Human papillomaviruses (HPV) are common viruses that can cause warts. There are
more than 100 types of HPV. Most are harmless, but about 30 types put you at risk for cancer.
HPV NYC Treatment
Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI). The virus infects the
skin and mucous membranes. There are more than 40 HPV types that can infect the genital areas of men and women, including
the skin of the penis, vulva (area outside the vagina), and anus, and the linings of the vagina, cervix, and rectum. You cannot
see HPV. Most people who become infected with HPV do not even know they have it.
Most people with HPV do not develop symptoms or health problems. But sometimes, certain types of HPV can cause genital
warts in men and women. Other HPV types can cause cervical cancer and other less common cancers, such as cancers of the vulva,
vagina, anus, and penis. The types of HPV that can cause genital warts are not the same as the types that can cause cancer.
HPV types are often referred to as “low-risk” (wart-causing) or “high-risk” (cancer-causing),
based on whether they put a person at risk for cancer. In 90% of cases, the body’s immune system clears the HPV infection
naturally within two years. This is true of both high-risk and low-risk types.
Genital warts usually
appear as small bumps or groups of bumps, usually in the genital area. They can be raised or flat, single or multiple, small
or large, and sometimes cauliflower shaped. They can appear on the vulva, in or around the vagina or anus, on the cervix,
and on the penis, scrotum, groin, or thigh. Warts may appear within weeks or months after sexual contact with an infected
person. Or, they may not appear at all. If left untreated, genital warts may go away, remain unchanged, or increase in size
or number. They will not turn into cancer.
Cervical cancer does not have symptoms until it is
quite advanced. For this reason, it is important for women to get screened regularly for cervical cancer.
Other less common HPV-related cancers, such as cancers of the vulva, vagina, anus and penis, also may not have signs
or symptoms until they are advanced.
Genital HPV is passed
on through genital contact, most often during vaginal and anal sex. A person can have HPV even if years have passed since
he or she had sex. Most infected persons do not realize they are infected or that they are passing the virus to a sex partner.
Very rarely, a pregnant woman with genital HPV can pass HPV to her baby during vaginal delivery. In these cases,
the child may develop warts in the throat or voice box – a condition called recurrent respiratory papillomatosis (RRP).
HPV can cause normal cells on infected skin or mucous membranes to turn abnormal.
Most of the time, you cannot see or feel these cell changes. In most cases, the body fights off HPV naturally and the infected
cells then go back to normal.
infection. Approximately 20 million Americans are currently infected with HPV, and another 6.2 million people become newly
infected each year. At least 50% of sexually active men and women acquire genital HPV infection at some point in their lives.
Genital warts. About 1% of sexually active adults in the U.S. have genital warts at any one time.
Cervical cancer. The American Cancer Society estimates that in 2008, 11,070 women will be diagnosed with cervical
cancer in the U.S.
Other HPV-related cancers are much less common than cervical cancer.
The American Cancer Society estimates that in 2008, there will be:
- 3,460 women diagnosed
with vulvar cancer;
- 2,210 women diagnosed with vaginal and other female genital cancers;
- 1,250 men diagnosed with penile and other male genital cancers; and
- 3,050 women and
2,020 men diagnosed with anal cancer.
Certain populations may be at higher risk for HPV-related
cancers, such as gay and bisexual men, and individuals with weak immune systems (including those who have HIV/AIDS).
RRP is very rare. It is estimated that less than 2,000 children get RRP every year.
A vaccine can now protect females from the four types of HPV that cause most
cervical cancers and genital warts. The vaccine is recommended for 11 and 12 year-old girls. It is also recommended for girls
and women age 13 through 26 who have not yet been vaccinated or completed the vaccine series.
who choose to be sexually active, condoms may lower the risk of HPV, if used all the time and the right way. Condoms may also
lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that
are not covered by a condom—so condoms may not fullyprotect against HPV. So the only sure way to
prevent HPV is to avoid all sexual activity.
Individuals can also lower their chances of getting
HPV by being in a mutually faithful relationship with someone who has had no or few sex partners. However, even people with
only one lifetime sex partner can get HPV, if their partner was infected with HPV. For those who are not in long-term mutually
monogamous relationships, limiting the number of sex partners and choosing a partner less likely to be infected may lower
the risk of HPV. Partners less likely to be infected include those who have had no or few prior sex partners. But it may not
be possible to determine if a partner who has been sexually active in the past is currently infected.
