How Genital Warts Are Diagnosed

HPV viral infection appears, after an incubation period of 1 to 3 months, as typical exophytic (outward-growing) papillary projections known as condylomas.

Because genital condylomas — or genital warts — are transmitted sexually in about 99.9% of cases, they are found in the urethra (urinary opening), vulva (external genital area), perineum (the tissue between the vaginal opening and the anus), vagina, anus, and rectum.

In advanced cases, smaller lesions can merge to form large, broad-based, cauliflower-like masses that are frequently secondarily infected. These masses can grow large enough to cause complications during childbirth.

Asymptomatic cervical lesions are identified on a Pap smear test by the characteristic "halo nuclear" cytological changes (koilocytes). Lesions that shed these types of atypical cells are generally flat condylomas and are not visible to the naked eye.

However, when stained with 3–5% acetic acid and examined colposcopically, they become opaque and visible.

Lesions examined under colposcopic magnification frequently show typical papillary features (turning white with acetic acid staining).

Diagnosis results either from direct observation of typical exophytic lesions, or from identifying flat lesions after acetic acid staining, magnified via colposcopy as needed based on size.

A biopsy should be taken from all cervical lesions, as well as any other treatment-resistant lesions, in order to rule out neoplasia and condyloma lata associated with syphilis.

If you have even the slightest concern about genital warts, you should be sure to see a doctor. Only your doctor can properly diagnose whether a lesion is a genital wart (condyloma). Attempting to treat it yourself can cause the warts to spread more aggressively. Creams containing antibiotics or cortisone should never be used to treat genital warts.