What is Human Papillomavirus (HPV)?

HPV, or Human Papillomavirus, is a widespread infection that can target various areas of the body. There are more than 100 different types of this virus. Some strains may cause warts on the skin, such as on the hands, feet, or face. Around 30 types specifically affect the genital region, which includes areas like the vagina, vulva, cervix, penis, scrotum, anus, and rectrum. Among these, certain types are responsible for genital warts, while others are classified as high-risk strains because they can lead to cancers, including cervical, vaginal, and vulva cancer. Regular checkups, like Pap tests and HPV screenings, help identify abnormal cell changes early, allowing treatment before they develop into cancer.

How does Human Papillomavirus contribute to the development of cervical cancer?

Some types of HPV, especially types 16 and 18, can cause abnormal changes in the cells of the cervix, a condition known as cervical dysplasia. If these changes are not detected and treated, they can sometimes develop into cervical cancer over time.

In many younger individuals, especially those under 30, the body’s immune system often clears the virus naturally without medical treatment. However, after age 30, HPV tests and Pap smears become important tools for monitoring cervical health. A positive HPV result may indicate a higher risk, meaning your healthcare provider could recommend more frequent checkups.

Regular screening starting around age 21 is one of the best ways to catch potential problems early. It’s also important to keep in mind that having HPV or abnormal cervical cells doesn’t necessarily mean you will develop cancer, especially with timely monitoring and care.

How long does it take for HPV to cause cancer?

HPV itself does not directly become cancer, but certain high-risk types of the virus can damage cervical cells over time. These changes are known as precancerous lesions, and if they are not identified and treated, they may progress into cancer later on. This development is usually slow and gradual, often taking several years or even decades. Regular screenings, such as Pap tests or HPV tests, are important because they can spot abnormal cells early, allowing treatment before cancer forms.

What signs show you might have HPV?

HPV that affects the genital area often goes unnoticed because it usually doesn’t cause obvious symptoms. When signs do show up, the most common is the appearance of genital warts. These warts can look like small bumps, skin tags, or clusters with a rough texture, similar to cauliflower. They might develop soon after infection or take weeks, months, or even years to appear. Genital warts are highly contagious and can sometimes cause itching or discomfort.

On the other hand, high-risk HPV types usually don’t produce visible symptoms until the infection has advanced and begun to cause more serious problems, such as cancer.

Are all types of warts associated with HPV?

Yes, all warts are caused by HPV, but not every type of HPV works the same way. This can be a bit confusing, especially when trying to understand the difference between the strains that lead to common or genital warts and those that may increase the risk of cancer.

Some strains, such as HPV types 6 and 11, are responsible for most cases of genital warts. These warts, while uncomfortable or embarrassing, are not dangerous. Other strains of HPV can cause warts in different areas of the body, including:

• Flat warts, which are smooth and slightly raised.

• Plantar warts, found on the bottoms of the feet.

• Periungual or subungual warts, which form around or under the nails.

It’s important to note that high-risk HPV types linked to cancer do not cause warts. This means that while all warts come from hPV, not every HPV strain produces visible warts.

How is HPV transmitted?

Genital HPV is most often transmitted from one person to another through direct skin-to-skin contact during sexual activity such as vaginal, anal, or oral sex. The virus spreads when the genital areas like the penis, scrotum, vulva, vagina, anus, or rectrum come into contact with an infected partner.

Although less common, HPV can also be transmitted through hand-to-genital contact, such as during manual stimulation. This way of spreading the virus is not as well understood and happens much less frequently than direct sexual contact.

How easily can HPV be passed on?

HPV spreads very easily because it only requires direct skin contact, not the exchange of bodily fluids. This means the virus can be passed from one person to another even without ejaculation. A partner can transmit HPV without realizing it, and the infection can occur even if there are no visible signs or symptoms.

Who can get HPV?

Anyone who is sexually active can get HPV through intimate skin-to-skin contact. This includes vaginal, anal, or oral sex, as well as close genital touching, even if there’s no penetration or ejaculation. If a person already has the virus, they can pass it to their partner without realizing it since HPV often doesn’t cause visible symptoms.

People with weakened immune systems, such as those living with HIV, may have more difficulty clearing an HPV infection, which can increase their risk of developing complications. Men who have sex with men (MSM) also face a higher likelihood of contracting certain strains of HPV that are linked to cancer. In these cases, healthcare providers may suggest tests like an anal Pap exam to check for abnormal cell changes that could develop into cancer.

HPV and females:

For women and people with a cervix, HPV is especially concerning because some high-risk types of the virus can lead to cervical cancer if not detected early. Routine Pap smears and HPV screenings are essential for spotting precancerous changes before they progress. HPV can also cause genital warts, which are uncomfortable but not cancerous.

HPV and males:

While HPV can still affect men, it typically presents fewer health risks. Many infections resolve naturally without treatment. However, HPV can sometimes cause genital warts or, in rare cases, cancers of the penis, anus, or throat. Because these cancers are uncommon, regular HPV screenings for men aren’t usually recommended. 

The best ways to lower your risk of HPV are vaccination and practicing safer sex by using condoms or dental dams consistently and correctly.

What problems can HPV cause?

The most concerning issue that can arise from an HPV infection is the development of cancer. Among HPV-related cancers, cervical cancer is the most frequently diagnosed.

Though much less common, HPV can also be linked to cancers in other areas of the body, such as the anus, penis, throat, vagina, and vulva.

