There are over one hundred types of human papillomaviruses. The majority of them are unimportant because they produce no skin lesions and you never even know that you had an infection. A minority of the various types of HPV cause warts. While warts are contagious and cosmetically unappealing, they are not medically significant. There is no perfect cure for warts, and a large number of treatments have evolved to remove them. The most common treatments each work about 70 percent of the time and include freezing, burning, or cutting the warts off, or using an acid solution to remove the wart. Unfortunately, removing the wart does not necessarily remove the virus hidden in the surrounding skin, so recurrences are common. The good news is that many warts will disappear on their own, even without treatment.
A very few types of HPV are associated with dysplasia and cancer. In the case of anal, vulvar, or penile lesions, there are usually obvious skin changes that are signs of the dysplasia or cancer, and the treatment is either freezing the lesion (cryotherapy) or surgically removing the abnormal skin. While it is never fun to have a precancerous or cancerous lesion, these are relatively mild cancers with a very low chance of spreading elsewhere in the body. Recurrences are common because the virus remains in the surrounding area, so regular monitoring for future lesions is important.
There are four types of HPV that are associated with over 90 percent of cervical cancers: types 16, 18, 31, and 45. Because the cervix is hidden inside the vagina, there is no obvious lesion to warn someone about potential problems. However, regular pap smears, which use a brush to collect cells from the surface of the cervix, provide an opportunity to look for dysplasia or cancer. The current recommendation is that women receive a pap smear every year until they have three normal pap smears in a row and then every two to three years thereafter.
If a pap smear demonstrates dysplasia, there are many treatments available. One is simply to closely follow the lesion. A large number of the mild dysplasias and even some of the severe dysplasias return to normal on their own. Alternatively, one could have the lesion frozen or burned or surgically cut out of the cervix.
However, if a pap smear shows actual cancer, the treatment is more complicated. It usually involves surgery, such as a hysterectoour (removal of the uterus), and sometimes involves radiation or chemotherapy. In any given year, over ten thousand women are diagnosed with cervical cancer, and almost four thousand women die from the disease.