested for HPV and all of them were negative, there is still a chance that you became infected and cleared the virus on your own between tests (this usually happens before the age of 30).
Is it possible to get infected with HPV again?
Unfortunately yes. After exposure to the virus, lasting immunity does not develop, and infection from new sexual partners is quite likely. In addition, if you are infected with one type of virus, you will not develop immunity against other types.
Relapse Prevention
Even after disappearing on their own, papillomas can reappear due to any disruption of the immune system. How to prevent their occurrence? Dermatologists give patients the following recommendations:
- enrich your diet with vitamins;
- to refuse from bad habits;
- do not overcool;
- treat small wounds on the skin with antiseptics in a timely manner;
- avoid excessive dryness of the skin;
- don't get overtired.
These measures will help strengthen the immune system and prevent relapse of papillomatosis.
Types of HPV
There are many types of HPV, more than 200. They are usually divided depending on their ability to cause cancer. All types of the virus are divided into three groups:
- Conditional oncogenic HPV (the safest),
- HPV of average oncogenic risk,
- HPV of high oncogenic risk (the most dangerous).
HPV of high oncogenic risk includes only 15 types of virus (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82), while viruses of types 16 and 18 cause cancer most often: about 70% of all cases of cervical cancer are their work. The rest are associated with cancer much less frequently.
Important!
If you are infected with one of the “dangerous” viruses, this does not mean that there will definitely be cancer. Most often, our immune system defeats HPV in an average of 1-2 years. Even if HPV persists in the body, precancerous lesions or cancer may never develop.
It should be understood that different types of HPV affect different parts of the body. Not all of them are related to gynecology. For example, "skin" viruses (types 1, 2, 3, 4 and 10) cause common or flat warts. In addition, not all viruses that affect the skin and mucous membranes of the genitals (penis, scrotum, perineal or anal area, vagina, vulva or cervical mucosa) can cause cancer. Thus, HPV types 6 and 11 are responsible for the occurrence of genital warts in 90% of cases, but they do not cause cervical cancer.
How to protect yourself from HPV?
“Only vaccination will protect against HPV. The vaccine, especially the nine-valent one, protects against the most dangerous types of HPV, but not against all known types. Girls and boys should be vaccinated from the age of 9.”
Nosov Vladimir Borisovich
expert
Head of the Department of Obstetrics, Gynecology and Gynecological Oncology, European Medical Center (EMC), Gynecological Oncologist, Obstetrician-Gynecologist
Stages of disease development
In most cases, HPV does not cause any symptoms or problems, and the immune systems of young women under 30 clear it within a few months. However, in 10-20% of women, HPV infection becomes chronic - the virus continues to live in the body and does not disappear for a long time. In this case, high-risk HPV can sooner or later cause cell changes: dysplasia (precancerous condition), and then cervical cancer (Fig. 1).
Important!
If HPV is detected, do not panic! It may disappear by the next examination. Having a virus does not mean you are sick. If HPV persists in the body, come for examinations regularly, at least once a year. A virus can only pose a threat if its consequences are not controlled. Dysplasia must be treated in time, then cancer will not develop.
This development of the disease is rare (infection leads to cell transformation in less than 1% of infected people), but it poses a real danger.
Figure 1. Stages of HPV infection. Rarely, human papillomavirus leads to transformation of healthy cells, which can result in cancer. Source: CC0 Public Domain
The duration of development of the disease in this case is individual. In some patients, the initial stage can last for years without leading to cancer. The likelihood of developing cancer increases with age. From infection to the appearance of dysplasia (precancerous condition) and cervical cancer, on average, 10–20 years pass (Fig. 2).
Figure 2. How HPV infection manifests itself with age. The risk of developing cancer due to HPV increases markedly after age 40. Source: CC0 Public Domain
Symptoms
At the initial stage, a person, as a rule, does not know about his disease, but is contagious to others. HPV very often does not manifest itself at all, but certain types can cause the growth of flat or pointed warts - papillomas or condylomas - on the skin and mucous membranes. Their appearance may occur several weeks or even months after infection.
Condylomas: treat or remove?
“If condylomas bother you cosmetically, bleed or get touched by clothing, they need to be treated. In other cases, you can leave it alone.”
