What Are Genital Warts?
Warts are caused by viruses and can appear anywhere on the body. Those that show up in the genital area are caused by the human papillomavirus, commonly called HPV, and are easily transmitted by sexual contact.
HPV infection is the most common sexually transmitted disease (STD) in North America. Certain forms of the virus can cause cervical, rectal, vulvar, vaginal, and penile cancer.
After a person has been infected by HPV, it may take 1 to 3 months (or longer in some cases) for warts to appear. Some people who have been infected never get warts.
What Causes Genital Warts?
Genital warts are caused by certain strains of HPV. Warts found on other parts of your body are caused by a different virus. You can't get genital warts from touching your own body or someone else with a wart on the hand or foot.
The ways that genital warts spread include:
- Intercourse, including anal, vaginal-vaginal, and penile-vaginal
- Skin-to-skin contact between genital areas
- Oral sex
Genital Warts and HPV Symptoms
Like many STDs, the human papillomavirus does not always have visible symptoms. But when symptoms do occur, warts may be seen around the genital area. In women, warts can develop on the outside and inside of the vagina, on the cervix (the opening to the uterus), or around the anus. In men, they may be seen on the tip of the penis, the shaft of the penis, on the scrotum, or around the anus. Genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.
Because there is no way to predict whether the warts will grow or disappear, people who have been infected should be examined and treated, if necessary.
What do genital warts look like?
Genital warts look like small flesh-colored, pink, or red growths in or around the sex organs. The warts may look similar to the small parts of a cauliflower, or they may be very tiny and hard to see. They often appear in clusters of three or four, and may grow and spread rapidly. They usually are not painful, although they may cause mild pain, bleeding, and itching.
Although rare, other symptoms can include:
- Dampness near genital warts
- Vaginal discharge
- Bleeding during sex, or afterward
- Tenderness around your genital area
Genital Warts and HPV Diagnosis
The ways your doctor will check for genital warts, related STDs, or both include:
Visual exam. An examination of visible growths to see if they look like genital warts
Vinegar solution. Application of a mild acetic acid (vinegar) solution to highlight less visible growths
Pelvic exam. A complete pelvic exam and Pap smear
HPV test. A specialized test for high-risk HPV (low-risk should not be screened for), collected in a way similar to a Pap smear. This is one way that HPV is diagnosed.
Biopsy. The doctor might take a sample of cervical tissue (if you have an abnormal Pap smear or visible abnormality) to make sure there are no abnormal cells that could develop into HPV-related cervical cancer. The tissue is examined under a microscope.
Rectal exam. Examination of the rectum to check for warts
You might be referred to a gynecologist (a doctor who specializes in female reproductive health) for further testing and biopsy.
Genital warts vs. herpes
Both are caused by viruses that are spread through sexual contact. Genital herpes, also known as herpes simplex type 2, causes sores and blisters that are filled with fluid. Genital warts generally don't lead to sores.
Genital Wart Treatment
Genital warts can be treated, although the virus that causes them can't be killed. With the right treatment, genital warts can disappear.
Do genital warts go away?
Your immune system might fight the infection, causing genital warts to go away on their own.
How long do genital warts last?
HPV is a lifelong infection. Your genital warts may go away with treatment, but they could always come back.
Medications
Don't try to treat genital warts with over-the-counter wart removers. They're not meant to be applied to your genitals. Topical medicines for genital warts include:
Imiquimod (Zyclara). This drug boosts your immune system's response to the infection. Avoid sexual contact while the cream is on your skin, because it can make condoms less effective or damage your partner's skin. Your skin might change color in the area where you use the cream. You also might have blisters, pain, coughing, rashes, and fatigue.
Podophyllin (Podocon-25) and podofilox (Condylox). These medicines destroy genital wart tissue. A health care professional can apply it in the office, or you might be given a version to use at home. Podofilox shouldn't go inside your body. It's also not recommended if you're pregnant. Side effects include sores, irritated skin, and pain.
Trichloroacetic acid. This chemical burns away genital warts, and it can be used inside your body. You might have sores, irritated skin, or pain when you use it.
Sinecatechins (Veregen). This topical medicine can treat genital warts in and around your anus, as well as other parts of the body. It may change your skin color where it's applied. It also can cause, burning, itching, and pain.
Procedures
If your genital warts don't improve with medicine, you may need a procedure to remove them. Larger genital warts also might have to removed. Procedures to do that include:
Cryotherapy. This involves using liquid nitrogen to freeze the wart. A blister will form, prompting your body to slough off the wart and dead skin as new skin is formed. You might need more than one session. You might have pain and swelling afterward.
Electrocautery. An electrical current burns away the wart. Side effects include pain and swelling.
Surgical excision. The wart is cut away. You'll need anesthesia to keep you from feeling pain during the procedure. You might have pain afterward.
Laser treatment. A beam of light is directed at the wart to remove it. This treatment is more expensive than others, and it's used on cases that are especially difficult. You might have pain afterward, and the area may form a scar.
Loop electrosurgical excision procedure. This is also called LEEP, and it uses an electrically charged wire loop to remove warts. It's sometimes used to remove warts on your cervix.
What happens if I don't get treated?
Having high-risk HPV can increase your risk of cervical, rectal, and penile cancer. But not all forms of the virus are linked to these cancers. If you have genital warts, it is important to get annual checkups to screen for cancer.
Managing Genital Warts and HPV
If you have genital warts:
- Keep the area as dry as possible.
