Genital warts are contagious, fleshy growths in the genital or anal area. They are one of the most common types of sexually transmitted infection.

They are also known as venereal warts or condylomata acuminata. They are caused by the human papillomavirus (HPV), and they are a symptom of HPV.

Genital warts consist of fibrous overgrowths covered by a thickened, outer layer. They can appear around a man's scrotum, anus, and penis, or a woman's vulva, cervix, vagina, or anus.

They are usually benign, or non-cancerous, but some types can become cancerous in time.

In appearance, genital warts are often flesh-colored or gray swellings. If several cluster together, they may resemble a cauliflower. Some may be too small to be seen by the naked eye.

About 1 in 100 sexually active people in the United States have genital warts. Between 2011 and 2014, the prevalence of HPV was 7.3 percent amongst adults aged 18 to 69 years.

It is possible to have HPV without showing symptoms. Genital warts often appear about 3 months after infection. However, in some cases, there may be no symptoms for many years.

Fast facts on genital warts

  • Genital warts are contagious.
  • They are caused by human papillomavirus (HPV) infecting the skin.
  • The biggest risk factor for genital warts is unprotected sex.
  • Some genital warts respond well to topical medication.
  • 1 in 100 sexually active people in the United States have genital warts.

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Genital warts are highly contagious.
Image credit:
Author George Chernilevsky, own work

A topical cream can remove most genital warts. Topical means that medicine is applied directly to the skin.

Doctors will only treat patients who have visible warts. The type of treatment depends on:

  • the location of the warts
  • the number of warts
  • the appearance of the warts

The following treatments are effective for removing genital warts:

  • Topical medication: A cream or liquid is applied directly onto the warts for several days each week. This may be administered at home or in a clinic. Treatment may continue for several weeks.
  • Cryotherapy: The warts are frozen, often with liquid nitrogen. The freezing process causes a blister to form around the wart. As the skin heals, the lesion slides off, allowing new skin to appear. Sometimes, repeated treatments are needed.
  • Electrocautery: An electric current is used to destroy the wart, generally under local anesthetic.
  • Surgery: The wart is excised, or cut out. A local anesthetic will be used.
  • Laser treatment: An intensive beam of light destroys the wart.

It is common for doctors to use more than one treatment at the same time.

Treatments are not painful but may sometimes cause soreness and irritation for up to 2 days. People who experience discomfort after treatment can take over-the-counter (OTC) painkillers for relief.

People who experience soreness may find that a warm bath helps to relieve discomfort. After a bath, the affected area must be dried completely. Patients should not use bath oils, soap, or creams until after the treatment is completed.

OTC treatments specified for non-genital warts are not suitable for the treatment of genital warts.

Genital warts will generally resolve without treatment. However, some presentations of genital warts grow and multiply if left alone.

Treating genital warts greatly reduces the risk of transmission.

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Being prepared with sexual protection can keep genital warts at bay.

To avoid catching or spreading genital warts, it is important for sexually active people to take preventive steps.

These can include:

  • abstinence from sexual contact
  • using protection, such as a condom or dental dam
  • women receiving the HPV vaccine
  • openly informing partners about genital warts
  • quitting smoking

It is crucial for sexually active people to practice safe sex.The genitals of either partner can seem to be HPV-free as no warts are present. However, the virus can still spread without visible symptoms.

Pap tests and genital warts

A Pap test, also known as a Pap smear, is a procedure to test for cervical cancer in women. The test involves collecting cells from the woman's cervix. Cervical cancer is a possible complication of HPV infection.

Women should have HPV vaccinations and regular pelvic exams and Pap tests. These can also detect cervical and vaginal changes that may be triggered by the onset of genital warts.

HPV vaccinations do not protect against all types of HPV. Women are advised to continue attending screenings after vaccination.

Genital warts, like other warts, are caused by over 100 types of HPV that infect the top layers of the skin. Only a small number of strains can cause genital warts.

Those that do cause genital warts are highly contagious and passed on through sexual contact with a person who has HPV. Other types of HPV do not carry this trait.

It is estimated that up to 65 percent of people who have sexual relations with a person who has genital warts will become infected.

Complications

HPV can change the structure of infected cells and can lead to further complications.

Cancer: HPV infection is associated with cervical cancer, as well as cancer of the vulva, anus, penis, mouth, and throat. Not all HPV infections lead to cervical cancer, but it is crucial for a woman's long-term health that she attends regular Pap screenings.

Pregnancy problems: There is a small risk that a mother may pass on genital warts during childbirth. Laryngeal papillomatosis can occur.

A newborn with laryngeal papillomatosis may have genital warts in the mouth. Hormonal changes during pregnancy may also cause genital warts to grow, bleed, or multiply.

The following will increase the risk of contracting genital warts:

  • having unprotected sex
  • having unprotected sex with many different people
  • having sex with a person whose sexual history is unknown
  • oral sex
  • starting sexual relations at a young age
  • having stress and other viral infections at the same time, such as HIV or herpes

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A Pap smear is a clear method of diagnosing HPV.

A doctor can usually diagnose genital warts by looking at them.

The examination may involve looking inside the vagina or anus. On rare occasions, the doctor may take a biopsy of the wart.

People should go for a checkup if:

  • they have genital warts
  • the person with symptoms recently had unprotected sex with a new partner
  • the person with symptoms or their partner have had unprotected sex with an individual outside of the relationship
  • the partner of the person with symptoms advises that they have an STI
  • there are symptoms of a sexually transmitted infection (STI)
  • the patient is pregnant or trying to conceive

The doctor or nurse may ask the patient to come back at a later date, even if no warts are detected. Visible warts may not appear immediately after infection.

Some genital warts are so small that they can only be detected with a colposcopic exam of the cervix and vagina or a Pap smear. A colposcope is a visual device used to examine the cervix in detail.

Genital warts are not dangerous, but they can indicate the present of HPV. Some types of HPV can lead to cancer. Removing the warts can help prevent transmission, but even if any visible warts go away with treatment, the virus may remain.