Genital Warts

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Genital warts are one of the most common types of sexually transmitted infections. At least half of all sexually active people will become infected with human papillomavirus (HPV), the virus that causes genital warts, at some point during their lives. Women are somewhat more likely than men to develop genital warts.

Symptoms

In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, the anal canal, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or the anus. Genital warts can also develop in the mouth or throat of a person who has had oral sexual contact with an infected person.

The signs and symptoms of genital warts include:

  • Small, flesh-colored or gray swellings in your genital area
  • Several warts close together that take on a cauliflower shape
  • Itching or discomfort in your genital area
  • Bleeding with intercourse

Often, genital warts may be so small and flat that they can’t be seen with the naked eye. Sometimes, however, genital warts may multiply into large clusters.

When to see a doctor

See a doctor if you or your partner develops bumps or warts in the genital area.

Causes

The human papillomavirus (HPV) causes warts. There are more than 40 different strains of HPV that specifically affect the genital area. Genital HPV is spread through sexual contact. In most cases, your immune system kills genital HPV and you never develop signs or symptoms of the infection.

Risk factors

Factors that can increase your risk of becoming infected include:

  • Having unprotected sex with multiple partners
  • Having had another sexually transmitted infection
  • Having sex with a partner whose sexual history you don’t know
  • Becoming sexually active at a young age

Complications

Genital wart complications may include:

  • Cancer. Cervical cancer has been closely linked with genital HPV infection. Certain types of HPV also are associated with cancer of the vulva, cancer of the anus, cancer of the penis, and cancer of the mouth and throat. Human papillomavirus infection doesn’t always lead to cancer, but it’s still important for women to have regular Pap tests, particularly if you’ve been infected with higher risk types of HPV.
  • Problems during pregnancy. Genital warts may cause problems during pregnancy. Warts could enlarge, making it difficult to urinate. Warts on the vaginal wall may reduce the ability of vaginal tissues to stretch during childbirth. Large warts on the vulva or in the vagina can bleed when stretched during delivery.Rarely, a baby born to a mother with genital warts may develop warts in his or her throat. The baby may need surgery to make sure his airway isn’t blocked.

Tests and diagnosis

Because it’s often difficult to detect genital warts, your doctor may apply a mild acetic acid solution to your genitals to whiten any warts. Then, he or she may view them through a special magnifying instrument, a colposcope.

Pap tests

For women, it’s important to have regular pelvic exams and Pap tests, which can help detect vaginal and cervical changes caused by genital warts or the early signs of cervical cancer — a possible complication of genital HPV infection.

HPV test

Only a few types of genital HPV have been linked to cervical cancer. A sample of cervical cells, taken during a Pap test, can be tested for these cancer-causing HPV strains.

Treatments and drugs

If your warts aren’t causing discomfort, you may not need treatment. But if your symptoms include itching, burning and pain, or if visible warts are causing emotional distress, your doctor can help you clear an outbreak with medications or surgery. However, the lesions are likely to come back after treatment.

Medications

Genital wart treatments that can be applied directly to your skin include:

  • Imiquimod. This cream appears to boost your immune system’s ability to fight genital warts. Avoid sexual contact while the cream is on your skin. It may weaken condoms and diaphragms and may irritate your partner’s skin.One possible side effect is redness of the skin. Other side effects may include blisters, body aches or pain, cough, rashes, and fatigue.
  • Podophyllin and podofilox. Podophyllin is a plant-based resin that destroys genital wart tissue. Your doctor must apply this solution. Podofilox contains the same active compound, but can be safely applied by you at home.
  • Trichloroacetic acid (TCA). This chemical treatment burns off genital warts. TCA must always be applied by a doctor. Side effects can include mild skin irritation, sores or pain.

Surgery

You may need surgery to remove larger warts, warts that don’t respond to medications, or — if you’re pregnant — warts that your baby may be exposed to during delivery. Surgical options include:

  • Freezing with liquid nitrogen (cryotherapy)
  • Electrocautery
  • Surgical excision
  • Laser treatments

Prevention

Using a condom every time you have sex can significantly reduce your risk of contracting genital warts. Although condom use can reduce your risk, it is not 100 percent effective. You can still get genital warts.

 

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