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  • Genital wart

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    Genital warts are a sexually transmitted infection caused by certain types of human papillomavirus (HPV). They are generally pink in color and project out from the surface of the skin. Usually they cause few symptoms, but can occasionally be painful. Typically they appear one to eight months following exposure. Warts are the most easily recognized symptom of genital HPV infection. HPV types 6 and 11 are the typical cause of genital warts. It is spread through direct skin-to-skin contact, usually during oral, genital, or anal sex with an infected partner. Diagnosis is generally based on symptoms and can be confirmed by biopsy. The types of HPV that cause cancer are not the same as those that cause warts. Some HPV vaccines can prevent genital warts as may condoms. Treatment options include creams such as podophyllin, imiquimod, and trichloroacetic acid. Cryotherapy or surgery may also be an option. After treatment warts often resolve within 6 months. Without treatment, in up to a third of cases they resolve on their own. About 1% of people in the United States have genital warts. Many people, however, are infected and do not have symptoms. Without vaccination nearly all sexually active people will get some type of HPV at one point in their lives. The disease has been known at least since the time of Hippocrates in 300 BC.

  • Molluscum contagiosum

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    Molluscum contagiosum (MC), sometimes called water warts, is a viral infection of the skin that results in small, raised, pink lesions with a dimple in the center. They may occasionally be itchy or sore. They may occur singly or in groups. Any area of the skin may be affected, with abdomen, legs, arms, neck, genital area, and face being most common. Onset of the lesions is around 7 weeks after infection. It usually goes away within a year without scarring. MC is caused by a poxvirus called the molluscum contagiosum virus (MCV). The virus is spread either by direct contact including sexual activity or via contaminated objects such as towels. The condition can also be spread to other areas of the body by the person themselves. Risk factors include a weak immune system, atopic dermatitis, and crowded living conditions. Following one infection, it is possible to get reinfected. Diagnosis is typically based on the appearance. Prevention includes hand washing and not sharing personal items. While treatment is not necessary some may wish to have the lesions removed for cosmetic reasons or to prevent spread. Removal may occur with freezing, opening up the lesion and scraping the inside, or laser therapy. Scraping the lesion can, however, result in scarring. The medication cimetidine by mouth or podophyllotoxin cream applied to the skin may also be used. Approximately 122 million people globally were affected by molluscum contagiosum as of 2010 (1.8% of the population). It is more common in children between the ages of one and ten years old. The condition has become more common in the United States since 1966. MC is not a reason to keep a child out of school or daycare.

  • Genital herpes

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    Genital herpes is an infection by the herpes simplex virus (HSV) of the genitals. Most people either have no or mild symptoms and thus do not know they are infected. When symptoms do occur, they typically include small blisters that break open to form painful ulcers. Flu-like symptoms, such as fever, aching, or swollen lymph nodes, may also occur. Onset is typically around 4 days after exposure with symptoms lasting up to 4 weeks. Once infected further outbreaks may occur but are generally milder. The disease is typically spread by direct genital contact with the skin surface or secretions of someone who is infected. This may occur during sex, including anal and oral sex. Sores are not required for transmission to occur. The risk of spread between a couple is about 7.5% over a year. HSV is classified into two types, HSV-1 and HSV-2. While historically mostly cause by HSV-2, genital HSV-1 has become more common in the developed world. Diagnosis may occur by testing lesions using either PCR or viral culture or blood tests for specific antibodies. Efforts to prevent infection include not having sex, using condoms, and only having sex with someone who is not infected. Once infected, there is no cure. Antiviral medications may, however, prevent outbreaks or shorten outbreaks if they occur. The long term use of antivirals may also decrease the risk of further spread. In 2015 about 846 million people (12% of the world population), had genital herpes. In the United States, more than one-in-six people have HSV-2. Women are more commonly infected than men. Rates of disease caused by HSV-2 have decreased in the United States between 1990 and 2010. Complications may rarely include aseptic meningitis, an increased risk of HIV/AIDS if exposed to HIV-positive individuals, and spread to the baby during childbirth resulting in neonatal herpes.

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