Genital Dermatology

Human Papillomavirus (HPV) Treatment

Dr. Liew Hui Min

accredited consultant dermatologist

Human papillomavirus (HPV) is a common viral infection that affects the skin and mucous membranes. Most cases resolve on their own, but certain types can cause warts or lead to cellular changes that may require medical attention. HPV spreads through direct skin-to-skin contact and is one of the most widespread infections, with many people encountering it at some point in their lives.

Symptoms Causes Types Diagnosis Treatment Prevention When to See a Dermatologist FAQ

HPV Symptoms

Most HPV infections are asymptomatic and resolve without treatment. However, some types can cause:

Skin warts: Small, rough bumps that appear on hands, feet, or other body areas. These are usually painless but may cause discomfort if located on pressure points like the soles of feet.
Genital warts: Soft, flesh-coloured growths in the genital or anal area that may appear as single bumps or clusters. They might cause mild itching or discomfort but are often painless.
Flat warts: Smooth, slightly raised lesions that commonly appear on the face, legs, or arms. These are typically smaller than other warts and may appear in groups.
No visible symptoms: Most HPV infections produce no noticeable signs. Many people only discover they have HPV through routine cervical screening tests.

Causes and Risk Factors of HPV

HPV spreads through direct contact with infected skin or mucous membranes. Risk factors include:

Skin-to-skin contact

The virus transmits through direct touching of infected areas, including during intimate contact. Even areas not covered by barrier protection can spread the virus.
Weakened immune system

People with compromised immunity from conditions or medications have reduced ability to fight off HPV infections. This includes those with HIV, organ transplant recipients, or people on immunosuppressive drugs.
Multiple partners

Having numerous intimate partners increases exposure opportunities to different HPV types. The risk rises with each new partner, as HPV is extremely common.
Age factors

Common warts occur most frequently in children and young adults, while genital HPV infections peak in late teens and early twenties. The immune system’s response to HPV can vary with age.
Damaged skin

Cuts, scratches, or areas of broken skin provide easier entry points for the virus. This explains why warts often develop around bitten nails or scraped knees.

Types of HPV

There are more than 200 known types of human papillomavirus (HPV). These are grouped based on where they infect the body and their potential to cause health problems:

Low-risk HPV types

These types cause warts on the skin or genitals. For example, types 6 and 11 are responsible for most cases of genital warts. They do not lead to cancer.

High-risk HPV types

About 14 types are considered high risk because they can cause abnormal cell changes. Types 16 and 18 are linked to most HPV-related cancers. These types often do not show symptoms until cell changes have already developed.

Cutaneous HPV types

These affect the outer skin and cause warts such as common warts (hands), plantar warts (feet), and flat warts (face or legs). Different types tend to affect specific skin areas.

Mucosal HPV types

These infect moist areas like the genitals, anus, mouth, and throat. Both low-risk and high-risk HPV types can affect these regions.

HPV Diagnosis Methods

HPV diagnosis depends on the location and appearance of lesions. Methods include:

Visual examination: Dermatologists can often identify warts by their characteristic appearance, location, and texture. Special magnification tools may help distinguish warts from other skin conditions.

Dermoscopy: A handheld device provides magnified viewing of skin lesions with special lighting. This helps differentiate warts from other growths like skin tags or seborrhoeic keratoses.

Biopsy: Removal of a small tissue sample for laboratory analysis when the diagnosis is uncertain. This can confirm HPV presence and rule out other skin conditions.

HPV Treatment Options

HPV-related skin conditions can often be treated without surgery using topical or minimally invasive methods. If these approaches are not effective, minor surgical procedures may be recommended to remove persistent or resistant lesions.

Non-Surgical HPV Treatment

Topical medications: Prescription creams containing imiquimod or podophyllotoxin with cantharidine help the body fight the virus or destroy infected cells. These require consistent application over several weeks.

Cryotherapy: Liquid nitrogen freezes wart tissue, causing it to blister and fall off within days. Multiple treatments spaced weeks apart may be needed for stubborn warts.

Laser therapy: Pulsed dye lasers target blood vessels feeding warts, whilst CO2 lasers vaporise wart tissue. This option works well for warts resistant to other treatments.

Surgical HPV Treatment

Surgical excision: Direct cutting away of wart tissue using a scalpel under local anaesthetic. This allows complete removal and tissue examination if needed.

Electrosurgery: High-frequency electrical current burns and destroys wart tissue whilst controlling bleeding.

HPV Prevention and Management

HPV prevention focuses on reducing skin contact with infected areas and supporting immune health. Key strategies include receiving the HPV vaccine, which is most effective before exposure and helps protect against both high-risk and wart-causing strains. Avoiding skin trauma reduces the risk of viral entry, while not picking or scratching warts helps prevent further spread. Regular skin checks support early detection and timely intervention. For effective prevention and care, consulting a qualified dermatologist ensures accurate diagnosis and personalised treatment planning.

When to See a Dermatologist

Consult a dermatologist if you:

Notice new or persistent warts
Experience discomfort or itching in affected areas
Are unsure whether a lesion is HPV-related
Require evaluation for genital or facial warts
Seek preventive care or vaccination

Frequently Asked Questions

Can HPV warts spread to other parts of my body?

Yes, touching or scratching warts can transfer virus particles to other skin areas, especially if the skin is broken or damaged. Covering warts and washing hands after contact may reduce self-spreading.

How long do HPV skin infections typically last?

Most HPV infections clear within two years as the immune system fights off the virus. Visible warts may disappear sooner with treatment, though the virus might remain dormant in skin cells.

Are over-the-counter wart treatments suitable for all warts?

Pharmacy wart treatments work well for common hand and foot warts but shouldn’t be used on facial or genital warts. These sensitive areas require professional assessment and prescription treatments.

Can someone have HPV without any visible warts?

Most HPV infections never produce visible symptoms, and many people carry the virus without developing warts. The virus can still be transmitted during these asymptomatic periods through skin contact.

Dr Liew Hui Min

Dually Accredited Dermatologist In Singapore and the UK

Dr. Liew Hui Min is an accredited consultant dermatologist from the Ministry of Health and the General Medical Council UK.

Her clinical interest includes:

Paediatric Dermatology,
Women’s Dermatology,
General Adult Dermatology.

Having trained in major London Hospitals, Dr Liew returned to Singapore in 2014 as a Consultant at KK Women’s and Children’s Hospital (KKH) where she specialised in paediatric, women, obstetric and vulva dermatology. Currently, Dr Liew practices at The Skin Drs. clinic located at Gleneagles Hospital.

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