Nosov Vladimir Borisovich
expert
Head of the Department of Obstetrics, Gynecology and Gynecological Oncology, European Medical Center (EMC), Gynecological Oncologist, Obstetrician-Gynecologist
The number and nature of tumors caused by HPV varies. In some patients, everything is limited to the appearance of 1-2 small warts, while in others, the affected area and the number of individual elements turn out to be quite large. Condylomas can be either single or multiple, and have different shapes from dome-shaped or filamentous to mushroom-shaped and plaque-shaped with a smooth or bumpy surface (Fig. 3). Some genital warts grow extensively, giving them some resemblance to cauliflower. The color of condylomas is usually white or flesh-colored, less often pink, red or brown.
Figure 3. Some types of HPV lead to the formation of condylomas (pointed warts) on the skin and mucous membranes, often in the genital area. Source
Genital warts are benign formations, they are not dangerous, but in many people they form complexes, cause increased anxiety and reduce the quality of sexual life.
In women, condylomas can form on the cervical mucosa. The growth of condylomas in the anus and urethra (or urethra) can make it difficult to go to the toilet. Sometimes condylomas can hurt or itch, and when injured, they can bleed.
Other reasons
However, there are also quite dangerous reasons for the disappearance of papillomas. Sometimes a person accidentally picks off a wart and does not notice it. It seems to him that the growth disappeared on its own, but in fact the papilloma was traumatized. In this case, a bleeding wound forms at the site of the rash.
It is important to remember that traumatizing warts is very dangerous. This can provoke malignant degeneration of papilloma cells. There is also a risk of infection in the wound. It is necessary to treat the damaged area with an antiseptic, apply a bactericidal adhesive plaster on top and consult a dermatologist.
Sometimes patients notice that a red formation has appeared next to the usual papilloma. Soon after this, the simple wart disappears, and a new rash remains on the skin.
This means that the patient has a benign vascular tumor - a hemangioma. It looks like a red or purple growth on the skin. The adjacent wart begins to darken and gradually dies. This occurs due to the fact that the hemangioma takes a lot of blood, and the nutrition of the tissues in the papilloma stops.
Diagnostics
The effectiveness of treatment and prevention of cancer development largely depends on the timely detection of high-oncogenic risk HPV. It is believed that all women after 30 years of age should be regularly diagnosed with HPV.
Which doctor should I contact?
If you are a woman and you do not have any symptoms or complaints, you still need to see a gynecologist once a year. Your doctor may order an HPV test as part of your general health check.
You should also consult a doctor if you find suspicious growths on your body. The choice of specialist will depend on the location of the warts or new moles. If you are concerned about the genital area and anus, it is advisable to make an appointment with a venereologist, urologist or gynecologist. Otherwise, a dermatologist will help you.
Should men be tested for HPV?
“Men do not need to be tested - a positive test does not change anything. There is still no cure for HPV, and condoms do not prevent transmission of the virus to a partner. Men under 45 years of age are recommended to get vaccinated - the sooner the better.”
Nosov Vladimir Borisovich
expert
Head of the Department of Obstetrics, Gynecology and Gynecological Oncology, European Medical Center (EMC), Gynecological Oncologist, Obstetrician-Gynecologist
What tests should I take?
As part of women's health screening in Russia, they usually do a PAP test and, at the same time, after reaching the age of 30, they take an analysis for the presence/absence of high-oncogenic risk HPV (cotesting).
The PAP test (Papanicolaou smear) is familiar to most women. It is taken from the cervical canal, as well as its outer surface and from the vaginal vaults. This cytological study allows you to see the slightest changes in cells. To make it even more informative, they resort to HPV testing.
Important!
When given a choice between “conventional” and “liquid-based” cytology, “liquid-based” should be selected. This method allows you to purify the sample and save a larger number of cells for study.
The HPV test is a vaginal smear. It is taken to find the DNA of “dangerous” viruses (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82). The amount of virus is not taken into account (daijin tests have no clinical use and should not be taken into account), the analysis can be either positive or negative.
If both tests are negative (no changes in cells, no HPV detected), the next scheduled examination can be carried out after 3 years. If the PAP test is negative, but HPV is detected, the patient is at risk. She is prescribed a colposcopy (examination of the inside of the vagina and cervix), if necessary, a biopsy (sampling of a small fragment of biomaterial for further examination), and routine examinations are carried out at least annually (Fig. 4).
