What Are Genital Warts?

Genital warts, also known as condylomata acuminata, are one of the most common sexually transmitted infections (STIs). In the United States, 340,000 to 360,000 people are affected by genital warts each year, though many infections do not cause symptoms.

This article discusses the symptoms, causes, diagnosis, and treatment prevention of genital warts. Suggestions for prevention are also included.

Symptoms

Genital warts are abnormal growths typically found in the genital regions. They often appear on the moist tissue of the genital area. They may occur as a single small, flesh-colored bump or as a group of bumps in the genital area.

They can vary in size and sometimes appear shaped like a cauliflower. In some instances, the warts are too small to be seen.

In women, genital warts most commonly occur on the labia and near the opening of the vagina. For men, they are most common at the tip of the penis but may also appear along the shaft.

Both men and women may develop warts around the opening to the anus. Anal sex is not necessary for these to occur. Men and women may also develop warts in the mouth or throat related to oral sex.

Causes

You may feel confused and a little nervous if you have been learning about genital warts. That is because there is a lot of misunderstanding about human papillomavirus (HPV) and the complications of different virus strains.

While HPV is the cause of genital warts, the strains that cause genital warts are not typically the same ones that cause cancer.

Around 90% of genital warts are caused by HPV 6 and HPV 11. The types of HPV that cause warts are called non-oncogenic (non-cancer causing).

The variants of HPV that raise your risk for cancer are called oncogenic. Roughly 70% of cervical cancers are caused by HPV 16 and HPV 18. Most oral cancers caused by HPV are due to HPV 16. Another 20% of cervical cancers are caused by HPV types 31, 33, 34, 45, 52, and 58.

In other words, the strains of HPV which cause genital warts are different than the strains which cause cervical cancer. However, the risk factors for developing HPV are the same for both the genital-wart-causing strains and the cervical-cancer-causing strains.

Risk Factors

HPV can be contracted by anyone who is sexually active. The virus is transmitted through skin-to-skin contact. Several factors increase the risk of developing genital warts:

• Condomless vaginal sex
• Anal sex
• Oral sex
• Genital-to-genital contact
• Multiple sexual partners
• A weakened immune system

A 2015 research study showed a correlation between smoking and increased time to clear HPV from the body. People with a history of STIs are more likely to become infected with HPV.

Diagnosis

Many people have HPV and never know because they do not develop symptoms. There are no specific tests for non-cancer causing genital warts. Most healthcare providers will diagnose warts based on a clinical examination (looking at your genital area). The Centers for Disease Control and Prevention (CDC) does not recommend regular testing to diagnose genital warts.

Pap smears are used to screen for the cancer-causing strains of HPV. Regular testing for HPV in women is recommended to screen for cervical cancer and other complications of HPV. If an abnormality is found on your Pap smear, your healthcare provider may recommend additional testing. Specifically, a DNA test, which can test for high-risk strains of HPV, can be conducted.

It is important to note that the HPV tests you may have taken do not test for the genital-wart-causing strains of the virus. According to the CDC, HPV tests only test for the cancer-causing strains of the virus. The tests are only recommended for women who are 30 or older.

Treatment

There is no cure for HPV. Treatments may be targeted at your symptoms including genital warts. Your healthcare provider will recommend treatment depending on your diagnosis and the severity of your infection.

There are prescription medications available that can be applied to the affected areas. Some medications you will apply yourself, and others need to be applied by a healthcare professional.

Self-Applied Treatments

Self-applied treatments include:

• Aldara (imiquimod 5% cream)
• Condylox (podofilox 0.5% solution);
• Veregen (sinecatechins 15% ointment)

Follow the instructions from your healthcare provider about how to use these medications, and be sure to reach out if you develop side effects or your warts get worse.

Clinician-Applied Treatments

Some wart treatments need to be performed by medical professionals. Common HPV treatments include:

• Cryotherapy freezes off warts with liquid nitrogen
• Electrosurgery destroys warts with an electric current
• Surgical excision cuts out warts
• Podophyllin (25% solution)
• Trichloroacetic acid/ bichloroacetic acid
• Injection of interferon into the warts
• Laser treatment

Treatment will remove warts from the skin but does not stop you from transmitting HPV to others.

If your healthcare provider finds complications of HPV infection, like changes to the cells on your cervix or signs of cervical cancer, other treatments may be recommended.

Prevention

Avoiding risk factors, such as multiple sexual partners, can reduce your risk of contracting HPV and, thus, genital warts. Condoms may lessen your risk but do not always prevent transmission of HPV because HPV can spread with only skin-to-skin contact. If you are between the ages of 9 and 45, immunization may help prevent infection.

Immunization is available, which may protect you against contracting the HPV virus. Currently, only one HPV vaccine is used in the United States—Gardasil-9. This vaccine, which was approved in 2014, protects against HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Summary

HPV, the virus that causes genital warts and some cancers, is one of the most common sexually transmitted infections. Not everyone who is living with HPV will develop symptoms.

Genital warts are most commonly transmitted through sexual activity, including skin-to-skin contact. You can transmit HPV to a partner, even if you do not have visible warts. Genital warts are diagnosed by healthcare providers during a physical examination. Treatment is available if your symptoms are bothersome, but there is no cure for HPV infection.

A Word From Verywell

There are many misconceptions surrounding the development of both genital warts and HPV. It is important to remember that not all strains of HPV cause genital warts, and the strains that do cause genital warts do not cause cervical cancer.

However, the risk factors for transmitting all strains of HPV that infect the genital area remain the same, including condomless sex and a weakened immune system. If you are experiencing any symptoms of genital warts, seek medical attention to rule out other conditions and learn about which medication could help treat your symptoms.