There are important steps girls and women can take to prevent cervical cancer. The HPV vaccine can protect against
most cervical cancers (see above). Cervical cancer can also be prevented with routine cervical cancer screening and follow-up of abnormal results. The Pap test can identify abnormal
or pre-cancerous changes in the cervix so that they can be removed before cancer develops. An HPV DNA test, which can find
high-risk HPV on a woman’s cervix, may also be used with a Pap test in certain cases. The HPV test can help healthcare
professionals decide if more tests or treatment are needed. Even women who got the vaccine when they were younger need regular
cervical cancer screening because the vaccine does not protect against all cervical cancers.
is currently no vaccine licensed to prevent HPV-related diseases in men. Studies are now being done to find out if the vaccine
is also safe in men, and if it can protect them against HPV and related conditions. The FDA will consider licensing the vaccine
for boys and men if there is proof that it is safe and effective for them. There is also no approved screening test to find
early signs of penile or anal cancer. Some experts recommend yearly anal Pap tests for gay and bisexual men and for HIV-positive
persons because anal cancer is more common in these populations. Scientists are still studying how best to screen for penile
and anal cancers in those who may be at highest risk for those diseases.
Generally, cesarean delivery
is not recommended for women with genital warts to prevent RRP in their babies. This is because it is unclear whether cesarean
delivery actually prevents RRP in infants and children.
HPV test on the market is only used as part of cervical cancer screening. There is no general test for men or women to check
one’s overall “HPV status.” HPV usually goes away on its own, without causing health problems. So
an HPV infection that is found today will most likely not be there a year or two from now. For this reason, there is no need
to be tested just to find out if you have HPVnow. However, you should get tested for signs of disease that HPV can
cause, such as cervical cancer.
Genital warts are diagnosed by visual inspection. Some
health care providers may use acetic acid, a vinegar solution, to help identify flat warts. But this is not a sensitive test
so it may wrongly identify normal skin as a wart.
Cervical cell changes (early signs
of cervical cancer) can be identified by routine Pap tests. The HPV test can identify high-risk HPV types on a woman’s
cervix, which can cause cervical cell changes and cancer.
- As noted above, there is currently
no approved test to find HPV or related cancers in men. But HPV is very common and HPV-related
cancers are very rare in men.
There is no treatment
for the virus itself, but a healthy immune system can usually fight off HPV naturally. There are different treatments
for the diseases that HPV can cause:
Visible genital warts can be removed and performed by a health
Cervical cancer is most treatable when it is diagnosed and treated early. There
are new forms of surgery, radiation therapy, and chemotherapy available for patients . But women who get routine Pap testing
and follow up as needed can identify problems before cancer develops. Prevention is always better than
Our goal at NYC Dermatology is to be the Tiffanys of Skin
Care. I personally see every new patient who visits our office. I am not just
a physician, I am a Board Certified Dermatologist. My goal is, quite simply, to provide the type of dermatologic care which I would seek for my own family.
This is a very important point, since physicans often use the phrase "Doctor's Doctor" to refer to those individuals who typically are selected by
physicians themselves for personal care. I am confident that my practice fully meets that definition. This is the type
of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be
treated: with courtesy, dignity and respect. I carefully listen to their skin-care concerns and offer a variety of options
including a treatment plan that I believe will give them the best results and the best dermatologist. We also support our
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NYC Dermatology is a full service cosmetic dermatology practice under the direction of Dr. Rothfeld. We offer the latest, most innovative
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Our mission is to provide high
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informed decisions about their skin care.
Dr. Gary Rothfeld is a board-certified dermatologist and dermatologic
surgeon who specializes in aesthetic procedures. Dr. Rothfeld cares for all types of skin conditions with a special emphasis
in the areas of cosmetic dermatology and laser surgery. Dr. Rothfeld was raised in New York , and as a young man was
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Every patient is a unique palette of conditions, goals and temperament that
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Dr. Rothfeld strives to listen and understand the patient's specific goals and concerns,
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Trained in Dermatology, NYC Dermatology by Board Certified Dermatologist NY Dermatology Dr. Gary Rothfeld possesses the special knowledge, skills and professional capability that distinguishes him as an outstanding Dermatologist in NYC , Manhattan , New York at NYC Dermatology by Board Certified Dermatologist. Top New York City Dermatologist, Dr. Rothfeld in Manhattan treats
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under the medical supervision of Dr. Gary Rothfeld, a Board Certified Dermatologist.