Figure 4. Basic screening for cervical cancer. Source
Treatment begins only if cervical dysplasia is diagnosed based on the results of a PAP test and biopsy.
Do I need to look for HPV if I have genital warts?
If you find yourself with condylomas, you do not need examination. The appearance of warts in itself indicates infection with a virus. An analysis from the cervix or vagina will be unnecessary, but if necessary, you can take an analysis from the condylomas themselves.
HPV and pregnancy
Experts recommend that women planning pregnancy undergo a comprehensive examination to detect HPV infection.
During pregnancy, a woman with HPV may develop genital warts or abnormal cellular changes in the cervix. They can be detected through routine screening. The vaccine is not recommended for pregnant women. Research suggests it does not cause problems in babies born to women who were vaccinated during pregnancy, but more research is still needed. The expectant mother should not receive any doses of the HPV vaccine until after her pregnancy.
The risk of passing HPV to your baby during childbirth is very low. Even if infants become infected with human papillomavirus, their bodies usually clear the virus on their own.
In children and adolescents
Can papillomas disappear on their own in a child? In childhood, simple and vulgar warts are most common. They can go away on their own during puberty. Teenagers experience serious hormonal changes in the body. This can lead to the disappearance of papillomas.
However, hormonal changes can also trigger the appearance of warts. Simple papillomas in adolescence are not a pathology. During puberty, such neoplasms may appear and disappear. Children's warts finally disappear in adolescence, when hormonal levels stabilize.
Treatment
There is no effective treatment for HPV; only the manifestations of the disease can be treated. Women who are diagnosed with human papillomavirus should simply monitor the infection. In this case, you should take a PAP test (cytological smear) once a year. It will help prevent the development of cervical cancer.
Condylomas: to remove or not?
Condylomas caused by HPV are usually simply monitored (in about half of the cases they disappear on their own), resorting to treatment only if there are unpleasant symptoms - itching, bleeding, burning, pain or for cosmetic reasons. Usually, for each patient, the doctor selects individual therapy for condylomas, which takes into account their character and the patient’s health characteristics. Such therapy may include:
- the use of local antitumor, cauterizing drugs or catechins - creams or solutions that are applied pointwise to condylomas (some of them are contraindicated during pregnancy);
- local immunomodulatory therapy - the solution is applied directly to the condylomas daily for a week - imiquimod (cannot be used during pregnancy);
- local cauterizing agents and keratolytics (salicylic, acetic, lactic acids;
- surgical treatment - removal, freezing or cauterization (under local anesthesia).
Surgery is usually recommended if the warts have grown significantly, are causing discomfort, are in the vagina, urethra, or around the anus, and do not respond to other types of treatment. Condylomas should be removed if the doctor has reason to believe that they can cause cancer (for example, they are combined with a precancerous skin condition).
It is useless to remove condylomas in order to protect your sexual partner from the virus, since the virus can remain in the body. Getting rid of warts also does not reduce the risk of developing cancer in the future. After removal of condylomas, there is always a chance that they will appear again.
How HPV is NOT treated: immunomodulators and antiviral drugs
A positive test for HPV often becomes a reason to take various medications, despite the fact that this infection has no cure. The following will not help you against HPV:
- immunomodulators and any means “to enhance immunity”,
- antiviral drugs.
HPV cannot be cured, you can only protect against it through vaccination.
Complications
Complications due to the human papillomavirus can be dangerous, but they can be avoided if the body is regularly examined for tumors.
Condylomas
A small number of condylomas may not cause discomfort to a person, but their growth in some cases significantly affects the quality of life: sexual activity, psychological state. In addition, condylomas can:
- bleed,
- hurt, cause a burning sensation and itching,
- interfere with going to the toilet,
- interfere during childbirth.
Cervical cancer
The most common complication of HPV infection is cervical cancer. The risk of developing it depends on the type of virus. We already know that doctors identify the 15 most “dangerous” types of HPV, and routine screening for women’s health includes analysis for their presence in the body.
