How Genital Warts Appear and Spread

Genital warts are caused by the human papillomavirus (HPV), which is the most common sexually transmitted disease. Knowing how it is spread, how to recognize genital warts, and how to prevent it is important in reducing your risk. The Gardasil vaccine is recommended for people of both sexes ages 9 through 26. It may prevent genital warts, but it is not a treatment for them.

Types of HPV in Genital Warts

There are more than 200 different strains of HPV. Certain strains of HPV that are considered "high-risk" can lead to some types of cancer (such as cervical cancer, oral cancer, and anal cancer). Other strains that are considered "low-risk" can lead to genital warts. HPV strains 6 and 11 cause roughly 90 percent of genital warts and are considered to have a low risk of producing cancer. However, sometimes HPV types 16, 18, 31, 33, and 35 may be found in genital warts (usually along with HPV 6 or 11) and these are associated with a higher risk of cancer.

HPV and How Genital Warts Are Spread

HPV is spread through skin-to-skin sexual contacts 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 infections. Usually, this period lasts about three months, but in many cases, it can last for years.

Genital warts are clustered growths that can affect the penis, vagina, anus, and perineum area. The bad news is that there is no cure for HPV, but the good news is that although genital warts may be unsightly, they rarely develop into cancer.

You may wonder whether a bump or growth that's found anywhere in your genital region is a genital wart, or you may want to know what to look for on your sexual partner. Here's more information that can help you figure that out.

What They Look Like

When symptoms of HPV are present, they are often invisible to the untrained eye, especially without magnification. In some cases, genital warts never appear or can appear years after contracting the virus. When visible warts 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.

You cannot rely on the visual presence of genital warts to determine whether someone is infected with HPV. In some cases, genital warts never appear or can appear years after contracting the virus.

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 doctor will make a diagnosis usually by visual inspection, but some warts are not readily visible to the naked eye. Doctors 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 doctors 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 doctor. A doctor 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 doctor if you do not have genital warts. If you suspect that you may have genital warts, see your doctor. 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.