- Wear all-cotton underwear. Man-made fabrics can irritate the area and trap moisture.
Experts recommend that you abstain from sex while you're having treatment for genital warts. Condoms don't provide complete protection against HPV and genital warts. Talk to your doctor about your concerns, and then have an honest discussion with your partner.
If my partner has genital warts, will I get them?
HPV and genital warts are contagious. If your partner is infected with HPV, there's always the risk it will spread through sexual contact to you. HPV can't be cured. Even without visible warts, the virus can spread.
Genital Wart and HPV Complications
An HPV infection can increase your risk of cervical cancer. Infections also have been linked to cancers of the throat, mouth, anus, penis, and vulva. Not all HPV infections cause cancer. But it's important to have a Pap smear regularly to check for signs of cervical cancer. This is especially key if your HPV infection is one of the higher-risk strains.
HPV also can cause pregnancy complications. Sometimes the warts become larger during pregnancy, which can make it hard to urinate. If your vaginal wall has warts, it might be hard for it to stretch the way it needs to during childbirth. Warts in your vagina or on your vulva can stretch during delivery, causing bleeding.
Your doctor might recommend you have warts removed so that your baby doesn't come in contact with them during delivery. Although it's rare, babies exposed to genital warts and HPV are sometimes born with genital warts in their throats. They might need surgery to clear their airways.
Genital warts recurrence
An HPV infection never goes away. You can get genital warts again, even after treatment.
HPV and Genital Wart Prevention
Anyone who's sexually active can get or spread HPV. Things that can make you more likely to get genital warts include:
- Having more than one sex partner (or a partner who does)
- Being pregnant
- Having a weakened or damaged immune system
- Smoking
Condoms aren't 100% effective, because they do not cover the entire penis or surrounding areas. Abstaining from sex is the only 100% effective way to avoid HPV infection. If you have sex, limiting your number of partners can decrease your risk.
Vaccination
HPV vaccines – given as a series of shots – can protect you from some types of HPV, which has multiple strains. If you've already been exposed, though, the vaccine doesn't make the virus go away. There are three types of HPV vaccines, but two of them are no longer used in the U.S.
Gardasil 9. This is the only vaccine you can get in the U.S. since 2017. It protects against the HPV-16 and HPV-18 strains, which are the most high-risk. It also protects against the strains 31, 33, 45, 52, and 58, which are linked to cervical cancer. And it protects against strains 6 and 11, which cause genital warts.
Gardasil. This was the first HPV vaccine that the FDA approved. It became available in 2006. It protects against strains 16, 18, 6, and 11. It doesn't provide as much protection against cervical cancer as Gardasil 9.
Cervarix. This vaccine became available in 2009. It protects against the strains 16 and 18, which cause most cervical cancers. But it doesn't protect against the strains that cause genital warts, and it offers less protection against cervical cancer than Gardasil 9.
It's recommended that everyone get the vaccination before they can be exposed to HPV through sexual contact. The vaccine only protects you against strains of HPV that you don't have already. The CDC offers these guidelines, based on age:
- Children ages 11-12 should receive the vaccine as part of their regularly scheduled vaccinations. It's safe in children as young as 9.
- Adults ages 26 and younger should receive the vaccine. That recommendation applies whether you've never received a vaccine or started the series earlier and never finished it.
- Adults up to age 45 should receive the vaccine in certain circumstances. Research shows it can prevent HPV infections in this age group, too.
If you're older, you still might benefit from the vaccine if you haven't been exposed to certain strains of HPV already. But insurance coverage can be limited by age. Talk with your doctor about your sexual history and whether the vaccine might help you.
Other prevention methods
If you're sexually active, these steps can provide some protection against HPV:
- Use condoms or dental dams during sex.
- Get routine tests for sexually transmitted infections and follow up with recommended treatment.
- Let your partners know if you have an HPV infection so they can be tested and treated, if needed.
- Don't douche.
Takeaways
The human papillomavirus, or HPV, is one of the most common sexually transmitted infections. Certain strains of HPV are linked to cancers of the cervix, vulva, vagina, penis, and rectum. Other strains cause genital warts. Genital warts are usually not a major health risk, and there are several ways to treat them. Your doctor may suggest a topical medication or a procedure to remove genital warts. Getting treatment right away can reduce the symptoms of genital warts, which can include itching and discomfort. Once you have HPV, the infection itself can't be treated. But a vaccine can prevent HPV in those who haven't been infected yet. The CDC recommends vaccination for people through age 26. Children's vaccines are generally scheduled at age 11 or 12, but the vaccine is safe for those as young as 9.
Genital Warts and HPV FAQs
What is mistaken for genital warts?
If you have a condition called vestibular papillomatosis, (VP) you might be worried that you have genital warts. A doctor can tell if you have VP rather than genital warts. You also can get skin tags (acrochordons) in your genital area. These harmless growths are often attached to your skin by a fleshy stalk. They don't hurt, but they can cause irritation if your clothes rub against them.
How do I know if my warts are HPV?
Genital warts and warts on other parts of your body – such as your hands or feet – are caused by different viruses. Your doctor can perform tests to determine whether you have genital warts.
Is HPV an STD?
Yes, HPV is a sexually transmitted disease or infection. There are many strains of HPV. It's so common that 80% of people who are sexually active will have an HPV infection at some point. Vaccination can protect you against some HPV strains.
Do HPV warts turn into cancer?
The strains of HPV that cause genital warts are not the same strains linked to cancer. Genital warts are not cancer.
