Warts are caused by viruses and can appear anywhere on the body. Those that show up in the genital area are caused by the human papillomavirus, commonly called HPV, and are easily transmitted by sexual contact.
HPV infection is the most common sexually transmitted disease (STD) in North America. Certain forms of the virus can cause cervical, rectal, and penile cancer. According to the CDC, at least 50% of sexually active men and women will get a genital HPV infection at some point in their lives.
After a person has been infected, it may take one to three months (or longer in some cases) for warts to appear. Some people who have been infected never get warts. If you think you have been infected, see your doctor, even if you cannot see warts.
What Do Genital Warts Look Like?
Genital warts look like small flesh-colored, pink, or red growths in or around the sex organs. The warts may look similar to the small parts of a cauliflower or they may be very tiny and difficult to see. They often appear in clusters of three or four, and may grow and spread rapidly. They usually are not painful, although they may cause mild pain, bleeding, and itching.
How Do I Know If I Have Genital Warts?
Like many STDs, HPV does not always have visible symptoms. But when symptoms do occur, warts may be seen around the genital area. In women, warts can develop on the outside and inside of the vagina, on the cervix (the opening to the uterus), or around the anus. In men, they may be seen on the tip or the shaft of the penis, on the scrotum, or around the anus. Genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.
Because there is no way to predict whether the warts will grow or disappear, people who suspect that they have been infected should be examined and treated, if necessary.
What Tests Are Used to Detect Genital Warts?
Your doctor may perform the following tests to check for genital warts:
- An examination of visible growths to see if they look like genital warts
- Application of a mild acetic acid (vinegar) solution to highlight less visible growths
- A complete pelvic exam and Pap smear (for women)
- A specialized test for HPV, collected in a way similar to a Pap smear
- Biopsy of cervical tissue to make sure there are no abnormal cells that could develop into HPV-related cervical cancer; a biopsy involves taking a small sample of tissue from the cervix and examining it under a microscope.
- Examination of the rectum
Female patients are sometimes referred to a gynecologist (a doctor who specializes in female reproductive health) for further testing and biopsy.
How Are Genital Warts Treated?
Unfortunately, no treatment can kill the virus that causes the warts. Your doctor can remove the warts with laser therapy or by freezing or applying chemicals. Some prescription treatments are available for at home use. Surgery may be necessary for warts that are large or difficult to treat. Still, recurrence remains a problem. You may need to return to your doctor for more treatment.
What Happens If I Don't Get Genital Warts Treated?
Unfortunately, despite treatment, having HPV can increase your risk of cervical, penile, and rectal cancer. But not all forms of the virus are associated with these cancers. If you have genital warts, it is important to get annual checkups to screen for cancer.
How Can I Prevent Getting Infected With Genital Warts?
Your best bet at preventing infection is to abstain from sex or limit sexual contact to one uninfected person. If that is not an option, condoms may provide some protection, but condoms are not 100% effective, since they do not cover the entire penis or surrounding areas.
There are three vaccines available to protect against HPV:
- Gardasil protects against infection from four strains of HPV. Two of these strains, HPV-16 and HPV-18, account for about 70% of cervical cancers. The other two strains covered by the vaccine, HPV- 6 and HPV-11, account for about 90% of genital warts. The vaccine is approved for 9- to 26-year-old males and females.
- Gardasil 9 prevents infection by the same HPV types as Gardasil, plus HPV-31, HPV-33, HPV-45, HPV-52, and HPV-58. Collectively, these types are implicated in 90% of cervical cancers. It's approved for use in females ages 9-26 and males ages 9-15.
- Cervarix, which is formulated for females between ages 9-25, protects against HPV-16 and HPV-18.