There is no cure for human papillomavirus (HPV) but most people with HPV infections do not require treatment because the body rids itself of the virus on its own. Less than 1 percent of patients with HPV infection develop problems, such as genital warts, according to the National Women’s Health Resource Center.

There are several treatments available for genital warts, which are caused by HPV infection. Among factors that are considered in the treatment of genital warts include:

• Size and location of warts
• Number of warts
• Patient preference
• Treatment cost
• Convenience
• Adverse side effects

The goal of treatment is usually to remove unsightly warts and alleviate bothersome symptoms.

Some treatments are administered by patients at home and others are performed in a physician’s office. Several creams and gels are available by prescription. These are applied by the patient and are safe and easy to use. There are two different types of topical treatments:

• Antimitotic agents (drugs that inhibit cell growth by stopping cell division). This gel or solution is applied to the wart. It works by destroying the skin of the wart.
  
  
• Biological response modifier. This cream is used for treatment of external genital warts and perianal warts (warts occurring in or around the anus). It stimulates the immune system to fight off the warts.

Over-the-counter medications to treat common warts found on hands and feet should not be used to treat genital warts.

Procedures performed in a physician’s office to treat genital warts include:

• Cryotherapy. During this procedure, the wart is frozen with liquid nitrogen. Freezing causes a blister to form around the wart. Then, dead tissue sloughs off in about a week. This procedure causes minimal pain and must be performed by a physician. Cryotherapy performed on the cervix can cause a profuse watery discharge for approximately one month following the procedure.
  
  
• Chemicals and acids. There are several chemicals and acids that are applied to the surface of the wart by a physician. The chemical or acid causes a blister to form which lifts the wart off the skin so the physician can remove it. The chemical or acid does not usually cause pain, but some pain may be experienced from the resulting blister.
  
  
• Electrocautery (burning off warts with an electrical current). Genital warts are removed by burning them with a low-voltage electrified probe. This is performed in a physician’s office with local anesthesia.
  
  
• Minor surgery to remove warts. This involves cutting away the genital wart. This is performed in a physician’s office with local anesthesia.
  
  
• Laser surgery (using an intense light to destroy warts). This is typically used to remove larger or more extensive genital warts, particularly those that have not responded to other treatments. This is performed in a physician’s office with local anesthesia.
  
  
• Interferon. A human protein known to stimulate the immune system and fight viruses is injected directly into the wart. Though it is as effective as other treatments, it is chosen less frequently because of the inconvenient method of administration, frequent office visits and incidence of side effects.

Although in many cases the immune system rids the body of HPV, the virus can travel to the lower level of tissue where it remains. This can cause genital warts to come back. It is recommended that patients watch for recurrences, which most frequently occur during the first three months after treatment.

HPV is a common and manageable condition. However, living with the condition can be distressing and inconvenient. The period after diagnosis may be an especially emotional time, with many people experiencing feelings of shame and fear. As a result, people with HPV may benefit from seeking counseling or attending a support group.  

In June 2006, the U.S. Food and Drug Administration (FDA) approved the first vaccine (Gardasil) for HPV. In clinical studies, the vaccine was highly effective in preventing persistent infection with two high-risk viruses, HPV 16 and 18, which cause over 70 percent of cervical cancers. The vaccine also protects against HPV types 6 and 11, which cause approximately 90 percent of genital warts.

The HPV vaccine is a recombinant vaccine, meaning that it contains no live virus. The virus in the vaccine is a genetically engineered protein and cannot cause the HPV infection. It is administered in a series of three injections into muscle tissue over a six-month period.

The CDC's Advisory Committee on Immunization Practices (ACIP) has recommended that the vaccine be routinely given to girls aged 11 and 12. However, it can be given to girls as young as nine years old at the discretion of the physician or healthcare provider. The HPV vaccine optimally should be given before females become sexually active.

Although women who have not be exposed to HPV gain full benefits of the vaccine, it offers protective benefits to women who have been sexually active and may have been exposed to HPV. For that reason, the ACIP recommends that females between the ages of 13 and 26 also receive the vaccine.

The HPV vaccine has not been approved for use in males but clinical studies are continuing to determine its effectiveness in men. In addition, women who are allergic to yeast should not receive the vaccine. Additional studies are also being conducted to monitor pregnancy outcomes of women who have received the vaccine and the long-term effectiveness of the drug.

Women who receive the vaccine should continue to follow other prevention strategies, such as regular Pap tests and gynecological examinations. The vaccine does not protect against other STDs and women should use methods to protect themselves against the diseases.

For those who are sexually active, prevention can be difficult because most people do not know they are infected. However, there are a number of ways to reduce the risk of infection, including:

• Practicing abstinence. Refraining from vaginal, oral and anal sex with anyone.
  
  
• Being monogamous. Having a long-term relationship with an uninfected partner may prevent infection. However, the virus is so common that having sex with only one lifetime partner does not guarantee prevention of HPV infection.
  
  
• Reducing the number of sexual partners. For those not in a long-term relationship, reducing the number of sexual partners will decrease the risk of becoming infected.
  
  
• Using a condom. Latex condoms can provide some protection if they cover the area of HPV infection. New studies have indicated that regular, correct condom use can protect women from HPV infection and cervical dysplasia.
  
  
• Using a dental dam (square piece of latex placed over the vaginal or anal opening during oral sex). Using a dental dam during oral sex can reduce the risk of infection.
  
  
• Avoiding sex with a partner with genital warts. A person with visible signs of genital warts should abstain from sex until the warts are removed. This reduces the risk of spreading HPV.
  
  
• Getting regular Pap smears. While these tests do not prevent the spread of HPV, they can detect abnormal cell changes, which can lead to cervical cancer or other complications.

Spermicidal foams, creams, jellies (and condoms coated with spermicide) have not been proven to be effective in preventing the spread of HPV. In fact, they may cause microscopic abrasions that make it easier to contract a sexually transmitted disease. Spermicides are not recommended for routine use.