How Human Papillomavirus (HPV) Is Treated

Human papillomavirus (HPV) is a sexually transmitted virus with over 170 distinct viral types. Some low-risk HPV types can cause genital warts, while other high-risk types may lead to cancer, including cervical cancer and anal cancer.

While there is a vaccine to prevent HPV, there is no cure for the virus itself. The treatment is instead focused on managing health conditions that arise from HPV. This includes monitoring people with high-risk HPV for changes in cells that can lead to cancer.

This article explores the various approaches to managing HPV, including those used to treat genital warts and those used to avoid HPV-related cancers.

Home Remedies and Lifestyle

There are no home remedies that can directly treat HPV or any of its symptoms. However, there are things you can do to better avoid cancer if you have been diagnosed with one of the 14 high-risk HPV types.

If you have been diagnosed with a high-risk type, like HPV16 and HPV18, it doesn't mean that you will get cancer. In fact, many infections will resolve on their own without treatment.

But, if the HPV infection persists, it may be in your best interest to practice safer sex and quit smoking to reduce your odds of getting cancer. Here's why:

Practice Safer Sex

If you have HPV, condoms and other forms of safer sex not only prevent the spread of HPV to others, but they also protect you from getting sexually transmitted infections (STI) that can facilitate cellular changes that lead to cancer.

This includes chlamydia, a sexually transmitted bacterial infection that studies suggest may help HPV grow and survive on the cervix.

Similarly, HIV on its own is known to increase the risk of cervical cancer by six-fold, and anal cancer by 16-fold. When HPV is involved, the risk is amplified.

Quitting Cigarettes

On its own, smoking cigarettes doubles the risk of cervical cancer compared to not smoking. Studies have long suggested that females with high-risk HPV who smoke are more likely to develop cervical cancer than females with high-risk HPV who don't.

The risks extend well beyond just cervical cancer. There is strong evidence that smoking can also increase the risk of HPV-related head and neck cancer.

Prescriptions

Genital warts and anal warts are caused by human papillomavirus. There are roughly 40 different low-risk HPV types that can cause genital warts, the vast majority of which are caused by HPV6 and HPV11.

The HPV types that cause genital warts rarely cause cancer. Even so, they can be itchy painful, or unsightly.

Most genital warts will resolve on their own without treatment within 18 to 24 months. If they don't (or the warts are especially distressing), your healthcare provider can prescribe medications that you apply at home to help clear them.

There are three at-home preparations commonly prescribed for genital or anal warts:

• Aldara (Imiquimod): This topical cream fights genital warts by boosting the local immune response. It is applied once nightly for up to 16 weeks. Common side effects include skin redness. Some people may also experience fatigue, body aches, blisters, or a rash.
• Condylox (podofilox): This topical gel contains a plant-based resin that destroys wart tissues. It is applied two to three times daily in cycles (three days on, four days off) for up to four cycles. Common side effects include mild skin irritation. Sores can also sometimes occur.
• Veregen (sinecatechins) This topical cream is used for external genital warts and warts around the anus. It is applied three times daily for up to 16 weeks. Common side effects include skin redness, itching, or mild burning.

Surgery and Specialist-Driven Procedures

Specialist procedures, including surgery, are sometimes used to treat genital warts that are not responsive to at-home treatments. The same applies to HPV-related changes in cells that can lead to cancer, referred to as dysplasia.

Genital Warts

Healthcare providers sometimes recommend a watch-and-wait approach if a genital wart is small and uncomplicated. The hope is that it will eventually go away on its own without treatment.

If it doesn't and prescription medications fail to clear them, there are several in-office procedures that may help:

• Trichloracetic acid: This is a topical acid solution that is applied by a healthcare provider to gradually remove a genital or anal wart. The treatment is repeated weekly as needed. Common side effects include redness, pain, swelling, burning, skin lightening, and sores. Trichloroacetic acid should not be used on warts near the tip of the penis.
• Cryotherapy: This is a procedure in which a genital wart is gradually removed with liquid nitrogen. The procedure is repeated every two weeks as needed. Common side effects include redness, pain, burning, and skin lightening.
• Electrocautery: This is a procedure that uses electricity to burn away warts. Care is required to control the depth of the burn to prevent scarring. It is repeated every two weeks as needed. Common side effects include redness, pain, swelling, burning, skin lightening, and sores.
• Laser therapy: This is the removal of a genital wart with a carbon dioxide laser. It is repeated every one to two weeks as needed. Common side effects include redness, pain, swelling, burning, and skin lightening.
• Surgery: This involves the removal of a genital wart using a scalpel, scissors, surgical shaver, or a spoon-like cutting device called a curette. A local anesthetic is used, and sutures may be needed. Common side effects are pain, bleeding, and scarring. Infection is possible.
  

