Anal Warts

Anal warts are benign small skin growths that appear in the perianal area and may also be present in the anal canal. They initially appear as small pimples which may grow in size and cover the entire area.

CAUSES

Warts are caused by the Human Papilloma Virus (HPV), which is mainly sexually transmitted. The HPV virus is considered the most common sexually transmitted disease and affects both sexes. This particular virus is extremely easily transmitted and can manifest itself even years after being infected. But a person can be infected with the virus even without sexual contact. Any direct contact in the anus area (hand contact, fluids from a positive patient) can lead to the appearance of warts in the area.

SYMPTOMS

Warts are usually asymptomatic. They rarely cause pain and most of the time are not noticed by the patient. Usually the patient at some point notices the existence of small painless skin formations in the area of the anus or genitals which makes him suspect the existence of warts.

Other symptoms are:

    Bleeding

    Itching

    Mucous rectal discharge

PREVENTION

The HPV virus can exist in our body for a long time without any symptoms. There are steps we can take to protect ourselves from the virus.

These include:

    Avoiding sexual contact with people who have warts

    Limiting sexual partners

    Always have sex with precautions

    Sexual partners should be laboratory tested for HPV even if they are asymptomatic

    HPV vaccine which must be given between the ages of 9 and 26 before becoming sexually active

DIAGNOSIS

The diagnosis is usually performed by clinical examination of the area by a General Surgeon. In some cases, it may be necessary to have a proctoscopy, which allows us to see the inside of the anus, which is performed in the doctor’s office.

TREATMENT

If warts are not treated they can multiply and grow in size as well as extend inside the anus. Without treatment, the risk of rectal cancer increases. HPV has many types. Some of these types have been blamed for causing rectal cancer. The specific types do not cause warts, but in a person suffering from warts it is very likely that the type of the virus that cause cancer coexist.

Wart treatment options include:

   – Topical ointments that are usually used in cases with small number of warts both in size and number

   – Cryocoagulation of the warts, again in a relatively small number

   – Topical treatments with liquids that burn warts (podophyllin)

–         Surgical removal of warts with local or general anesthesia depending on their number. The latter is the most effective treatment of warts and is carried out using a laser in the doctor’s office or clinic. When warts appear near the anus, the anal canal should always be inspected with a proctoscope and any internal warts should be removed. The warts are sent for biopsy while there is also the possibility with further specialized tests to establish which types of the virus are present in the patient.

FREQUENT QUESTIONS

I feel something in the area of the genitals and anus. Do I have warts?

Most likely not. There are many conditions (skin tags, papillomas, cysts, moles, hemorrhoids, etc.) that occur in the same area and can confuse the patient

Which doctor should I see if I suspect I have warts?

The General Surgeon and the Dermatologist are the specialties that deal with this condition

Should I treat the warts even if they don’t cause me any problems?

Yes, if warts are diagnosed then they must be treated to avoid complications

What is the best treatment for warts?

This depends on their number, size and location. In general, the most effective method is considered to be laser cauterization

I developed warts while being sexually exclusive with the same partner for a long time. Can this happen?

Yes, this can happen. The sexual partner may be infected from a previous partner and the virus may remain inactive for a long time.

Can I get cancer because of warts?

Types of the HPV virus have been implicated in anal and genital cancer, so this possibility exists

What anesthesia do I need  for the surgical treatment of warts?

Laser treatment of a small number of warts can be performed in the office under local anesthesia. In case of a large number or location inside the anus then general or spinal anesthesia is necessary

Can warts reappear after laser removal?

The virus may continue to exist in the patient’s body. Therefore, review of the area  is needed at certain time intervals so that if a new wart appears it can be treated immediately at its initial stage.