Genital Warts: Symptoms, Treatments, and Prevention

Medically Reviewed By Wendy A. Satmary, MD
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Genital warts are flesh colored or grayish bumps that occur in the genital area. Human papillomavirus (HPV) is the virus that causes them. Although there is currently no cure for genital warts, some treatments are available. Doctors can often diagnose this sexually transmitted infection (STI) by examining the bumps.

Treatment may involve topical medications or procedures, such as cryotherapy (freezing), electrocautery, laser therapy, or surgery. After treatment, genital warts may never return. However, they may recur in some cases.

This article covers genital warts and the virus that causes them. It also explores the symptoms, diagnostic methods, and treatment options associated with this common STI.

What are genital warts?

Genital HPV is the most common STI in the United States. It affects about 43 million adults and older teenagers.

HPV spreads during skin-to-skin contact with visible genital warts. However, the virus can still spread even if the person has no symptoms. In fact, most people with HPV do not know it. They never develop genital warts.

Genital warts can appear weeks to months after infection with HPV. They can be big or small, flat or raised, and solitary or clustered. In males, they can appear on the scrotum or penis. In females, they can affect the cervix, vagina, or vulva. They can also occur near or inside the anus and urethra.

Without treatment, genital warts may go away with time, remain unchanged, or increase in number. 

There are roughly 100 types of HPV. Genital warts are associated with HPV types that have a low risk of causing cancer, namely HPV 6 and HPV 11. High risk HPV has a higher risk of causing cervical, penile, or anal cancer.

An HPV vaccine protects against most types of HPV that cause genital warts and HPV-associated cancer. It is available for all sexes and works best when a person receives the vaccine before becoming sexually active and exposed to HPV. The ideal age for HPV vaccination is ages 9–12 years, but it is suitable for people up to age 45 years.

Because you cannot always tell who has HPV, the only sure way to avoid the virus is to avoid sexual contact. The risk of infection increases if you have multiple sexual partners and engage in sex without a barrier method. Condoms, for example, can reduce the risk of HPV disease and genital warts.

Contact your doctor if you notice any new or unusual bumps on or near the genitals. If you are sexually active, talk with your doctor about HPV vaccination.

What are the symptoms of genital warts?

Genital warts can affect the anus, cervix, penis, scrotum, urethra, vagina, or vulva. They can also appear in the groin or on the thigh.

Sometimes, they can be so small that it requires magnification to see them. They may also form large clusters. They may be flat or raised and cauliflower-like.

Common symptoms of genital warts

Common symptoms of genital warts include:

  • bleeding from the urethra or vagina
  • flesh colored, white, grayish, or dark bumps in the genital area
  • itching

What causes genital warts?

Genital warts are a type of STI. Certain types of HPV cause the infection.

Genital warts spread through direct skin-to-skin contact. However, they do not have to be visible to be contagious, and they may not develop until weeks or months after the infection occurs.

What are the risk factors for genital warts?

Several factors increase the risk of developing genital warts. That said, not all people with risk factors will get them. 

Risk factors for genital warts include:

  • alcohol or drug use, which lowers inhibitions and can lead to risky behaviors
  • a compromised immune system due to such conditions as HIV, corticosteroid use, organ transplant medications, or cancer and cancer treatments
  • multiple or anonymous sexual partners
  • a personal history of an STI
  • sexual contact with someone who engages in high risk sexual behaviors or who has had an STI
  • smoking

How do you prevent genital warts?

You may be able to lower your risk of genital warts by:

  • avoiding sexual contact
  • avoiding contact with visible genital warts
  • engaging in sexual activity with one monogamous partner
  • getting the HPV vaccine
  • using barrier methods such as condoms during sexual contact, though condoms may not protect all affected areas of skin

HPV vaccination lowers the risk of many HPV-related diseases. In the U.S., the 9-valent HPV vaccine is designed to prevent initial HPV infection and HPV-related disease, including:

  • cervical, vulvar, and vaginal cancer
  • anal cancer
  • oropharyngeal cancer
  • head and neck cancers
  • precancerous lesions
  • genital warts

How do doctors diagnose genital warts?

It can be embarrassing to discuss your genitals and sexual activity with a doctor. However, it is essential for your overall health, especially if you think you have genital warts.

Your doctor will ask you questions and may order some tests to confirm the diagnosis.

Questions your doctor may ask include:

  • What are your symptoms?
  • When did you first notice them?
  • Do you have any medical conditions, especially ones that can affect your immune system?
  • Are you sexually active?

Most often, doctors can diagnose genital warts after a physical exam. You may need one or both of these tests as well:

  • HPV test: This test on cervical cells can check for the low risk HPV type that causes genital warts (HPV 6 and HPV 11). This test can also detect high risk HPV that is associated with cancer and precancer.
  • Biopsy: Although not usually necessary, a biopsy can help your doctor rule out any other condition that may be causing your symptoms. Additionally, a doctor may want to perform a biopsy for warts that do not respond to several treatment cycles.

What are the treatments for genital warts?

Genital warts do not always require treatment. In 80% of cases, the infection clears within 2 years.

Treating genital warts will not cure the infection. It is also possible for warts to recur after treatment. The decision of whether or not to treat them is a personal choice.

However, treatment does have several benefits, including:

  • preventing disfigurement and other complications
  • reducing the chance of spreading the infection
  • relieving the symptoms

The type of treatment you receive depends on your preference, the practitioner’s experience, and the extent and location of the warts.

Some common treatments include medications and procedures to remove warts.

Medications

Doctors may prescribe topical medications that you apply at home to destroy warts. These drugs include:

  • imiquimod cream (Aldara)
  • podofilox solution or gel (Condylox)
  • podophyllin resin (Podocon-25, Podofilm)
  • sinecatechins ointment (Veregen)
  • trichloroacetic acid

Oral isotretinoin may be an add-on therapy when genital warts are extensive or resistant. Doctors may also recommend it for people with compromised immune systems.

Procedures

Some office-based procedures that doctors may recommend to treat genital warts include:

  • cryotherapy to freeze away the warts
  • electrocautery to destroy the warts with an electric current
  • laser treatment to destroy and remove the warts using light energy
  • surgery to cut out the warts

What are the potential complications of genital warts?

Without treatment, genital warts can sometimes cause complications. In some people, these can be serious. People with weakened immune systems are more likely to have serious problems. 

Some complications of genital warts include:

  • bleeding or pain 
  • disfigurement
  • spread to a newborn baby during labor and delivery
  • spread to a sexual partner
  • an increased susceptibility to additional STIs

Genital warts are associated with the types of HPV that have a low risk of causing cancer, most commonly HPV 6 and HPV 11. Cancer from these strains of HPV is quite rare and occurs more commonly in people with compromised immune systems.

Infection with a high risk strain of HPV can lead to cancer. However, prevention is possible with vaccination.

Summary

Genital warts are the most common STI. They are associated with the types of HPV that have a low risk of causing cancer.

As you cannot always tell who has HPV, the only way to protect yourself from genital warts and HPV infection is to avoid sexual contact. If you are sexually active, using barrier methods such as condoms can reduce the risk of HPV and genital warts. Also, getting the HPV vaccine protects against most types of HPV that cause genital warts and HPV-associated cancer.

Most cases of genital warts go away on their own within 2 years. However, treating them can make you more comfortable and prevent the spread of the infection to others.

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Medical Reviewer: Wendy A. Satmary, MD
Last Review Date: 2022 Feb 28
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