It’s important to note that being infected with HPV, even with a high-risk strain, does not necessarily mean you will develop cancer.

Another condition associated with HPV is the appearance of genital warts. These warts can cause irritation, itching, and discomfort, which may affect daily activities. However, aside from these symptoms, they generally do not pose a serious health threat.

How do healthcare providers check for HPV?

Healthcare professionals use different methods to identify HPV infections, depending on whether there are visible signs or not. In many cases, if you have warts on your genitals or other areas, a provider can usually diagnose them through a physical exam alone. However, certain types of HPV don’t show obvious symptoms, which means you might only find out about the infection through routine screening.

A Pap test is often done to check for unusual or precancerous cell changes in the cervix. These changes are usually caused by high-risk strains of HPV and, if left untreated, can develop into cervical cancer over time.

An HPV test directly looks for the virus itself and identifies whether you have a type of HPV that’s linked to a higher risk of cervical cancer.

If your results show abnormal cells or a positive HPV test, your provider may suggest additional examinations, such as colposcopy. This involves using a special magnifying device to closely examine the cervix. If anything looks suspicious, they might take a small tissue sample (biopsy) to check for signs of precancerous or cancerous cells.

In places where more advanced testing isn't available, a technique called Visual Inspection with Acetic acid (VIA) might be used. With this approach, a vinegar-based solution is applied to the cervix, which makes irregular or abnormal cells turn white, making them easier to see.

How is HPV managed or treated?

While there’s no cure that completely removes HPV from your system, treatment focuses on addressing the health issue it causes, such as visible warts or abnormal cervical cell growth. Management strategies depend on the severity and location of the problem. 

Some common treatment options include:

Freezing (Cryotherapy): this involves applying extremely cold temperature to the affected tissue to destroy warts or precancerous cells.

Surgical removal: Procedures like LEEP (Loop electrosurgical excision procedure) or a cone biopsy can be used to cut away sections of tissue containing abnormal cells.

Laser treatment: A focused beam of light targets and destroys affected areas with precision.

Burning techniques (Electrocautery): High heat from an electrical current can be applied to remove warts or damaged tissue.

Chemical treatments: Substances like trichloroacetic acid (TCA) may be used to chemically remove external warts.

Tropical medications: Certain creams or solutions, such as those containing imiquimod or podofilox, can be applied directly to warts to help eliminate them.

Only a small percentage of people with high-risk HPV develop cervical changes that require these interventions, but monitoring through regular screenings helps catch problems early before they turn into something more serious.

What happens after being diagnosed with HPV?

Most people with HPV have a positive long-term outlook, especially if their immune system is strong. In many cases, the body naturally clears lower-risk strains of the virus within a year or two without causing serious health problems.

However, some types of HPV are considered high-risk because they can lead to more serious complications, such as cervical cancer. If you test positive for one of these strains, your healthcare provider will likely suggest regular checkups and additional screenings, like Pap tests, to closely monitor any changes. Detecting these issues early makes it much easier to treat them and prevent cancer from developing.

Is HIV curable?

There is currently no direct cure for HPV itself. However, in many cases, the body’s immune system naturally fights off the virus over time. For most people, the infection disappears on its own, usually within one to two years.

Does HPV remain contagious forever?

No, not always. You can pass HPV to others as long as the virus remains in your system, even if there are no visible signs like warts. This means that even after warts go away, the infection can still be transmitted if the virus hasn’t fully cleared from the body.

The most effective way to completely avoid HPV is by not engaging in sexual activity at all. However, for those who are sexually active, there are several ways to lower the chances of getting the virus and reduce the risk of related health problems, like cervical cancer.

Here are some steps to help protect yourself:

Get the HPV vaccine: The vaccine offers strong protection against several strains of the virus. It works best when given before someone becomes sexually active, often recommended around ages 11 or 12. Even if you’ve already been sexually active, getting the vaccine can still provide protection against strains you haven’t been exposed to yet.

Schedule regular checkups: Routine screenings, like pap smears or HPV tests, can detect early changes in cervical cells before they become cancerous. It’s generally advised to start Pap tests at age 21, but your healthcare provider can help determine the right schedule for you.

Communicate with your partner: if you've been diagnosed with HPV it’s important to let your partner know. This allows them to get tested and take precautions. Your healthcare provider may recommend avoiding sexual activity until treatment for genital warts or other related conditions is complete.

Use protection during sexual activity: while condoms and dental dams don’t completely prevent HPV transmission because the virus spreads through skin-to-skin contact, they can significantly lower the risk when used consistently and correctly.

When is it important to visit your doctor?

Reach out to your healthcare provider if you notice any concerning signs or changes.

This includes the appearance of unusual growths, such as genital warts, which may show up around areas like the vagina, anus, or mouth. These warts often have a bumpy, cauliflower-like texture.

If you receive irregular Pap test results, it could suggest possible cell changes linked to HPV and may require additional testing to better understand what's happening.

It’s also important to discuss how often you should be screened for HPV or related conditions. If you have a weakened immune system, your body may have a harder time controlling the virus, so regular monitoring and open communication with your provider are especially important.

What questions should I ask my healthcare provider?

Here are some questions you might consider asking your healthcare provider:

• What are my treatment options for this type of HPV?

• Is the strain I have likely to cause serious health problems?

• How often should I come in for screening or checkups?

• What steps can I take to reduce the risk of passing HPV to someone else?

• Am I eligible for the HPV vaccine, and would it still be beneficial for me?