Condylomas: everything you need to know about this silent, frequent and recurring infection

Often ignored, rarely understood, genital and anal warts – or condylomas – are nevertheless among the most common sexually transmitted infections (STIs).

Amidst embarrassment, taboos, and concerns, they remain shrouded in misconceptions. How are they transmitted? What are the real risks? How can you protect yourself effectively? To shed light on this little-known condition, we gathered insights from two experts at the Nice University Hospital: Professor Jérôme Delotte, head of the women-mother-child unit, and Dr. Clémentine Mazoyer, a specialist in digestive surgery.

What is a condyloma?

It is a benign tumor caused by the human papillomavirus (HPV), a common and highly contagious virus that causes one of the most widespread sexually transmitted infections (STIs). In many cases, these warts disappear spontaneously, without treatment, under the action of the immune system. When they are not eliminated, genital warts appear as small, pinkish or grayish growths, usually painless, located on the genitals or anus. Sometimes, they can cause itching or bleeding. But beyond the physical symptoms, these lesions also have a significant psychological impact, as they often cause feelings of shame and anxiety, which can disrupt sexual and social life.

How are these warts caught?

Genital warts do not necessarily require penetrative sex to transmit. Simple skin-to-skin contact between the genitals or anus is enough to transmit the virus. Intimate caresses, oral sex, or the use of sexual objects can be enough to transmit the virus. Condoms reduce the risk but do not provide complete protection.

Are there any risk factors?

Men and women are equally affected. Unprotected sex, especially anal sex, increases the risk, but it is not essential for developing condylomas in this area. Immunocompromised individuals, such as those living with HIV or who have undergone a transplant, are more at risk. Stress or fatigue can promote their development, even in healthy patients.

Can the virus remain dormant for years?

Absolutely. HPV can remain dormant in the body for years before manifesting itself. The appearance of condylomas is therefore often unrelated to infidelity or recent infection. It's not uncommon for patients to suddenly develop lesions simply because the previously silent virus reactivates.

How is the diagnosis made?

It is mainly based on a clinical examination: the doctor identifies the lesions with the naked eye. Depending on the location, additional tests may be necessary: ​​an anoscopy to explore the anal canal, a urethroscopy in men if urethral involvement is suspected, and a gynecological examination with a cervical smear in women. Screening sexual partners is also recommended.

Is the risk of cancer significant?

Genital warts are most often benign. The HPVs responsible are generally low-risk, but some types of HPV can be linked to cancer, which warrants monitoring and additional testing in specific cases.

How does the support work?

It depends on their size, number, and location. For small, few lesions, local treatments, such as creams, can be applied by the patient themselves. When the condylomas are larger, numerous, or resistant, physical destruction methods such as cryotherapy or laser are preferred. In more extensive or complicated cases, surgery may be necessary to remove the lesions. After treatment, it is advisable to use protection during sexual intercourse for at least two weeks.

Is there a risk of recurrence?

Yes, condylomas can frequently recur after treatment (approximately 30% of cases) because the papillomavirus sometimes remains latent in the body and causes new lesions. This is why, even after treatment, follow-up is necessary.

The importance of vaccination

The French National Authority for Health (Has) recommends HPV vaccination for all young people, girls and boys, from the age of 11. The vaccination schedule is two doses for adolescents starting vaccination before the age of 15, and three doses for those starting from the age of 15. Vaccination is recommended up to the age of 26 for catch-up. It aims to prevent HPV-related cancers (cervix, anus, throat, penis) as well as genital and anal warts (condylomas).