How Genital Warts Appear and Spread

Genital warts are caused by the human papillomavirus (HPV) - the most common sexually transmitted disease.

Knowing how genital warts spread, how to recognize them and what prevention strategies exist is important for reducing your risk and the risk of spread to others.

Types of HPV in Genital Warts

Around 150 different strains of HPV. have been identified - with approximately 40 of them shown to infect the genital area. Most sexually-active people will encounter some form of HPV in their lifetime, but not all strains carry the same levels of risk.

"High-risk" strains (i.e. 16 and 18) causes the majority of cervical, penile, vulvar, vaginal, anal, and oropharyngeal cancers and precancers, while strains 6 and 11 cause genital warts. HPV strains 6 and 11 are responsible for nearly all cases of genital warts and typically do not lead to cancer.

More than 90% of new HPV infections, including those caused by high-risk HPV types, clear or become undetectable within 2 years, and clearance usually occurs in the first 6 months after infection.

HPV and How Genital Warts Are Spread

HPV is spread through skin-to-skin sexual contact such as genital-on-genital rubbing, intercourse, oral sex, and anal sex. When you have genital warts, you can spread them to a sexual partner. Using a condom can help reduce the risk of transmission, though it doesn't offer 100 percent protection since some areas of a man's genital region are still exposed.

The HPV virus penetrates the skin and mucous membranes through microscopic openings in those surfaces. After exposure, an incubation period takes place. During this time, there are no signs or symptoms of infection. Genital warts typically develop two to three months after infection, but not everyone infected with HPV strains 6 and 11 go on to develop warts.

There is no cure for HPV or, by extension, genital warts - but if you notice a bump or growth anywhere in the genital region (i.e the penis, vagina, anus, and perineum areas) you'll want to talk to your healthcare provider to find out the cause and inform your sexual partner if HPV is determine to be the cause.

What Genital Warts Look Like

As previously mentioned, genital warts may not show up for two or three months after HPV infection, if ever. When they do appear, they typically appear as flesh-toned or gray growths. They can be raised or flat. They appear on, in, and around the genitals. They can grow in clusters that resemble cauliflower, or they can appear singularly.

Their appearance of genital warts can vary dramatically. They can range in size from less than 1 millimeter to several centimeters in diameter if a cluster of warts merges together. Genital warts can be smooth or rough, flat or raised, and may have fingerlike projections.

The presence, of lack thereof, of genital warts should not be used to determine whether or not you or a partner have HPV.

Where Genital Warts Are Found

The location of genital warts doesn't always match up with areas of sexual contact. The CDC notes that while they usually occur at the site of reported contact, they can be found at sites where people report no history of sexual contact.

In women, genital warts can appear inside and outside the vagina and on the inner thighs. They can also appear in the anal region. They can be found growing inside and outside the anus and in the area between the anus and the vagina.

In men, genital warts can appear on the penis, including under the foreskin if the man is uncircumcised and on the shaft of a circumcised penis. They can also appear on the scrotum, testicles, anus, groin, and thighs.

Pictures

Please note that these are graphic images that show male and female genitalia in detail. Discretion is advised.

Male Genital Warts Pictures

• Photo 1: Genital warts on the penis.
• Photo 2: Close-up of a cluster of genital warts on the scrotum

Female Genital Warts Pictures

• Photo 1: Cluster of genital warts on the labia.
• Photo 2: Large cluster of genital warts on the labia.

Several pictures of genital warts on the Internet show extreme cases that are so severe that warts block the vaginal and anal openings. Cases such as these are uncommon.

Diagnosis

Your healthcare provider will make a diagnosis usually by visual inspection, but some warts are not readily visible to the naked eye. Practitioners may use a technique known as acetal whitening, in which a solution of 5 percent acetic acid is applied to suspicious areas. After about 10 minutes, these areas will become white if they contain genital warts. 

In addition, magnification using colposcopy can help healthcare providers visualize lesions inside the vagina and on the cervix. If any suspicious areas are found, a biopsy can confirm the presence of HPV and identify the viral subtype. 

Will Treatment Remove the Growths?

If no treatment is given, genital warts may go away on their own, often within one year. But it is also possible that they will grow and spread. They can also simply stay and remain the same size.

Treatments include creams or gels that you apply yourself. These are not over-the-counter medicines meant for other kinds of warts; you need to get them from your healthcare provider. A practitioner can also use cryotherapy to freeze them off or surgically remove them with laser or cutting instruments.

With treatment, you will usually have wart-free periods. That is good for cosmetic reasons, but you may still be able to pass HPV to sexual partners. 

A Word From Verywell

You can't rely on whether you can see genital warts to know if you or someone else is infected and can transmit HPV. Discuss the benefits and risks of the Gardisil vaccine with your healthcare provider if you do not have genital warts. If you suspect that you may have genital warts, see your medical professional. If you have been diagnosed with genital warts, you may still be able to transmit HPV to your sexual partners even if the warts are gone.