What Are Genital Warts? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Genital warts develop as a symptom of infection with certain types of the human papillomavirus (HPV). Known medically as Condyloma acuminata, genital warts are a common type of sexually transmitted disease (STD).

Although warts can be a nuisance, they are treatable and are typically not dangerous to your health, according to Planned Parenthood.

And while there are some kinds of HPV that can cause cancer, those types are rarely associated with genital warts, notes past research.

However, it is possible to be infected with more than one type of HPV at once. So people with genital warts should not skip screenings for or ignore symptoms of cancers caused by HPV.

Even better than treating HPV-related warts is preventing them, and many cases of genital warts can be prevented by the HPV vaccine — the same vaccine that prevents against infection with numerous types of cancer-causing HPV.

Signs and Symptoms of Genital Warts

Genital warts are soft, moist growths that are generally flesh-toned. They may be flat, raised, or shaped like a cauliflower (if they grow in clusters), according to Medline Plus.

These blemishes may appear throughout the genital and anal areas, and so are sometimes referred to as anogenital warts.

In women, genital warts can grow in or around the vagina, vulva, urethra, cervix, and anus.

In men, they may also appear inside or outside the anus, as well as on the penis, scrotum, urethra, or surrounding areas, such as the groin area and thighs.

In both men and women, Condyloma acuminata can also develop in the mouth and throat, and on the tongue and lips.

Genital warts can cause itching, burning, or discomfort in the genital area as well as bleeding during intercourse.

Learn More About Genital Warts Symptoms

Causes and Risk Factors of Genital Warts

Genital warts are caused by HPV, which is the most common sexually transmitted infection in the United States, according to the Centers for Disease Control and Prevention (CDC).

HPV isn't a single virus, but rather a group of more than 150 related viruses. Each of these has a designated number, or HPV type.

HPV types 6 and 11 are responsible for 90 percent of genital warts, according to NYU Langone Health.

You can get genital warts if you have intimate, skin-to-skin contact with someone who’s infected with a type of HPV that causes genital warts, even if they don't have any visible warts.

According to MedlinePlus, you have an increased risk of developing and spreading genital warts if you:

  • Are pregnant
  • Are stressed and have another viral infection, such as herpes
  • Have a weakened immune system from medications or other health conditions, including diabetes and HIV or AIDS
  • Use tobacco or drink alcohol
  • Are sexually active at an early age, or have unprotected sex with multiple partners
  • Have another STD

Although genital warts inside the anus predominately affect people who have had receptive anal intercourse, they can also occur in men and women who have no history of anal sexual contact.

How Are Genital Warts Diagnosed?

Genital warts are usually diagnosed by their appearance, but in some cases, a biopsy may be performed by your doctor or dermatologist to be sure. A biopsy involves removing a part or all of a wart and sending it to a laboratory for further testing.

In women, an abnormal Pap smear (a procedure in which cells removed from the cervix are examined under a microscope) may prompt your doctor to perform a procedure known as colposcopy, which enables the doctor to take a close look at your cervix.

A colposcope looks somewhat like a microscope or pair of binoculars that’s mounted on a stand. The exam is done by inserting a speculum into a woman’s vagina, rinsing the cervix with a vinegar-like solution, and positioning the colposcope so that it shines a bright light onto the cervix. The colposcope itself is not inserted into the vagina, nor does it need to touch the woman’s body at all, notes Planned Parenthood.

Colposcopy may reveal internal genital warts or other types of abnormal tissue.

The HPV test, which requires a sample of cells is taken from the cervical area with a swab or small brush, only tests for high-risk HPV types that can cause cancer. It does not test for low-risk HPV types that can cause genital warts, according to Lab Tests Online.

Prognosis of Genital Warts

The prognosis of genital warts is hard to predict. Sometimes people have them just once, while others may have recurring outbreaks. The warts can be treated, but they won’t be cured — and the HPV that causes them won’t be cured either, according to the Cleveland Clinic.

