HPV infection

Your doctor might be able to diagnose human papillomavirus (HPV) infection by looking at your warts.

If genital warts aren't visible, you'll need one or more of the following tests:

• Vinegar (acetic acid) solution test. A vinegar solution applied to HPV-infected genital areas turns them white. This may help in identifying difficult-to-see flat lesions.
• Pap test. Your doctor collects a sample of cells from your cervix or vagina to send for laboratory analysis. Pap tests can reveal abnormalities that can lead to cancer.
• DNA test. This test, conducted on cells from your cervix, can recognize the DNA of the high-risk varieties of HPV that have been linked to genital cancers. It's recommended for women 30 and older in addition to the Pap test.

Warts often go away without treatment, particularly in children. However, there's no cure for the virus, so they can reappear in the same place or other places.

Medications

Medications to eliminate warts are typically applied directly to the lesion and usually take many applications before they're successful. Examples include:

• Salicylic acid. Over-the-counter treatments that contain salicylic acid work by removing layers of a wart a little at a time. For use on common warts, salicylic acid can cause skin irritation and isn't for use on your face.
• Imiquimod. This prescription cream might enhance your immune system's ability to fight HPV. Common side effects include redness and swelling at the application site.
• Podofilox. Another topical prescription, podofilox works by destroying genital wart tissue. Podofilox may cause burning and itching where it's applied.
• Trichloroacetic acid. This chemical treatment burns off warts on the palms, soles and genitals. It might cause local irritation.

Surgical and other procedures

If medications don't work, your doctor might suggest removing warts by one of these methods:

• Freezing with liquid nitrogen (cryotherapy)
• Burning with an electrical current (electrocautery)
• Surgical removal
• Laser surgery

Treatment for HPV in the cervix

If you have an abnormal HPV or Pap test, your gynecologist will perform a procedure called a colposcopy. Using an instrument that provides a magnified view of the cervix (colposcope), your doctor will look closely at the cervix and take samples (biopsy) of any areas that look abnormal.

Any precancerous lesions need to be removed. Options include freezing (cryosurgery), laser, surgical removal, loop electrosurgical excision procedure (LEEP) and cold knife conization. loop electrosurgical excision procedure (LEEP) uses a thin looped wire charged with an electric current to remove a thin layer of a section of the cervix and cold knife conization is a surgical procedure that removes a cone-shaped piece of the cervix.

You'll likely start by seeing your primary care provider. Depending on where your warts are located, you may be referred to a doctor who specializes in disorders of the skin (dermatologist), feet (podiatrist) or reproductive organs (gynecologist or urologist).

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

• Your symptoms, including any that seem unrelated to the reason for your appointment
• Key personal information, including major stresses, recent life changes and your sexual history
• All medications, vitamins or other supplements you take, including the doses
• Questions to ask your doctor

For HPV infection, questions to ask your doctor include:

• What's the most likely cause of my symptoms?
• Are there other possible causes?
• Do I need to have any tests?
• How can I prevent HPV infection in the future?
• Are there brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

• When did your symptoms begin?
• Are you in a monogamous sexual relationship? Is your partner?
• Where have you found lesions?
• Are the lesions painful or itchy?
• Does anything seem to improve your symptoms?
• What, if anything, appears to worsen your symptoms?