In addition, HPV can cause other types of cancer that are much less common than cervical cancer. HPV types 16 and 18 are the leading cause of anal cancer. Cancer of the vulva, vagina or penis, on the contrary, is not always associated with HPV (as is oropharyngeal cancer).
HPV is often associated with problems that it is not the cause of:
- HPV does not cause infertility,
- HPV is not the cause of inflammatory diseases of the cervix and vagina,
- HPV does not disrupt the menstrual cycle,
- HPV cannot cause miscarriage or missed pregnancy,
- HPV, which often causes cancer, is not transmitted during pregnancy and childbirth; natural childbirth is allowed if HPV is present.
Papillomas in the mouth and throat
Can papillomas in the mouth disappear on their own? On the mucous membrane of the oral cavity, both ordinary flat warts and genital warts are observed. Not all rashes go away on their own.
In any case, you should not wait for papillomas in the mouth to go away on their own. After all, they can be very easily injured while eating. And this is fraught with malignant degeneration of tumors. Therefore, papillomas in the oral cavity need to be treated and, if necessary, removed.
Can papillomas in the throat disappear on their own? Patients often ask otolaryngologists this question. There are cases when rashes on the tonsils and throat disappear on their own. However, you should not count on such an outcome. Papillomas in the throat cause severe discomfort to the patient when breathing and swallowing. In addition, they often degenerate into malignant tumors. Therefore, in this case, you cannot delay treatment.
Disease prevention
Considering that HPV has no cure, the importance of preventing infection cannot be underestimated.
How not to get infected
First of all, it is necessary to increase the level of the body's defenses. If you have bad habits, it is better to give them up or at least significantly reduce the consumption of alcohol and tobacco. The breakdown products of tobacco tar enter the vaginal mucus, weakening the local protective properties of the vagina, making the cervix more vulnerable to HPV.
An important point in preventing human papillomavirus is being selective in choosing sexual partners. In monogamous relationships, the risk of HPV infection is much lower than in polygamous relationships. Sex education for children also plays a certain role in prevention, but more important is the awareness of parents about the possibilities of vaccine prevention.
Vaccination
The most effective protection against HPV is vaccination. Today, in most developed countries of the world, vaccination against HPV is an integral part of the vaccination schedule. First of all, it is relevant for girls under 18 years of age who have not yet begun sexual activity, but it has proven effectiveness in women up to 26 years of age, and in the case of a nine-valent vaccine - in men and women from 9 to 45 years of age inclusive. Since HPV infection often occurs during the first sexual contact, the ideal age for vaccination of girls is 12–14 years. It makes sense for adult women to get the vaccine if they plan to change sexual partners. Vaccination will help prevent infection with new types of the virus.
Boys also need vaccinations. It not only helps reduce the spread of infection, but also protects against genital warts.
HPV vaccines protect against several types of the virus:
- bivalent vaccine Cervarix - against the most dangerous viruses types 16 and 18,
- quadrivalent vaccine Gardasil - against viruses types 6, 11, 16 and 18,
- nine-valent vaccine Gardasil-9 - against viruses types 6, 11, 16, 18, 31, 33, 45, 52 and 58 (in Russia it is still difficult to find, but in Europe it is easily available in clinics and pharmacies without a prescription and without a doctor’s referral ).
The vaccination schedule depends on age. For children and adolescents under 15 years of age, these are two doses of the vaccine with an interval of 6-12 months, for adults - three doses (schedule 0, 1-2, 6 months). Additional revaccinations are not required; the effect after the vaccine lasts for at least 20 years.
Important!
HPV vaccines are highly safe and do not contain live viruses. Undesirable effects after vaccination include: redness at the injection site, headache, dizziness, nausea. HPV vaccines do not affect the ability to have children and do not cause infertility.
Activation of the immune system
Can papillomas disappear on their own for no apparent reason? This often occurs when the immune system is activated. Let's assume that the patient has changed his lifestyle: he began to eat right, gave up bad habits, and regularly takes vitamins. This leads to normalization of the immune system, and in some cases, to the disappearance of warts.
Papillomas may disappear after a course of therapy with immunomodulators. These drugs do not affect the activity of the HPV virus, but they strengthen the body's defenses. Sometimes this treatment is enough, and the warts disappear on their own.