People with genital warts will continue to be infectious and therefore need to practice safer sex with any sexual partners. According to Planned Parenthood, some steps you can take to reduce your risk of spreading genital warts include:

  • Encouraging your partner to discuss the HPV vaccine with their doctor if they haven’t already been vaccinated
  • Using barrier methods, such as condoms and dental dams, during vaginal, anal, and oral sex
  • Abstaining from sex (even with barrier methods) if you have visible warts
  • Not smoking, as smoking may cause a flare-up of warts
  • Communicating openly and honestly about your health status and your partner’s risk of getting genital warts from you

Duration of Genital Warts

Genital warts can go away with or without treatment, or they can last for years. Sometimes genital warts return after they are treated or removed.

Treatment and Medication Options for Genital Warts

There’s no cure for genital warts, but they can sometimes go away on their own if the body fights off the HPV. They may also linger or grow in size or number. If you have genital warts that are causing discomfort, or if you simply want them to go away, you’ll need to see a doctor. You should not attempt to self-treat genital warts, as you may cause permanent damage to your skin, noted an article in U.S. Pharmacist.

Your doctor may prescribe topical treatments for genital warts or, in certain cases, recommend a surgical option for removing them. But because none of these options eliminate the underlying viral infection, the warts can still come back, according to a review published in the Journal of Clinical and Aesthetic Dermatology.

Medication Options

There are several different topical medications to use for genital warts. Some of these medications have to be applied in a doctor’s office to make sure they’re applied correctly, and some of them can be applied at home, according to a guide published in American Family Physician.

  • Imiquimod (Aldara, Zyclara) is a topical ointment that upregulates the immune system to attack the wart until it goes away.
  • Podofilox (Condylox) is a topical solution that stops the infected cells from dividing and causes the tissue to die.
  • Sinecatechins (Veregen) are made of extracts of green tea leaves that are compounded into a topical ointment. They work by decreasing viral replication.
  • Trichloroacetic acid is a medication that dissolves the warts by destroying the protein in their cells. It can cause skin damage to areas outside the wart and so it is applied in the doctor’s office.

Surgical Options

There are several surgical procedures used to remove genital warts, according to Planned Parenthood.

  • Cryotherapy This removes the warts by freezing them, which causes a blister to form around the wart. Once it heals, the blister falls away.
  • Electrocautery This procedure removes warts by burning them with an electrical current.
  • Surgical Excision Surgery can be used to cut off the warts.
  • Laser Treatments For the most tough-to-treat warts, laser therapy can be used. Lasers use an intense beam of light to remove the warts.

Alternative and Complementary Therapies

There’s no evidence that any alternative or complementary therapies work to get rid of genital warts. What’s more, applying unproven substances to genital warts can irritate or damage the delicate skin in the genital area.

Having a healthy immune system may help to reduce the recurrence or growth of genital warts. To promote immune health, follow a healthy diet that includes a variety of fruits and vegetables, avoid processed foods and saturated fats, exercise regularly, and get the recommended amount of sleep, notes Harvard Health.

Learn More About Genital Warts Treatment

Prevention of Genital Warts

There are ways to avoid getting the types of HPV that infect the genitals, including those types of HPV that cause genital warts:

  • Get vaccinated with the HPV vaccine. This is an effective way to prevent both genital warts and a variety of types of cancer caused by HPV, including cervical cancer and oropharyngeal cancer. The vaccine protects against seven types of HPV that can cause cancer as well as the two types — HPV 6 and HPV 11 — that cause 90 percent of cases of genital warts. That means it’s still possible to get genital warts even with the vaccine, but the chances are greatly reduced, according to Nemours.

  • Make sure you use latex condoms correctly every time you have sex. Again, this lowers your chances of getting genital warts, but it is still possible for the HPV to infect areas not covered by a condom, according to the CDC.
  • Limit your number of sexual partners or be in a mutually monogamous relationship to reduce your chances of getting genital warts and other STDs.

RELATED: HPV-Related Oral Cancers Are on the Rise

Complications of Genital Warts

Large warts can obstruct the anus, urethra, or vagina, causing difficulties with excretion and sexual relations.

But even when genital warts pose no particular health risks, they are often psychologically distressing to those who have them. Studies conducted in numerous countries around the globe report that people with genital warts often experience shame, low self-esteem, low self-confidence, anxiety, and depression and report a reduced quality of life.