Dysplasia

Infection by high-risk HPV types can lead to abnormal changes in cells known as dysplasia. These changes range from low-grade (meaning the cells look mildly abnormal under the microscope) to high-grade (meaning the cells look severely abnormal under the microscope). When this occurs in the cervix, it is referred to as cervical dysplasia.

While mild dysplasia usually resolves on its own within two years, more forms may progress to an early form of cancer known as carcinoma in situ (CIS).

Cervical dysplasia can be diagnosed with a Pap smear. If you have an abnormal Pap smear result, a procedure called a colposcopy with biopsy will be ordered to view the cervix and obtain a sample of tissue for evaluation.

If there is evidence of cervical dysplasia, the healthcare provider may take a watch-and-wait approach if the dysplasia is mild. If the dysplasia is severe, they will want to remove the affected tissues with one of several procedures:

• Cryosurgery: This procedure is typically performed in a health provider's office. An instrument called a cryoprobe is placed on the affected tissue for several minutes to destroy affected tissues with extreme cold. In 85% and 90% of cases, the abnormal cells do not come back.
• Loop electrosurgical excision procedure (LEEP): Performed under local anesthesia in an operating room or a healthcare provider's office. the procedure involves an electrically charged loop made of thin wire that is passed across the cervix to cuts away a thin layer of tissue.
• Cold knife conization: This is performed in an operating room under sedation. For this procedure, the healthcare provider will cut out a small, cone-shaped piece of affected tissues. Cold knife conization can be used to diagnose and treat cervical dysplasia and CIS.

These and other procedures (such as electrocautery and laser therapy) may be used to treat HPV-related dysplasia in the throat, anus, vulva, penis, tonsils, or mouth. This includes infrared cautery (IRC) which uses bursts of infrared light to destroy dysplastic cells in people with anal dysplasia.

It is important to remember that dysplasia treatment only addresses the precancerous changes caused by HPV, not the infection itself. People who have been diagnosed with dysplasia will need to be monitored closely for recurrence. This is especially true if an HPV infection lasts for more than two years.

Vaccination

Scientists have long been trying to develop a therapeutic vaccine that can prevent high-risk HPV from causing cancer. Despite advances in research, there are currently no therapeutic HPV vaccines approved by the U.S. Food and Drug Administration (FDA).

This doesn't mean that the current preventive vaccine, called Gardasil-9, doesn't play a role in people who already have HPV. It actually does.

If you have been diagnosed with HPV but have no symptoms, you may be advised to get vaccinated to protect against the most common high-risk HPV types. Doing so provides added protection if you have one type of HPV but not another (such as HPV16 and HPV18 which accounts for 70% of all cervical cancer diagnoses),

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Summary

There is no cure for human papillomavirus (HPV). The treatment is instead focused on managing the conditions that HPV can cause.

This includes genital and HPV warts that may be treated with topical prescription drugs or removed with procedures like cryotherapy, laser therapy, electrocautery, and surgery.

There are also procedures used to treat HPV-related dysplasia (changes in cells that may lead to cancer). These include procedures known as LEEP, cold knife conization, and cryosurgery. The risk of HPV-related cancers can also be reduced by quitting cigarettes and avoiding sexually transmitted infections that can promote their growth.

A Word From Verywell

While an HPV infection can be distressing, it provides you the opportunity to catch a problem before it can become serious or even life-threatening.

By and large, treatments for HPV-associated conditions have few complications. Many of the treatments are covered, at least in part, by health insurance. Patient assistance and co-pay assistance programs are also available to reduce your out-of-pocket costs, in some cases to $0,

In the unlikely event that cancer is diagnosed, early treatment almost invariably leads to better outcomes.