Human Papillomavirus

Physicians at UT Southwestern Medical Center have years of experience and training in detecting and treating human papillomavirus (HPV) infection and in using the latest advancements, including vaccines, to prevent it.

Exceptional Care for HPV

Human papillomavirus (HPV) is a group of more than 200 viruses that causes warts and other growths on the skin or mucous membranes. HPV can cause both warts that are visible to the eye, and also cause precancerous and cancerous lesions of the cervix, vulva, vagina, and anus. Different subtypes of the virus cause different symptoms.

Our family medicine, general internal medicine, and OB/GYN physicians and their teams are experts in diagnosing and treating HPV-related disorders. We offer experienced, compassionate care to treat HPV symptoms and prevent complications such as cancer.

UT Southwestern is also a leader in HPV research. A study led by Dr. Jasmin Tiro found that a multicomponent outreach program increased completion of the three-dose HPV vaccination series that reduces the risk of cervical cancer caused by the virus. Dr. Tiro serves as co-leader of the Population Science and Cancer Control Program.

Causes and Risk Factors of HPV

HPV is transmitted from person to person usually through skin contact. The virus enters the body through a cut or other opening in the skin. HPV infections can result from vaginal, anal, or oral sex as well as contact with another person’s warts that were caused by HPV.

Risk factors are things that increase the chance of developing a condition. Not everyone with risk factors will develop HPV. Also, people without known risk factors can develop the disease. Risk factors for HPV infection include:

• Number of sexual partners
  
• Weakened immune system
  
• Areas of damaged or open skin
  
• Contact with HPV-related warts or surfaces exposed to HPV
  

Complications of HPV

HPV infection can lead to certain types of cancer. Learn more about HPV cancer and the treatment options we offer.

Symptoms of HPV

The body’s immune system is usually able to fight off HPV before warts develop. Sometimes though, the virus persists, causing warts in various areas of the body, depending on the type of HPV infection. Types of warts include:

• Genital warts: These can be flat, bumpy, or protruding. They develop on the vulva, anus, cervix, or vagina in women, and on the penis, scrotum, or anus in men.
• Common warts: These tough, bumpy growths usually develop on the hands, fingers, or elbows.
• Plantar warts: Hard growths can appear on the heels or balls of the feet.
• Flat warts: Raised, flat lesions can grow almost anywhere on the body.

In addition to warts, HPV can cause cancer, so any abnormal bleeding from the vagina or anus, any persistent itching, discomfort, or pain from the vulva, vagina, or anus should also be evaluated for HPV-related disease.

Preventing HPV Infection

Vaccines are available to prevent infection with the types of HPV that lead to anal, cervical, vaginal, and vulvar precancers and cancers. Gardasil 9® is the HPV vaccine used in the United States.

The Centers for Disease Control and Prevention (CDC) recommends the vaccine primarily for boys and girls ages 11 to 12, and the vaccine can be given at any time between ages 9 and 26. In fall 2018, the U.S. Food and Drug Administration approved the use of Gardasil 9 for men and women between the ages of 27 and 45.

Some ways to decrease the risk of HPV infection include:

• Limiting the number of sexual partners
  
• Using condoms or dental dams during vaginal, oral, or anal sex
  

Diagnosis of HPV

UT Southwestern’s experienced physicians conduct a thorough evaluation, which includes a:

• Physical exam
• Discussion of personal and family medical history
• Discussion of symptoms and risk factors

Our doctors can sometimes diagnose an HPV infection during the physical exam by examining any warts. For patients who don’t have visible warts, we might recommend one or more tests, such as:

• Acetic acid (vinegar) solution test: Applying a vinegar solution to genital warts caused by HPV turns them white, making them easier for doctors to identify.
  
• Pap test: During a woman’s pelvic exam, the doctor takes a small sample of cells from the cervix and vagina. The cells are analyzed in a laboratory to check for abnormal (precancerous) cells.
  
• HPV test: This test analyzes cells collected during a woman’s pelvic exam to check for DNA that indicate the presence of high-risk HPVs.
  

Treatment for HPV

Warts caused by HPV can go away without treatment, and the immune system can often destroy HPV on its own. However, warts can reappear, and sometimes the immune system cannot eliminate HPV.

There is no treatment for the HPV infection itself, but treatment of the symptoms can remove warts and prevent complications such as cancer. Treatment options include:

Medications

Over-the-counter and prescription medications that remove warts include:

• Salicylic acid
  
• Podofilox (Condylox)
  
• Trichloroacetic acid
  
• Imiquimod (Aldara, Zyclara), which boosts the immune system’s ability to recognize and destroy HPV

Surgery and Minimally Invasive Procedures

For persistent or recurrent warts, we can remove the warts with these procedures:

• Cryotherapy to freeze the wart with liquid nitrogen
  
• Electrocautery to burn the wart off with an electric current
  
• Laser surgery to vaporize the wart
  
• Surgery to remove the wart with a scalpel
  

For precancerous or cancerous cells on the cervix, our treatments include:

• Cone biopsy to remove the cells with a scalpel and examine them for signs of cancer
  
• Cryotherapy
  
• Laser surgery
  
• Loop electrosurgical excision procedure (LEEP), similar to electrocautery