The psychological impact of genital warts alone underscores the benefit of having adolescents vaccinated against HPV, before they’re likely to have been exposed to it.

Pregnancy and Genital Warts

Hormonal changes during pregnancy can cause genital warts to bleed or increase in size or number. Enlarged warts may impede urination, or (rarely) obstruct the birth canal and make it less elastic, according to American Sexual Health Association.

In rare cases, a woman with a type of HPV that causes genital warts may transmit it to her baby during childbirth, causing warts to grow in the child’s airways, a condition called recurrent respiratory papillomatosis, notes the Office on Women’s Health.

If you have genital warts while pregnant, your doctor will likely remove the warts via cryotherapy, electrocautery, or laser therapy to preempt any problems. However, in cases where the warts are not bothersome, and there is no concern about transmission, they may not need to be treated.

To avoid complications, it’s important to consult your doctor early in your pregnancy if you have genital warts.

Research and Statistics: How Many People Have Genital Warts?

In the United States, an estimated 500,000 to one million new cases of Condyloma acuminata are diagnosed each year, according to a review in The Journal of Clinical and Aesthetic Dermatology.

But other estimates point to a lower incidence of genital warts — about 360,000 cases each year, according to the CDC. (This number likely underestimates the true number of people with genital warts because it just includes the number of people who sought medical treatment for the warts.)

There is a gender disparity in the prevalence of genital HPV, with 46 percent rate for males and 40 percent for females for people ages 14 to 59, according to a 2018 review published in Human Vaccines & Immunotherapeutics.

The prevalence of genital warts among boys and men ages 15 to 39 in the United States increased significantly between 2003 and 2009, but remained stable in 2010, according to a report in the American Journal of Public Health.

The prevalence of genital warts among women of different age groups has seen various increases and decreases over the years. But overall, it has decreased in girls and women ages 15 to 24, likely due to the HPV vaccine, the study notes.

Black and Hispanic Americans and Genital Warts

According to data from the National Health and Nutrition Examination Survey from 2011 to 2014, the prevalence of any genital HPV was 64.1 percent in Black Americans, 41.4 percent in Hispanic Americans, and 40 percent in white Americans.

The HPV vaccination reduces a person’s chances of getting genital warts, and research indicates that inequities persist in HPV vaccination rates. A study published in Clinical Therapeutics found that although low-income Black, Hispanic, and Asian adolescents were equally or more likely to start the HPV vaccination series, they were less likely to get all the shots required for the series.

(Children who get the HPV vaccine before their 15th birthday need two doses; teens who start the vaccination series after they turn 15 need three, according to the CDC.)

What’s the Difference Between HPV and Genital Warts?

HPV is the cause of genital warts, but not all types of HPV cause genital warts. Of the approximately 150 different types of HPV, about 75 percent cause skin warts, and the other 25 percent infect the genitals and other mucous membranes, according to the American Cancer Society.

Some genital HPV types cause genital warts, and others can cause a variety of types of cancer.

Genital HPV types are spread through sexual activity, including vaginal, anal, or oral sex and are so common that almost all men and women will get one type of HPV at some point in their life.

About 90 percent of genital HPV infections go away by themselves, or become undetectable, without treatment.

Resources We Love

Sexual Health Resources

If you're sexually active, it's important to educate yourself about STDs. In addition to the resources listed here, many city and state agencies — as well as colleges and universities — offer programs that provide STD information and treatment. Most are free or low-cost.

American Sexual Health Association (ASHA)

This website offers a wealth of information on various aspects of sexual health and wellness – including genital warts and HPV. Be sure to check out their roundup of HPV myths versus facts, and their guide to discussing HPV with your partner.

Clinical Trials

Clinical trials are a way to stay connected and up-to-date with the latest research into genital warts. This website offers a useful starting point for finding clinical trials near you which are actively recruiting.

Planned Parenthood

This organization is a great source of accessible information about signs, symptoms, prevention and treatment of genital warts. They also offer a “Find a Health Center" service to help you locate a place to get tested or treated for genital warts (and other STDs).

Learn More About Sexuality and STD Resources

Additional reporting by Becky Upham.

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