Genital warts are small bumps or unusual growths that appear on and around the genitals. Close genital contact during sexual activity can spread human papillomavirus (HPV), which causes genital warts.
Genital warts are the result of HPV, which is a sexually transmitted infection (STI). According to the Centers for Disease Control and Prevention (CDC), HPV is the most common STI in the United States.
Once a person has acquired the infection, they may transmit it to others through sexual contact. However, not everyone with HPV will have genital warts and they may not experience symptoms.
While there is currently no cure, there are various ways of removing genital warts. Most methods will usually require a person to see a healthcare provider.
In this article, we look at symptoms, prevalence, treatment options, and prevention of genital warts in males with black skin.
Genital warts are small growths, or bumps, on the genitals. They can appear as a singular wart or a cluster of warts. In males, they can appear on the penis, scrotum, groin, and thigh. After oral or anal sex, they can also appear on the throat or anus.
There are many types of HPV, but only a few can cause genital warts. Genital warts are usually painless, and they do not cause any long-term health issues.
HPV is a common virus that can pass from one person to another through unprotected anal, vaginal, and oral sex.
The virus can also spread to another person through sexual activity with close skin-to-skin contact of the genitals or through sharing sex toys.
HPV can pass from a person with the virus to a sexual partner, even if they have no visible symptoms.
Evidence suggests that nearly all sexually active people who do not get the HPV vaccine will likely acquire an HPV infection at some point in their life. However, people cannot get genital warts from kissing, sharing cutlery, or swimming pools.
Prior to HPV vaccines, roughly 340,000–360,000 people had genital warts due to HPV every year. Roughly, 1 in 100 sexually active adults in the U.S. has genital warts at any given time.
However, due to the nature of genital warts, it is difficult to measure the prevalence. Most figures only account for the number of people receiving treatment for genital warts, meaning most data may underestimate the actual number.
Many studies instead focus on the number of people with HPV infections that may result in genital warts.
A 2013 study looked at the prevalence of HPV infections in 3,973 males aged 18–70 who were living in the U.S., Brazil, or Mexico. None of the participants had any symptoms of genital warts or STIs.
Participants self-reported their race as either:
- Asian/Pacific Islander
- multiple and mixed race
HPV infection rates across 12 months were highest in Black race participants, compared with other race participants. The rates among Black males were:
- 25.4% cancer-causing HPV type
- 43.2% noncancer-causing HPV type
- 45.7% for any HPV type
Noncancer-causing types of HPV included HPV types 6 and 11, which are the HPV types that cause genital warts.
The study concluded that differences in HPV infection rates between races could be due to the behavioral, social, economic, and geographic factors affecting distribution of HPV strains, and differences in genetics.
This is consistent with a 2018 study, which suggests that the highest prevalence of HPV in the U.S. is among non-Hispanic Black males in their late 20s.
Risk factors for genital HPV infections can include:
- age, with the highest rate of genital HPV infections affecting 20–24-year-olds
- suppressed immune system
- multiple HPV infections
- unprotected sex
- multiple sexual partners
Symptoms can appear long after people encounter the HPV that causes genital warts. People may experience symptoms weeks, months, or even years later.
Symptoms of genital warts in males may include:
- raised, flat, smooth, or rough growths on or around the genitals
- bumps that can appear the same color as surrounding skin, or slightly darker, or gray colored
- scattered or clustered bumps with a cauliflower-like texture
- warts that can appear on the penis, anus, scrotum, groin, or upper thighs
- warts that can appear in the mouth or throat after contracting the virus through oral sex
- warts that can sometimes feel painful, itchy, burning, or may bleed
The HPV type that causes genital warts does not cause cancer or any serious health complications.
However, other types of HPV can cause cancer if left untreated. According to the CDC, there are differences in rates of HPV-related cancers across different races and ethnicities:
- Anal and rectal cancers are higher in Black males compared with white males.
- Throat cancers are lower in Black and Hispanic males than in white and non-Hispanic males.
- Penile cancer is higher in Hispanic males compared with non-Hispanic males.
There is currently no HPV test for males.
For those with an increased risk of anal cancer, such as males who receive anal sex or are living with HIV, a healthcare provider may be able to offer an anal Pap test. If a person has any symptoms or concerns relating to cancer, they should see a doctor.
If people think they have genital warts, they can see their doctor for a diagnosis. A doctor may assess symptoms and examine the warts.
In some cases, a doctor may take a skin sample of the warts for laboratory testing to check they are genital warts rather than any other growth.
Some genital warts may clear without any treatment, but will likely reappear. People should not use over-the-counter wart treatment, as they are likely for other types of warts.
People can see their doctor for genital wart treatment. Treatment can vary depending on the amount and location of warts, and the health of the individual. Treatment may help to ease pain, itching, and irritation. It can also lower the risk of HPV spreading to other people.
A doctor may prescribe topical medication to apply to the warts, which can stop them growing or help the immune system fight the virus.
In other cases, a doctor may remove the warts with any of the following procedures:
- Cryosurgery: This freezes the warts off using liquid nitrogen.
- Excision: To cut out the warts.
- Electrocautery: This method uses an electric current to remove the warts.
- Laser treatment: This method uses an intense laser light to remove the warts.
If other treatments fail, a doctor may consider injecting antiviral medicine into the warts.
People can discuss possible side effects of treatments with their practitioner. For example, cryotherapy may cause an increased risk of hyperpigmentation in black skin.
Treatment can clear genital warts, but the virus may stay in the body. This means that genital warts may return after treatment. In some people, the immune system may get rid of the virus over time.
To help prevent genital warts, people can:
- use condoms and dental dams every time they have anal, vaginal, or oral sex, although the virus can still pass on through skin-to-skin contact
- use a condom to cover any shared sex toys, and wash after using
- limit the amount of sexual partners
- avoid sexual activity when genital warts are present, although the virus can still pass on with no visible symptoms
People can get a vaccine to protect against HPV infections. To be most effective, people will need the vaccine before they become sexually active.
The CDC recommend the vaccine for everyone when they are 11–12 years. People can also have the vaccine from 9 years. If people do not receive the vaccine at this age, they can receive it up until the age of 26 years for men.
If people are older than this, they may still be able to receive a vaccine. People can talk to their healthcare provider about the potential benefits of receiving the HPV vaccine past the age of 26.
Having a new sex partner at any age is a risk factor for getting a new HPV infection. People already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.
Certain types of HPV can cause genital warts. They are usually harmless bumps that appear on or around the genitals. People can see their doctor for treatment of genital warts, which may include topical medication or medical procedures to remove the warts.
Research suggests that genital warts may be more common among young Black adult males. People can reduce their risk of genital warts by using condoms during sexual activity, limiting sexual partners, and getting the HPV vaccine.