What are anal warts
Anal warts, also called condylomata acuminata, are benign tumour lesions caused by the HPV virus.
These lesions can appear both in the perianal area, inside the anus, and in the genital area. Initially, anal warts appear as small pinkish spots which can be perceived by touch. However, anal warts tend to increase in size and change until they take on the appearance of pedunculate growths called "condylomata". If left untreated, condylomata tend to become increasingly numerous.
HPV (Human Papilloma Virus) is a sexually transmitted virus. HPV can cause the onset of some skin and mucosal alterations, particularly in the genital area, including warts.
Some strains of the virus are able to determine genetic modifications in the cells of various tissues which can degenerate over time. Such alterations can in fact cause the onset of anus tumour, cancer of the mouth and pharynx, cervical cancer of the uterus and cancer of the penis. In this case, the infected cells become increasingly resistant and numerous, replacing healthy tissues.
Anal warts: symptoms
Anal warts occur with lesions of different colours, sizes and shapes which appear mainly on the genitals, inside and around the anus. However, especially in the case of immunosuppressed persons, condylomata can also appear inside the oral cavity or around the mouth.
The lesions initially consist of small pinkish spots in relief which often do not cause any pain. As they become larger, these spots can change colour and become growths called "condylomata" due to their characteristic shape. Condylomata can be isolated or grouped in a single area.
The lesions then tend to spread rapidly and to become increasingly numerous. During this phase, the affected areas may become itchy.
As anticipated, the warts are caused by the HPV virus. In most subjects, HPV shows no symptoms and regresses spontaneously. However, in some cases HPV can become the main factor for the development of tumours. The Papilloma Virus is in fact the cause of about 5% of cancers worldwide where on average every 8 seconds a tumour caused by HPV is diagnosed.
For this reason, when the first symptoms appear, it is essential to book a rectal examination. The specialist will be able to make an accurate diagnosis and identify the most suitable treatment.
Anal warts and HPV: diagnosis
The presence of the HPV virus in the anal canal is initially diagnosed by means of a Pap Smear or with a specific test. The Pap smear is a painless test during which some cells of the anal canal are taken with a special brush. Thanks to this examination, the virus can be identified without the need for a biopsy.
Evaluation of the samples taken confirms or excludes the presence of HPV. In the event of a positive outcome, the test also allows identifying the virus strain. Some strains of the HPV virus are in fact more responsible than others for condylomata degenerating into anal tumours.
Should the anal Pap smear show the presence of HPV, the specialist can request a High-Resolution Anoscopy (HRA). HRA is an examination which allows the identification of further lesions caused by the HPV virus, even at a very early stage.
Anal warts and HPV: causes
Anal warts are a highly contagious sexually transmitted disease caused by the HPV virus. This is why the causes of the disease are closely linked to the methods of infection.
The HPV virus is in fact one of the most widespread sexually transmitted diseases in the world and develops through direct contact with the skin or mucous membranes of the infected partner during anal, vaginal or oral intercourse. Towels and underwear can also carry the virus, although this type of infection is much rarer.
The HPV virus is able to modify the cells of our body and lead to the formation of lesions of the skin and mucous membranes, especially in the genital areas, including precisely, warts. Some strains of the HPV virus are called "high risk" because they increase the risk of developing tumours.
Normally our immune system is able to counteract this virus and block the formation of lesions which are the first step towards the onset of tumours. However, the immune system of some people is weakened to the point of not being able to fight the virus which can act much faster and more aggressively. Immunosuppressed patients therefore run greater risks of contracting the HPV virus and anal warts.
The HIV virus is the most common cause of immunodepression. But the weakening of the immune system can also be due to other causes including chemotherapy, chronic infections, blood disorders and organ transplants.