Genital warts are "caulifflowerlike" growths that appear in the genital and anal areas of the body. They are also called condylomata acuminata, venereal warts, flat condylomata, human papillomavirus (HPV), or papovavirus warts.

How do they occur?

Like other warts, genital warts are caused by a virus. Genital warts may be passed from person to person by sexual activity. They are more contagious, or more easily spread, than other warts. Genital warts are usually first seen 1 to 6 months after a person has been infected. It is possible, however, to be infected with the virus without having any visible warts.

What are the symptoms?

In women, dry, painless, cauliflowerlike warts can grow on the vulva (the outside visible part of female genitals), on the cervix, inside the vagina, or around the anus. In men, warts can grow on the tip or shaft of the penis and sometimes on the scrotum, in the urethra (the tube that carries urine out of the body), or around the anus. Genital warts are usually firm; rough; and flesh-colored, grayish white, or pinkish white. They usually appear as thin, flexible, solid elevations of the skin that look like small pieces of cauliflower. Some warts, however, are small and flat and may not be easily noticed. If left untreated, the warts may disappear on their own. They are more likely, however, to grow and form larger cauliflowerlike clusters of warts. You may have no symptoms or have occasional mild irritation, burning, itching, pain, foul smell, pain with intercourse, tenderness, increased vaginal discharge, or bleeding. Genital warts may occur on the cervix or in the vagina and may not cause any noticeable symptoms. However, a Pap smear may show cell changes that suggest a wart infection. Wart infection of the cervix can lead, in time, to cervical cancer in some women. This is one reason why a regular Pap smear is so important.

How are they diagnosed?

Genital warts on the skin are usually seen and recognized. An instrument called a colposcope will magnify the area so the health care provider can look more closely at the skin or the cervix. A sample of skin may be taken for lab tests to help confirm the diagnosis. Usually a Pap smear is done for women. A scope may be used to check for warts in a man's bladder and the urethra.

How are they treated?

It is very important that both sexual partners receive treatment if they have genital warts. Treating just one partner is not very effective because the other partner will reinfect the treated partner. Genital warts are spread by skin-to-skin contact. The main methods of treatment are:

Surgically removing the warts.
Removing the warts by freezing (cryotherapy).
Vaporizing the warts with a laser.
Burning off the warts (electrocautery).
Painting a chemical directly onto warts that are on the outside (not internal).

Chemical treatment involves clinic or office visits once or twice a week for 6 weeks. These treatments usually cause a burning discomfort and they are often unsuccessful. (The warts return 70% of the time.) This treatment may not be used if a woman is pregnant or thinks she might be pregnant. You may need local anesthesia during some of these treatments. Removal of the warts does not get rid of the virus. Because you will still have the virus after treatment, the warts could come back.

How effective is the treatment?

Genital warts can be successfully treated and removed. However, in some people the warts may reappear weeks or months later. If the warts reappear, they need to be removed again.

How can I take care of myself?

See your health care provider promptly. Genital warts are contagious, and your warts are likely to grow and spread without treatment.
Tell your partner(s) about the problem and insist that he or she be examined and treated.
Women should have follow-up Pap smears as recommended.
If you have genital warts and plan to get pregnant, have your warts treated first.

What can I do to help prevent the spread of genital warts?

To prevent the spread of warts to other areas of the body or to other people:

Keep the genital area clean and dry. You can use a hair dryer to help dry the area.
Don't scratch the warts.
Avoid sexual activity until the warts are completely healed.
Use latex condoms during sexual intercourse. Condoms can reduce your risk of getting genital warts, but warts can spread from areas not covered by a condom.
Wash your hands thoroughly after touching the area with warts.

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Robert B. McWilliams, MD Reproductive Endocrinology and Gynecology

Genital Warts

Robert B. McWilliams, MD
Reproductive Endocrinology
and Gynecology