Genital Warts: A Complete Guide
From prevention to diagnosis and treatment
- Genital warts are usually caused by low-risk types of HPV and do not mean cancer.
- When a wart appears does not show when you got HPV, and having warts is not, on its own, a sign of infidelity.
Find your starting point:
- If you have noticed a bump you are unsure about, start with diagnosing genital warts.
- If a wart has been confirmed, read about treatment options.
- To lower the chance of passing warts on and to learn about the vaccine, read preventing genital warts.
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Genital warts: what they are, symptoms and how they spread
What are genital warts?
Warts are soft, fleshy bumps that sometimes appear in clusters in the genital or anal area. They are usually linked to low-risk types of HPV, especially HPV 6 and HPV 11.
Who can get genital warts?
Anyone who is sexually active, woman or man, may get genital warts. The main way they spread is direct skin-to-skin contact in the genital area.
What are the symptoms of genital warts?
Warts are often painless, but they sometimes itch.
Warts may appear months or years after the virus enters the body. It is usually not possible to tell when it was passed on or by whom.
Genital warts, HPV and cancer: what is the difference?
HPV is a virus with many different types. Genital warts are usually linked to low-risk types and are not cancer. When some high-risk types stay in the body for a long time, they can raise the chance of certain cancers. Having warts does not mean you have cancer.
How are genital warts spread?
The main way genital warts spread is direct skin-to-skin contact in the genital area, rather than using public places or shared facilities.
Main routes of transmission
- Skin contact during vaginal, anal or oral sex
- Genital skin-to-skin contact, even without penetration
- Sharing sex toys
- Rarely, from mother to baby during childbirth
Unproven routes of transmission
- Swimming pool and hot tub water
- Public toilet seats
- Sharing towels, clothes, cups or dishes
- Shaking hands and hugging
If you notice a new or unexplained bump in the genital area or around the anus, have it examined so it can be diagnosed. If the bump bleeds for no clear reason, becomes an open sore, grows quickly, changes color or shape, or causes lasting pain or burning, do not put off seeing a doctor.
Choosing the best path for your situation
A new bump in the genital area
Not every bump in the genital area is a wart. Some bumps are normal or benign (harmless).
Genital warts are usually diagnosed by examination.
Until you are examined: do not squeeze or pick at the bump, and do not try to drain it.
Which test is right for diagnosing genital warts?
Blood tests, the Pap test (Pap smear; in the UK, a smear test) and the HPV test are not used to diagnose genital warts.
If the bump is still there, a doctor’s examination will show whether it is a wart or something else.
A home vinegar test is not reliable and can damage the skin.
Choosing a treatment for genital warts
Whether a topical medicine, freezing, laser or another method is chosen depends on where the warts are, how many there are and what they are like.
Before a bump is frozen, lasered or removed with heat, the diagnosis should be confirmed by examination or a biopsy.
During pregnancy: imiquimod, podofilox (podophyllotoxin), podophyllin and sinecatechins should not be used in pregnancy. Warts in pregnancy are treated with safe methods such as cryotherapy (freezing).
Can genital warts come back after treatment?
Warts may come back after treatment. This is more common in the first 3 months.
A recurrence does not mean the treatment has failed. Your doctor can decide the next step based on where the warts are, their size and how many there are.
A wart that does not respond to treatment calls for a fresh look at both the diagnosis and the treatment method.
Genital warts and a positive high-risk HPV test
You may have genital warts and a high-risk HPV infection at the same time. Low-risk and high-risk types do not turn into one another. Continue your cervical follow-up plan as your doctor advises.
A positive high-risk HPV test (high-risk HPV was found), including HPV 16 or HPV 18, does not mean cancer. But your cervical follow-up should be based on the HPV type, your Pap test result and your medical history.
Treating the warts does not replace follow-up of your high-risk HPV test result.
Lowering the risk for your partner, and deciding about the vaccine
Condoms lower the chance of passing warts on, but they do not cover all the skin in the genital area.
Avoid sex while you or your partner have active warts.
The vaccine: it does not treat an infection or warts you already have, but it can protect you against types that have not entered your body yet.
Frequently asked questions about genital warts
Treatment can remove visible warts, but there is no medicine that directly removes the virus itself from the body.
Even so, in many people the body brings the infection under control over time.
Treatment can clear visible warts, but they can come back, and no method can promise everyone a result without recurrence.
HPV is very common, and having warts is not, on its own, a sign of infidelity.
Warts do not stand in the way of marriage or a healthy relationship, and they can be treated and managed.
Warts may grow larger or more numerous during pregnancy. Passing the virus to the baby during childbirth is rare.
Having warts is not usually, on its own, a reason for a cesarean section (C-section). But if the warts block the birth canal, or a vaginal birth would carry a risk of heavy bleeding, a C-section may be needed. Your doctor will assess you and decide how you give birth.
Using these substances and medicines, or rubbing the bump, may cause burns, sores and infection. Acyclovir and penciclovir are herpes medicines and do not treat warts caused by HPV.
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