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HPV: Treatment, Procedure, Cost and Side Effects

Last Updated: Nov 01, 2021

What is the treatment?

Human papillomavirus, a sexually transmitted virus cause infection in many people who experience sex at a very early age or have sex with a partner having many partners or have many sex partners and it often gets cleared up without any treatment, without making people fall sick. There are 100 different types of HPV and most of them do not cause serious health issues. In case they persist and cause problems like genital warts, leading to cancer or even precancerous changes, then the symptoms might require treatment. Women may be prescribed to take some tests like Pap test to do a follow-up of the affected cells.

The analysis tests the presence of there are abnormal changes in the cells due to HPV infection, it could lead to cervical cancer which will need treatment or cervical dysplasia which is a precancerous cell change or another cell defect called cervical intraepithelial neoplasias, both of which get healed on their own. For treatment of these abnormal cells some methods like colonisation, laser therapy, loop electrosurgical excision procedure (LEEP) or cryotherapy are used on people. If the infection by HPV type 6 and 11 causes some raised or flat growths on your scrotum or cervix or thigh or groin or on the penis or anus, they are called genital warts and can be treated using Podofilox or Imiquimod cream or Podophyllin and trichloroacetic acid, surgical removal.

What are symptoms of HPV in females?

The symptoms of HPV in females depend upon its type, which may be low risk or high risk. In the case of low-risk HPV, generally pain and irritation and in some cases bleeding occurs, due to the development of warts in the cervix, high risk HPV cases are usually asymptomatic. The virus may live in the body for a long time and can cause infection in cells, which in turn can get transformed into malignant cells, causing cancer.

Does HPV have a smell?

HPV causes viral infections in women as well as men, which leads to the development of warts in the genital area or may develop into cancer in the specific region. The symptoms usually involve abnormal vaginal discharge which can be thick whitish consistency or it may contain blood. The thick whitish discharge is also present in the genital region of men. This has a characteristic foul or pungent smell which resembles the smell of fish.

Can you get HPV non-sexually?

HPV is a viral infection that is communicable. It is transmitted from one person to another through the skin to skin contact. As it is a sexually transmitted disease, the most common means of its spread is sexual activity with the infected person. Semen or saliva is not responsible for carrying the virus, only skin-to-skin contact is necessary for this. So a person can get affected sexually too.

Can men get HPV?

Women are the most commonly affected individual as far as HPV is concerned. But the males too can get affected, though the risk is lesser as compared to women. Although rare, the HPV virus can enhance the risk of genital cancer in men. Genital warts are also a consequence of this infection. It can also induce the chance of anal or penile cancer. Men with a stronger immune system are less prone to it.

How is the treatment done?

Only if HPV causes genital warts or cancer in the cervix or anus or penis of individuals, the appropriate treatment would be required. To treat genital warts medications like podofilox, podophyllin, imiquimod, and trichloroacetic acid can be used. Surgical interventions like cryotherapy would involve freezing of the virus-infected cells with liquid nitrogen thereby inhibiting their functions by forming a blister around the warts, burning the abnormal cells with electric current, surgical removal of the cells with the help of a scalpel, laser therapy to remove infected cells using intense light rays and LEEP technique is used wherein the abnormal cells are discarded with an electric current.

Imiquimod (Zyclara, Aldara) works by boosting up the immune system helping to fight the HPV, podofilox and podophyllin simply destroy the genital wart tissues. In case of cervical cancer also, if the cells are present only on the upper layers and have not migrated into the deeper layers the same surgical treatments can be applied as in case of genital warts. Only if the cancer recurs after other treatments, simple hysterectomy is carried out. Radiation therapy like high dose X-rays is also used to destroy cancer cells, chemotherapy is a common treatment for getting rid of cancer cells. HPV can also cause penile cancer in some men and the treatments include surgery, radiation therapy, chemotherapy and biologic therapy.

Surgery can be performed by cutting the tumor from the skin in thin layers using a microscope or by using laser beam to cut the lesions, circumcision that removes the affected foreskin of the penis or even by amputating partial or the whole penis. Radiation therapy uses high-energy X-rays or maybe other types of rays to inhibit the growth of cancer cells, chemotherapy uses drugs to kill or stop the cancer cells from growing.