To enhance every aspect of your
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Dermatology by Board Certified Dermatologist Dr. Gary Rothfeld is a board certified NYC Dermatologist
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A board certified dermatologist in NYC specializing
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Our goal at the manhattan office of Board Certified Derrmatologist , Dr.
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office consultation and examination you will be provided with a detailed plan of the treatments that will benefit you
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office in NYC
Sun Protection Ultraviolet radiation is the major cause of skin cancer, including melanoma. It is important
for everyone to be aware of its damaging effects and take measures to avoid overexposure.
Although many people enjoy
the appearance of tanned skin and think it looks "healthy," tanned skin is damaged skin. The ultraviolet radiation
in sunlight penetrates the deepest layers of the skin where it harms the cells. The body responds by making more pigment (melanin)
to try to protect itself, but the damage has already happened and may be permanent. The more exposure you have to the sun,
the more likely you are to develop skin problems later in life.
The damaging part of sunlight
is called ultraviolet radiation, or UV rays. It is categorized into three types:
- UVC rays
(wavelengths = 200 nm to 290 nm) are the shortest and most powerful of the UV rays. UVC is
the most likely to cause cancer if it reaches skin. Fortunately, most of it is absorbed by the ozone layer in our atmosphere.
However, there is concern that a thinning of the ozone layer may be causing more UVC to reach the earth's surface.
rays (wavelengths = 290 nm to 320 nm) are less damaging than UVC, but more of it penetrates to the earth's surface.
It is the most common cause of sunburn and skin cancer. UVB is particularly strong at the equator, at high elevations, and
during the summer.
- UVA rays (wavelengths = 320 nm to 400 nm)
are the least powerful of the UV rays, but they are present all year and can penetrate
windows and clouds.
The first and more effective way to avoid sun damage is
to stay out of tthe sun as much as possible.
If you cannot avoid being exposed to sunlight,
there are five basic defenses that you should keep in mind when you go outdoors:
peak hours of sunlight
Avoid Peak Hours of Sunlight (UV Index)
In general, UV rays are the greatest between 10 a.m. and 4 p.m.
It is best to avoid the outdoors during these hours without protection, particularly during summer, in tropical regions, or
at altitude. During this time, you should pay close attention to the appropriate use of sunscreen, clothing, sunglasses, and
You can obtain an accurate measure of the amount of UV rays in your area by looking
up the Ultraviolet (UV) Index. The UV Index is like a weather forecast. It provides a
report on the amount of damaging UV rays that are expected to affect a region on a particular day. The UV Index changes day
to day according to time of year, cloud cover, atmospheric ozone, and other factors.
The following table is a breakdown
of the UV Index. A high UV Index number means that you are at greater risk of being exposed to ultraviolet radiation. You
should take special care to avoid outdoor exposure to sunlight when the UV Index is moderate or greater.
- 0 to 2
- 3 to 4 = Low
- 5 to 6 = Moderate
- 7 to 9 = High
or more = Very high
The UV Index can be found on our Website or in local
papers, usually in the weather section.
There are several factors to consider when selecting the right
sunscreen. (See the Sunscreens handout for more information.)
actor (SPF) - Sunscreens are rated by the amount of protection they provide from UVB, measured as the "sun
protection factor" or SPF. Sunscreens with higher SPF provide greater protection from the sun. It is best to use sunscreens
that offer a minimum SPF of 15.
Broad-spectrum sunscreens - It is best to use a sunscreen that can
protect you from both UVA and UVB rays. These are called "broad-spectrum" sunscreens.
Most of the original sunscreens blocked only UVB, but increased awareness of the damage caused by UVA has lead to the
development of ingredients that protect against UVA too. Broad-spectrum sunscreens combine ingredients to provide a product
with greater protection.
Common sunscreen ingredients that provide protection
from UVB rays:
- PABA (para-aminobenzoic
- Padimate O and Padimate A (Octyl Dimethyl PABA)
sunscreen ingredients that provide protection from UVA rays:
- Avobenzone (Parsol 1789)
(oxybenzone, dioxybenzone, sulisobenzone)
Sunblocks - "Physical"
sunscreen ingredients lie on top of the skin and work by reflecting or scattering UV radiation. They are particularly useful
for people who are sensitive to the ingredients found in other sunscreens. Sunblocks often contain one or more of these ingredients:
- Titanium dioxide
- Iron oxide
Although past formulations
were unsightly (often leaving a white film on the skin), newer "microfine" formulations are invisible after being
applied. Microfine titanium dioxide is effective at protecting from both UVA and UVB rays.
