Sexual Health Advice - Patient Information Leaflets
Genital Warts (Anogenital Warts)
What are genital warts and what causes them?
Anogenital warts (sometimes just called genital warts) are small lumps that develop on the genitals and/or around the anus (back passage). They are caused by a virus called the Human Papilloma Virus (HPV). There are over 90 types of this virus. Most anogenital warts are caused by types 6 or 11. ‘Common warts' that many people have on their hands and feet are caused by a different type of HPV.
How do you get genital warts?
The virus is passed on by sexual contact. You need close ‘skin to skin' contact to pass on the virus. It can take weeks or months to develop warts after being infected with HPV.
Where do genital warts develop?
In men the warts usually develop on the outer skin of the penis. In women the warts usually develop on the vulva, just outside the vagina. Warts may also develop on the skin around the anus in both men and women. Sometimes warts develop inside the vagina, on the cervix, on the scrotum, and inside the anus. Rarely, they occur in the mouth or nose.
What are the symptoms of genital warts?
Warts appear as skin-coloured small lumps or larger cauliflower shaped lumps on the genital area. They may occur singly or in groups. In most cases, the warts cause no physical discomfort. They sometimes cause itching and soreness, especially if they occur around the anus. They are benign, that is, they cause no serious physical illness. However, the warts look unsightly and some people become distressed by this.
How are genital warts diagnosed?
Genital warts have a typical appearance. Therefore, no test is usually needed to confirm the diagnosis. However, up to 1 in 4 people with anogenital warts also have another sexually transmitted infection so you may be offered tests for these.
What are the treatment options for genital warts?
Whatever the treatment, it usually takes several weeks to clear the warts. Sometimes it can take up to six months of treatment to clear the warts.
In about 1 in 4 cases, the same infection will re-activate and new warts will develop. These warts can be treated in the same way.
Chemical treatments – a number of chemicals, when put onto warts, will ‘burn' or destroy the wart tissue:
Podophyllin has been used for a number of years and is a common treatment. It is a strong chemical and is only applied by a doctor or nurse. A small amount is placed on each wart and left on for four hours and then washed off. This is done 1 – 2 times per week until the warts have gone. It must not be used if you are pregnant.
Tricholoracetic acid is an alternative that is sometimes used. It is applied by a doctor or nurse once a week for several weeks.
Podophyllotoxin is another alternative that is similar to podophyllin, but is made up in a weaker strength into a cream or lotion. This may be prescribed for you to put on the warts at home. You should apply it twice daily for three days, followed by four days rest. This is repeated four times (so the whole treatment lasts about four weeks). You must not use it if you are pregnant.
Imiquimod cream is another alternative. The cream is applied to the warts and washed off 6 – 10 hours later. This is repeated three times per week for up to 16 weeks. Imiquimod may weaken condoms and diaphragms, and sexual contact is not recommended while the cream is on the skin.
Physical treatments – various techniques can destroy the wart tissue:
Freezing warts with liquid nitrogen is a common treatment. This is called cryotherapy. Liquid nitrogen is sprayed on or applied to the wart. Liquid nitrogen is very cold. The freezing and thawing destroys the wart tissue. To clear the warts fully you may need several treatments, a week or so apart.
Surgical removal of warts under local anaesthetic may be an option if you have just a few warts that can be easily removed in this way.
No treatment
One option is not to have any treatment. Anogenital warts are not serious, but they can be unsightly. Some people prefer to just leave them alone. There is a good chance that they will go away without any treatment. But this may take many months, or sometimes years.
What about treating my sexual partner for genital warts?
Condoms may prevent HPV from being passed on to new sexual partners who are not infected. Condoms also protect against other sexually transmitted diseases. It is advisable to use condoms when you have sex whilst you are being treated for warts, and for at least a further three months after they have gone.
Are genital warts associated with cervical cancer?
The types of HPV that most commonly cause anogenital warts (types 6 and 11) do not increase the risk of cervical cancer. However, some types of HPV that do increase the risk of developing cervical cancer are the cause of some cases of anogenital warts. So it is important that women have smear tests at the usual recommended times.
