Genital warts are skin growths caused by certain types of human papillomavirus (HPV). It’s one of the most common sexually transmitted infections, and yet, it’s also one of the least understood.
This guide to genital warts is intended for a broad audience, including individuals diagnosed with genital warts, their partners and members of the general public interested in learning more about HPV and associated conditions.
What are Genital Warts?
Genital warts (condylomata acuminata) are growths that appear on the genitals, anus, or surrounding skin. They are a visible manifestation of infection with certain types of human papillomavirus (HPV).
The majority of genital wart cases are caused by HPV strains 6 and 11. These are considered ‘low-risk’ HPV types because they are not typically associated with the development of cancer. High-risk types of HPV, on the other hand, are primarily linked to the development of certain cancers, including cervical, anal and oropharyngeal cancers.
What Genital Warts Look Like
Genital warts can vary in appearance. They may be:
- Colour: Flesh-colored, white, pink or slightly darker than the surrounding skin.
- Texture: Flat, raised, smooth or cauliflower-like.
- Size: From very small (pinhead-sized) to larger, and may appear in clusters.
In men, genital warts commonly appear on the:
- Penis (shaft or head)
- Scrotum
- Groin
- Anus (if anal sex has occurred)
Female genital warts commonly appear on the following:
- Vulva (outer part of the female genitals)
- Cervix (the opening to the uterus)
- Vagina
- Perineum (the area between the vagina and anus)
- Anus (if anal sex has occurred)
Genital Warts vs. Other Skin Conditions
Distinguishing genital warts from other skin conditions is crucial for accurate diagnosis and treatment. Here’s a comparison of genital warts with some common conditions that can appear in the genital area:
- Genital warts vs. herpes – Both are sexually transmitted infections but have distinct causes and appearances. Genital herpes presents as painful sores or blisters that rupture and crust over. In contrast, genital warts are usually painless bumps.
- Genital warts vs. skin tags – Skin tags are small, soft, flesh-coloured growths connected to the skin by a thin stalk. They are typically painless and not caused by a virus. Genital warts can be flat, raised or cauliflower-like and often appear in clusters, unlike isolated skin tags.
- Genital warts vs. molluscum contagiosum – Molluscum contagiosum is caused by the molluscum contagiosum virus. It presents as a small, raised, firm, and pearly bumps with a central dimple. It can also spread through sexual contact but is caused by a different virus than genital warts.
| Feature | Genital Warts | Herpes | Skin Tags | Molluscum Contagiosum |
|---|---|---|---|---|
| Cause | Human Papillomavirus (HPV) | Herpes Simplex Virus (HSV) | Not viral | Molluscum Contagiosum Virus |
| Appearance | Skin-colored, varied shapes, painless | Painful sores/blisters | Soft, flesh-coloured, stalk-like | Pearly bumps with a central dimple |
| Pain | Typically painless | Painful | Painless | Usually painless, but it may be itchy |
| Other Symptoms | May be itchy | Tingling, flu-like symptoms are possible | None | May cause itching |
Causes and Transmission of Genital Warts
Genital warts occur when HPV infects the skin and mucous membranes of the genital area. After infection, the virus causes cells in the affected area to grow abnormally, forming warts. The incubation period, or the time between infection and the appearance of warts, can vary from several weeks to months or even years.
How Do Genital Warts Spread?
Generally, genital warts are primarily transmitted through sexual contact (oral, vaginal and anal sex) with an infected individual. The virus is spread through skin-to-skin contact in the genital area.
Can You Get Genital Warts Without Sexual Contact?
Aside from sexual contact, there are rare instances where transmission may occur through other means. In rare cases, a mother can transmit HPV to her baby during vaginal childbirth. This can result in the development of genital warts or, more rarely, respiratory papillomatosis (warts in the baby’s throat).
The risk of contracting genital warts from non-sexual transmission, such as shared towels or toilet seats, is considered very low, as genital HPV is a fragile virus that does not survive well outside the body.
Risk Factors for Genital Warts
Certain factors can increase an individual’s risk of acquiring genital warts. These include:
- Unprotected sex – A sexual activity without barrier protection increases the risk of HPV transmission. Condoms are not 100% effective, as HPV can infect uncovered areas of the skin, but they do significantly reduce the risk.
- Multiple sexual partners – The higher the number of sexual partners a person has, the greater the exposure to HPV.
- Weakened immune system – People with conditions like HIV/AIDS, those taking immunosuppressant medications (e.g., after organ transplant) and those with other immune deficiencies are more susceptible to genital HPV infection and may have difficulty clearing the virus.
- Age group – Genital warts are most commonly diagnosed in young adults, particularly between the ages of 18 and 40, due to higher rates of sexual activity in this age group.
- Lack of HPV vaccination – Individuals who have not been vaccinated against HPV are at higher risk of acquiring the types of the virus that cause genital warts.
- Smoking and alcohol use – Smoking, excessive alcohol consumption and a weaker immune system may impair the body’s ability to clear the virus.
Complications of Genital Warts
While genital warts themselves are generally not life-threatening, they can lead to various complications:
- Chronic recurrence – Genital warts can recur even after successful treatment. This is because treatment eliminates the visible warts but may not completely eradicate the HPV virus from the body.