- Sunscreens are classified as "water-resistant" if they maintain their protection after two 20-minute
immersions in water. They are classified as "waterproof" if they maintain their protection after four 20-minute
immersions. You should seek a water-resistant or waterproof sunscreen if you will be participating in water sports, such as
swimming or water skiing, or will be actively sweating.
However, independent testing has shown many products do not
perform well in the real world. So it remains a good idea to apply sunscreen every time you leave the water, or frequently
if you are actively sweating.
Using a Sunscreen
Sunscreen should be applied
evenly and liberally on all sun-exposed skin within 30 minutes before going outside to give sunscreen time to take effect.
(Sunblocks are effective immediately after being applied.) Sunscreens should be reapplied every two hours or following swimming
or sweating. Apply sunscreen generously and reapply frequently at least every two hours.
The chemicals may lose
effectiveness over time, so it is important to throw away sunscreen that is past its expiration date
or is over two years old.
No sunscreen is 100% effective; take additional measures to avoid the
damaging effects of the sun's rays.
Clothing can provide excellent
protection from the sun. However, not all clothing is protective. A thin, wet, white t-shirt will provide almost no protection
from UV rays. When selecting clothes for sun protection, consider the following:
- Cover your head, shoulders, arms,
legs, and feet.
- Use a hat that is broad-brimmed (brim should be at least four
- Wear fabrics that are thicker or with a tight weave; these allow less
sunlight to penetrate the skin.
- Wear darker-colored clothes that absorb more UV rays.
- Wear clothing
made from nylon or Dacron because it is more protective than cotton.
- Avoid remaining
in wet clothes because wet fabric may allow more UV rays to penetrate the skin.
clothing with chemical absorbers to increase their protectiveness.
- Some clothing
comes with a UPF rating that stands for "Ultraviolet Protection Factor." This measures the ability of the fabric
to block UV radiation from penetrating to the skin. A fabric with a UPF 15 allows only 1/15th (6.66%) of the UV radiation
to penetrate your skin as compared to uncovered skin.
Garments fall into 3 categories:
protection: UPF = 15 to 24
- Very good protection: UPF = 25 to 39
protection: UPF = 40 to 50+
Choose clothing with a UPF rating of at least 15. Keep in mind that the UPF of a
garment will decrease over time as the fabric wears.
Overexposure to sunlight can cause cataracts
and macular degeneration, a major cause of blindness. Sunglasses can provide protection. However, not all sunglasses are of
value. A darker lens itself does not guarantee protection. Look at the label to ensure that the glasses provide UV protection.
Sunglasses should be large enough to shield your eyes from many angles. Look for sunglasses that are described as blocking
99% or 100% of UVA and UVB. The glasses may also be described as providing UV absorption up to 400 nm.
possible, remain in the shade when outdoors. Keep in mind that shade does not provide full protection from the sun because
UV rays can bounce off reflective surfaces, such as sand, snow, water, concrete, or even porch decks. In addition, some fabrics
used as shade devices, such as parasols or umbrellas, may not provide sufficient protection. If you seek shade under a cloth,
look for a fabric that is thick, tightly woven, and dark-colored.
Clear window glass provides protection from UVC and
UVB, but not UVA rays. If you are frequently exposed to sunlight while driving, the plastic interleaf of your windshield (which
prevents it from shattering) can help block the light, but side windows have no such protection. Non-drivers can make use
of additional window shade devices. Drivers in some states may be able to use darkly-tinted glass in the side windows, but
this is illegal in some states.
- Avoid the sun when its
UV rays are strongest, between 10 a.m. and 4 p.m.
- Use a broad-spectrum sunscreen with SPF 15 or greater.
Apply it 30 minutes prior to being exposed to the sun and reapply every two hours. Consider using a water-resistant sunscreen
if you will be active (sweating) or in the water.
- Use a sunblock on your lips.
- Wear a broad-brimmed hat
- Wear sunglasses.
- Wear tightly woven, dark clothing to
cover your arms, legs, and feet.
- Stay in the shade when possible.
reflective surfaces, such as water or snow.
- Avoid sunbathing.
be fooled by cloudy days since damaging rays can penetrate clouds.
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NYC Dermatology - Manhattan Dermatology - Skin Institute of
New York - Skin Cancer Doctor- NYC Cosmetic Dermatology- Cosmetic Dermatological Surgery - New York City -
Board Certified Dermatologist
Dr. Gary Rothfeld
- Board Certified Dermatologist - New York, NY
30 E. 60th St. Ste. 805
Manhattan, New York 10022