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Who is eligible for the treatment? (When is the treatment done?)

Treatment can be given to patients only with visible warts eliminating as many lesions as possible. HIV positive patients or immunosuppressed patients require other treatment methods too for complete eradication. Pregnant women with HPV infection are also eligible for treatment using keratolytics and cryotherapy, even surgical excisions in some.

Who is not eligible for the treatment?

People who do not have visible genital warts are of course not eligible for the respective treatment. If there is presence of mucosal human papillomavirus (HPV) or subclinical anogenital HPV, but there is no co-existence of dysplasia, then treatment cannot be recommended. This is because the latent virus present in the healthy skin beside the lesion may get activated by the treatment causing the condition to recur. Pregnant women cannot be treated with medications like podophyllin, 5-flurouracil and interferon.

Is HPV contagious for life?

HPV is a viral infection that is highly contagious. It is transmitted from one person to another through the skin to skin contact. Although it is a sexually transmitted disease, the infection can spread non sexually too. HPV can be present in the infected person for several years in the dormant stage, during which it does not show any symptoms and the person remains asymptomatic. The virus may multiply in number, still remaining without symptoms. Hence, in such cases, a chance of infection persists.

Are there any side effects?

There are side-effects of medication and surgery of genital warts. Application of Imiquimod (Aldara) causes redness of the skin along with blisters, body aches, fatigue, rashes and cough. Sinecatechins (Veregan) have side effects on the skin causing reddening, burning, pain and itching. Podophyllin and podofilox can cause mild skin irritation, aches and sores.

Also, if too much of the ointment is used or is not let air dried, it could spread to other areas and thereby cause side effects. Laser treatment can cause swelling, itching or pain in the affected area, sores in the treated area, scarring and shedding of tissues, discharge from vagina or penis and even tissues that stick together. Post-surgery you can expect a fever, a severe pain or bleeding continuing for about a week or a foul smell with a yellow discharge thereby giving rise to an infection.

What are the post-treatment guidelines?

Once your warts are treated you need to develop a few good habits to avoid their come back. The foremost step is to maintain proper hygiene, keep the area clean and avoid scratching it. If the area feels swollen or if it hurts then a cold pack may soothe it or over-the-counter medicine can also be taken. You should also wash your hands each time you touch your genital warts and lastly avoid sex if you feel uncomfortable and till they are completely gone. Women must regularly go for Pap tests and should be checked whether vaccine has been taken or not.

How long does it take to recover?

It takes about several weeks to months or even year to completely recover and totally get rid of the warts but they may also relapse which occurs more often. Some people can never get cleared of them in their life. The cancer also takes years to heal completely.

What is the price of the treatment in India?

The normal consultation fees for treatment of genital warts ranges between Rs.200 to Rs.2000. The treatment involves certain tests like PAP Test and HPV Test wherein PAP Test is charged somewhere around Rs. 200 to Rs. 1,500 and the HPV Test cost around Rs.2,000. 12.5 mg of Imiquimod cream cost around Rs. 268. Cost of Cervical cancer treatment ranges between about Rs. 3 lakh to Rs. 5 lakh.

Are the results of the treatment permanent?

The results for genital warts treatment are usually not permanent and have more than 50% chance of getting relapsed. Cervical and penile cancer treatments are generally permanent. But, as the virus cannot be eradicated easily, the condition can prevail.

What are the alternatives to the treatment?

If the symptoms of your HPV or the genital warts are not very prominent and do not cause you much discomfort it is not necessary to get a treatment done. You can maintain simple hygiene, abstain from sexual contact, always use barrier protection like condoms while sex, wash hands every time you touch warts, and avoid rubbing the affected area.

Summary: HPV is a viral infection that is highly contagious. It causes viral infections in women as well as men, which leads to the development of warts in the genital area or may develop into cancer in the specific region. The symptoms usually involve abnormal vaginal discharge which can be thick whitish consistency having a characteristic pungent smell. Women are more commonly affected than men and Control and management are possible by home remedies and self-care techniques.

References

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Written ByDr. Shazli Azad Bachelor of Ayurveda, Medicine and Surgery (BAMS)Gynaecology
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