- Increased risk of other STIs – The presence of open lesions or inflammation caused by genital warts can potentially increase the risk of acquiring or transmitting other STIs, such as HIV or herpes. This is because the disrupted skin barrier can make it easier for other pathogens to enter the body.
- Increased cancer risk – While genital warts are typically caused by low-risk HPV types, co-infection with high-risk HPV types can increase the risk of certain cancers.
- Complications during pregnancy – During pregnancy, hormonal changes can cause genital warts to grow larger or multiply. In some cases, large warts can obstruct the vaginal opening, potentially complicating vaginal delivery.
- Respiratory papillomatosis in newborns – In rare cases, pregnant women with genital warts can transmit HPV to their newborn during vaginal delivery. This can lead to the development of recurrent respiratory papillomatosis, a condition characterised by the growth of warts in the baby’s throat (a rare but potentially serious complication).
Diagnosis of Genital Warts
Accurate diagnosis is crucial for managing genital warts and differentiating them from other skin conditions. While self-examination can be a starting point, professional evaluation is essential for confirmation and appropriate treatment.
Self-Examination vs. Professional Diagnosis
Regular self-examination of the genital area can help individuals identify any new or unusual growths. However, it’s important to note that self-diagnosis can be unreliable, as other skin conditions can mimic genital warts.
Consult a healthcare professional if you notice any of the following:
- New or unexplained bumps or growths on the genitals, anus or surrounding skin.
- Warts that are painful, itchy or bleeding.
- Uncertainty about whether a growth is a wart or another skin condition.
If you suspect that you have genital warts, consider booking a consultation with a healthcare professionals for diagnosis and treatment:
Common Diagnostic Methods
- Visual examination – A doctor can diagnose genital warts simply by visually examining the affected area.
- HPV DNA testing – This test is typically used to detect high-risk HPV types in cervical screening (Pap tests) for women. It is not routinely used to diagnose genital warts caused by low-risk HPV types but may be used in some cases for further evaluation of cervical cancer risk.
- Colposcopy and biopsy – In uncertain cases, a colposcopy (examination of the cervix) and biopsy (removal of a small tissue sample) may be performed to confirm the diagnosis and rule out other conditions, especially in women with abnormal Pap test results.
Treatment Options for Genital Warts
The goal of treatment for genital warts is to remove visible warts and alleviate their symptoms. It’s important to understand that treatment does not eliminate the HPV virus itself, and recurrence is possible.
Topical Treatments
- Prescription creams
In-Clinic Procedures
- Cryotherapy freezes the warts with liquid nitrogen to remove the genital warts.
- Electrocautery uses an electrical current to burn off the genital warts.
- Laser therapy is used for warts that are difficult to reach or have not responded to other treatments.
- Surgical excision. Larger or stubborn warts may be surgically removed.
Prevention Strategies for Genital Warts
Preventing HPV infection is the most effective strategy for avoiding genital warts. Key prevention methods to prevent genital warts include HPV vaccination, safe sex practices and maintaining a healthy immune system.
Vaccination
HPV vaccination is safe and highly effective at preventing infection that causes most genital warts and certain cancers when administered before exposure. It is recommended for adolescents and young adults, with US FDA approving it from 9 years old..
Safe Sex Practices to Reduce Risk
If you are sexually active, it is important to practice safe sex by using condoms. However, condoms are not 100% effective because HPV can infect areas not covered by a condom.
Additionally, having a mutually monogamous relationship can reduce the risk of sexually transmitted HPV. In addition to this, regular screening is important for early detection and treatment.
Boosting Your Immune System
A healthy lifestyle aids a strong immune system, which may help the body clear HPV infections more effectively. Smoking, chronic stress, and poor nutrition can weaken the immune system and may increase the risk of HPV persistence.
Coping with Genital Warts
Some coping strategies that might help individuals diagnosed with genital warts include:
- Education – Learning about genital warts and how they are treated can help reduce anxiety and uncertainty.
- Support network – Building a network of family, friends and groups as your support can provide emotional comfort and understanding.
- Professional help – If emotional distress related to having genital warts is significant, seeking help from a professional can be beneficial.
Open communication with sexual partners is also important. It’s important to reassure partners that genital warts are treatable and that precautions can be taken to reduce transmission risk. It will help maintain trust and understanding in relationships.
Genital Warts in Men vs. Women: Key Differences
While genital warts are caused by the same virus in both men and women, there are some differences in how they manifest and the potential complications they can cause.
Men who have sex with men (MSM) are at a higher risk of developing anal warts due to anal intercourse. In women, while low-risk types of HPV cause warts, it can sometimes lead to cervical changes.
Do Genital Warts Go Away on Their Own?
In some cases, the body’s immune system can clear the HPV virus, However, the likelihood of genital warts going away on their own is very unlikely and treatment is usually required.
The immune system may not be able to clear the virus effectively, and warts may persist without treatment due to a weakened immune system and higher viral load in the body.
Conclusion
Treating genital warts can be challenging, but understanding the causes, preventive strategies, and treatment options can help you manage the condition effectively.
This informative guide is for informational purposes only and should not be considered medical advice. Individuals with suspected genital warts should seek professional advice from a healthcare provider for proper diagnosis and treatment.
