Human Papillomavirus (HPV)

Human papillomavirus (HPV) is a virus that infects the skin, genital area and lining of the cervix. It is spread during unprotected sex with an infected partner.

HPV is the most common sexually transmitted disease in the United States and in the world. Twenty million Americans are currently infected with HPV and an additional 6 million Americans are infected every year. Half of those newly infected with HPV are between 15 and 24 years of age.

Anyone can become infected with HPV, but your risk increases as you increase the number of sexual partners you — or your partner — have throughout your life.

There are many different types of papillomaviruses (about 100). Some types of papillomaviruses cause warts on the skin, some types cause warts in the anal and genital areas, and some types cause cervical cancer.

Many different HPV types cause cervical cancer. Two types (16 and 18) are the most common, accounting for about 7 of every 10 cases of cervical cancer. Similarly, many types of HPV cause anal and genital warts; but only two types (6 and 11) account for about 9 of every 10 cases. One vaccine, GARDASIL®, contains types 6, 11, 16 and 18. Another HPV vaccine, CERVARIX®, contains types 16 and 18 only. A new HPV vaccine, GARDASIL® 9, was licensed in December 2014. In addition to containing types 6, 11, 16, and 18, it also contains types 31, 33, 45, 52, and 58.

Symptoms of HPV vary from person to person and depend on the type of HPV. Some people do not develop any symptoms, but are still infected with HPV and can still spread the infection.

Symptoms may include:

• Genital warts on the penis (males); in and around the vagina (females); and in or around the anus (males and females)
• Genital warts that appear large or small; be raised or flat; look like small cauliflowers or flesh-colored. dome-shaped bumps
• Genital warts that cause itching, pain with sex, pain with bowel movements, and emotional distress about the physical appearance of the warts
• Abnormal changes in the cells of the cervix (in females), that could lead to cervical cancer

You can get HPV by having vaginal, oral or anal sex with someone who has the virus. In most cases, HPV is spread during vaginal and anal sex.

The virus can be passed from one person to another even if the infected person has no symptoms.

There is no specific test for genital warts. Your healthcare provider can make a diagnosis by examining the warts.

In some cases, your doctor may request a pap smear to help detect abnormal changes in a female's cervix. This requires a pelvic exam. Depending on the results of the Pap smear, some women will require a colposcopy (a test which removes a small piece of tissue from the cervix) to make a more definite diagnosis or to determine the extent of the abnormal cells.

There are three vaccines to prevent HPV: Gardasil®, contains four types of HPV; Cervarix®, contains two types of HPV; and Gardasil® 9, contains nine types of HPV.

The CDC recommended that all adolescents between 11 and 12 years of age receive the HPV vaccine. The vaccine can be given to girls as young as 9 years of age and is also recommended for all teenage and adult women between 13 and 26 years of age. The vaccine is given as a series of three shots; the second shot is given 2 months after the first; and the third shot is given 6 months after the first.

Boys between 9 and 18 years old can get the HPV vaccine (Gardasil®) which protects against four types of HPV.

Learn more about HPV and the HPV vaccine at CHOP's Vaccine Education Center.

In many cases, genital HPV infection resolves over time without any treatment.

You can remove warts using treatments applied by your healthcare provider in the office or by you at home.

• These include using medicated solutions or creams, freezing with liquid nitrogen, or removing surgically.
• Treatment is often determined by the size and number of warts, and may require multiple treatments over time.
• Warts may return after a few weeks or months and require repeat treatment.

Abnormalities of the cervix cells may require surgical procedures by a gynecologist to eliminate the abnormal cells.

Using condoms or other barrier contraceptives can help prevent the spread of HPV.

Whether you treat your genital warts or not, most will go away on their own.

It’s important to note that HPV infects skin cells, but doesn't always produce a genital wart. As a result, you can spread the infection to your partner without even knowing you are infected.

The types of HPV that cause abnormal changes in the cells of the cervix may lead to cervical cancer in the future. Women can spread genital warts to their newborn babies