Overview
Definition
Genital warts are a very common sexually transmitted infection, and appear as skin growths in the groin, genital, or anal areas. They can be different sizes and shapes. Some look like flat white patches, and others are bumpy, like tiny bunches of cauliflower. Sometimes you can't see the warts at all.
Symptoms
Most people infected with the virus that causes genital warts don't have symptoms. But if they do, the symptoms may be so mild that they may not know they are infected and may transmit the virus to a partner. The symptoms that may occur with genital warts include pain, itching, and bleeding.
If you have symptoms, they will probably occur 2 to 3 months after infection. But symptoms can appear anywhere from 3 weeks to many years after infection. Visible genital warts appear only during active infection. However, you can spread the virus even if you do not have any symptoms of infection or any visible warts.
In women, genital warts may appear on the vulva, vagina, cervix or anus and occasionally in the rectum or urethra. Women are often not aware of warts inside the vagina or on the cervix until a health professional finds them. The presence of genital warts does not increase the risk of cancer of the cervix.
In men, genital warts may appear on the outside of the penis, scrotum, anus and occasionally in the urethra or rectum. Men are often unaware that they have genital warts until the warts are identified by a health professional.
Causes
Genital warts are caused by the human papillomavirus, or HPV. There are many different types of HPV. Certain types of the virus cause genital warts and other types cause abnormal cervical cell changes and cervical cancer in women.
Genital warts are spread by skin-to-skin contact. The virus can be spread to or from the genitals, anus, mouth, or throat during sexual activities. However, warts in the mouth or throat are extremely rare. After the infection occurs, it may spread to other areas of the genitals or to the anal area.
You are more likely to get genital warts if you:
- Do not use condoms every time you have sex or genital contact.
- Have more than one sex partner or have a high-risk partner(s) who has had multiple sex partners or HPV-infected sex partners.
- Start sexual activity before age 18.
- Have an impaired immune system that makes it hard for your body to fight infection.
Complications
In women:
- Two common HPV types produce visible warts. Other HPV types do not produce visible genital warts; these types (which may be found with a Pap test) are associated with pre-cancerous cervical cell changes and cervical cancer.
- A pregnant woman infected with HPV may have more complicated warts than a woman who is not pregnant because the warts may increase in size, bleed, or become infected with bacteria. Warts may be passed onto the newborn, but this is extremely rare.
In men:
- Because HPV does cause cell changes, research is being done to determine whether HPV increases the risk of penile cancer.
- Among men who receive anal sex, HPV infection of the anal canal is associated with an increased risk of anal cancer; this risk may be especially high in men who are also HIV positive.
Tests and Diagnosis
A health professional can usually diagnose genital warts using your medical history and a physical examination. He or she may ask you questions about your symptoms and your risk factors. If your health professional finds abnormal tissue but cannot make a definite diagnosis, he or she may take a sample of tissue from the wart for laboratory testing.
In women:
Your health professional will give you a gynecological examination, which usually includes a Pap test. A Pap test screens for abnormal cells on the cervix. If areas of abnormal tissue on the cervix are found (which may be related to HPV infection), your health professional may recommend treatment.
In men:
While there is no screening test for HPV in men, some experts believe that men who receive anal sex should have a routine anal Pap test, especially if they are also HIV positive. Ask your health professional whether and how often you should be tested.
Treatment and Drugs
External HPV or genital warts can be treated. HPV infections are often acquired early (15 - 19 years of age) and the majority (> 80%) of these infections clear spontaneously within 18 months. Many people decide to treat them because of the symptoms or how the warts look. Warts may return after treatment in approximately 30% of people. They may require a number of repeat treatments. If you are diagnosed with genital warts and do not have symptoms or cosmetic concerns, you and your health professional may decide not to treat.
Talk to your health professional about whether or not you should treat genital warts, and which would be the best treatment for you. Treatments for genital warts include topical prescription medicines (applied directly to warts), freezing, laser or surgery. If warts return after treatment you may consider choosing a different form of treatment or not treating again.
Caution: Do not use non-prescription wart removal products to treat genital warts. These products are not intended to be used in the genital area and may cause serious burning.
Coping and Support
Finding out that you have genital warts may make you feel bad about yourself or about sex. Counseling or a support group may help you feel better.
Prevention
You can reduce your risk of spreading or becoming infected with the human papillomavirus (HPV) - or another sexually transmitted infection (STI) - by practicing safe sex.
- Use condoms.
- Avoid sexual contact if you have symptoms of an STI or are being treated for an STI.
- Avoid sexual contact with anyone who has symptoms of an STI or who may have been exposed to an STI.
- Vaccination - there is now a vaccine which prevents 70% of genital cancers and 90% of genital warts. This vaccine is available for men and women. It does not, however, affect the course of warts that you already have.
Your risk for an STI increases if you have several sex partners.
Last Updated: July 12, 2010
