External genital warts are common, but since they sometimes have no symptoms, people may not even notice them. When someone IS symptomatic, they get just a little freaked out when their health care provider tells them "it's genital warts." The nomenclature just sounds bad...but really, this is another skin manifestation of certain strains of the human papilloma virus (HPV) that is passed from one person to another by direct contact.
Usually, the skin at the point of entry of the virus has had some trauma that opens the door for the virus to invade into the skin layers. The viral particles can then set up shop with their DNA and replicate, replicate, replicate. After a while, the host's immune system will overpower the virus and kick it out. The process of becoming infected and realizing that there are warts can take weeks to months or even years if the virus is dormant for a time. The process of immune elimination is at least 6 months. Certain factors make people more susceptible to this viral invasion including having a history of herpes simplex virus, HIV, immune suppression from medications or chronic disease and the like. Pregnancy is included in the relative immunosuppression category of people, so pregnant women can frequently see a dramatic increase in wart size.
The HPV vaccine Gardasil offers immunity to the two most commonly associated subtypes of HPV (type 6 and 11) such that exposure from an infected partner will not result in transmission of the virus. This will help those young women who have been vaccinated (ages 9-26), but for older women, the warts are a source of embarrassment - they don't even want to talk to their gynecologist about it. But there are several excellent treatments available to shorten the number of weeks of symptomatic warts.
The older tried and true therapies included chemical acid agents to literally burn the warts. Also, super-freezing the lesions is effective (cryotherapy). But those involve multiple office visits for treatment. Most women prefer to self-treat in the privacy of their home. Home therapy with application of an immune system stimulating cream known as Aldara is effective, and now there is a botanical cream that has emerged on the market.
The new agent goes by the trade name of Veregen, and the proprietary ingredient is green tea. Yes, that's right, yet another use for green tea to improve health. I was as surprised as anyone to see that this product has not only gained FDA approval for use against genital warts, but it also has the support of the CDC. The sinecatechins topical 15% cream is applied three times a day to the affected skin lesions for up to 16 weeks (the usual duration is 12 weeks). Regression of the warts is progressive over that time. Like most things, there is always the potential for a side reaction, and in the case of Veregen, skin irritation, redness, swelling and ulceration have been seen. Nevertheless, this new therapy offers a "natural" solution to HPV-induced warts.