Genital Warts 101

    Genital Warts 101
    Published 24 December 2019
    Fact Checked
    Olga Adereyko, MD
    Reviewed by Olga Adereyko, MD, Primary Care Physician, General Practitioner, Medical Consultant
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    Genital warts are one of the most common sexually transmitted infections (STIs). They are usually transmitted through anal or vaginal sex, and rarely through oral sex. The cause of genital warts is the human papillomavirus (HPV), and they affect many people. Read on to learn more about them.

    What are genital warts?

    Genital warts are among the most common STIs because HPV, the virus that causes them, is so prevalent. There are different types of HPV, and almost all sexually active people will have at least one type of HPV at some point in their lives.

    Genital warts are mostly found in the moist areas of the genitals. They may appear as flesh-colored, small projections on the skin or look more like cauliflower. In many people, they are too small to see with the naked eye.

    What are the symptoms of genital warts?

    Genital warts can occur on the vulva, vaginal walls, perenium, cervix, anal canal, and anus. Genital warts can also grow on the shaft or tip of the penis and scrotum.

    Genital warts can also show up in the throat or mouth of someone who has oral sex with a person infected with HPV.

    The symptoms and signs of genital warts are as follows:

    • Tiny flesh-colored, pink, or brown bumps in the genital region
    • Cauliflower-like in appearance if several are close together
    • Discomfort and itching in the genital region
    • Bleeding during sex

    Some genital warts are flat and too small to be visible. However, in rare cases, HPV warts can multiply to form a large cluster of warts, especially in people who have a suppressed or weakened immune system.

    What are the complications of genital warts?

    Infection with HPV can result in the following complications:

    Cancer: An HPV infection of the genital tract is closely associated with cervical cancer. Certain other forms of HPV infection may be linked to cancers of the anus, penis, vulva, and throat and mouth. The strain of HPV that causes genital warts does not cause cancer.

    An HPV infection of the genital tract is closely associated with cervical cancer.

    HPV does not always cause cancer; however, it’s a good idea to get regular Pap tests, especially if you have already been diagnosed with a higher-risk HPV type. The HPV vaccine can prevent most types of cervical cancer.

    Complications during pregnancy: In rare cases, genital warts can enlarge during pregnancy and make it difficult to pee. Warts on the vaginal wall can also keep it from stretching properly during delivery. Genital warts in the vagina or on the vulva can also bleed when they are stretched during delivery.

    In very rare cases, babies born to women with genital warts can develop HPV warts in their throats. In such cases, the baby may need surgery to keep their airway clear.

    What causes warts?

    HPV causes genital warts, and more than 40 strains of the virus can infect the genital region.

    Genital warts are almost always spread by skin-to-skin and/or sexual contact. The HPV infection can spread to your partner even if the warts aren’t visible.

    You can get an HPV infection and genital warts in the following ways:

    • Having anal or vaginal sex
    • Sharing sex toys
    • In rare cases, having oral sex

    How to treat genital warts

    You may not need treatment for genital warts if they aren’t causing any pain or discomfort. However, if you’re experiencing pain, itching, or burning or you’re concerned about spreading the infection, your doctor can help you treat the symptoms with medicine or surgery. However, HPV genital warts often come back after treatment, as no cure exists for HPV yet.

    Medicines: Your doctor may recommend the following medications to treat genital warts:

    Imiquimod: This genital wart treatment cream helps your immune system fight the warts. You should avoid any type of sexual contact when you apply this cream to your skin. It can weaken diaphragms and condoms and may also irritate your partner’s skin.

    Some of the side effects of this cream include redness, blisters, body pain, rashes, fatigue, and cough.

    If you’re experiencing pain, itching, or burning or you’re concerned about spreading the infection, your doctor can help you treat the symptoms with medicine or surgery.

    Podofilox and podophyllin: A resin made from plants, podophyllin helps destroy genital warts. Your doctor will apply the solution to the affected region. The same active ingredient is present in podofilox, but you can apply this substance to the warts at home. You shouldn’t apply podofilox internally. Moreover, pregnant women shouldn’t use it at all. Some of the side effects include mild irritation of the skin, pain, and sores.

    Trichloroacetic acid: This is a type of chemical genital wart treatment that burns off the warts. It can be used for internal genital warts. Some of the side effects include mild skin irritation, pain, and sores.

    Sinecatechins: This cream can treat external genital warts and anal warts. Some of the mild side effects include redness, burning or itching, and pain.

    HPV genital warts often come back after treatment, as no cure exists for HPV yet.

    Over-the-counter wart removers shouldn’t be used on the genitals, so don’t use them to treat your genital warts.


    You may need surgery for genital wart removal in the following scenarios:

    • If your warts are large
    • If they don’t get better with medication
    • During pregnancy (to prevent exposing the baby to the warts during delivery)

    Some of the surgical options to remove warts are:

    Cryotherapy — Cryotherapy involves freezing the warts using liquid nitrogen. After freezing, a blister forms around the genital wart. As the skin heals, the blister falls off and new skin appears. You may need a repeat session of cryotherapy. Some of the side effects include swelling and pain.

    Electrocautery — In this genital wart removal technique, a doctor uses an electric current to destroy the warts. Some swelling and pain may occur after the procedure.

    Laser treatments — This expensive technique uses a high beam of light to target difficult-to-treat and extensive warts. Some of the side effects include pain and scarring.

    Why genital warts come back

    Genital warts are caused by an HPV infection. There are multiple strains of HPV, and the infection can stay in the skin even after treatment, causing a recurrence of warts.

    Genital warts can get better without any type of treatment; however, it may take several months. During this time, you can still spread the infection to your partner, and your warts may also reoccur.

    How to prevent genital warts

    You can prevent the spread of HPV to your partner by taking the following precautions:

    • Use protection (a condom) every time you have any sexual contact (vaginal, oral, or anal sex). Remember that if the virus is present in skin that is not protected by a condom, it can be passed on. 
    • Don’t share sex toys.
    • Don’t have any sexual contact while undergoing treatment.
    • Get vaccinated against HPV.


    Getting an HPV vaccine is the most effective way to protect against cervical cancer. According to the recommendations by the Centers for Disease Control and Prevention, children between 11 and 12 years old should get an HPV vaccine. It is best for children to get the vaccine before they get involved in any type of sexual activity.

    Vaccination and Pap tests are among the ways to prevent cervical cancer and genital warts, in particular.

    An HPV vaccine usually produces mild side effects that can include headaches, soreness at the injection site, and flu-like symptoms.

    Pap test

    Cervical cancer doesn’t produce any symptoms in its early stages, so it’s important for women to get regular Pap tests. Pap tests can detect precancerous changes that can occur in your cervix and turn into cancer. According to current guidelines, women between 21 and 29 years old should have a routine Pap test every three years.

    Women between 30 and 65 years old should continue having a routine Pap test every three years or every five years if they’re also being tested for HPV. Women older than 65 can stop having a Pap test if they have three normal Pap tests in a row or two normal HPV and Pap tests.

    A final note about genital warts

    Genital warts are a commonly occurring sexually transmitted infection caused by HPV. Infection with some strains of HPV can lead to cancer. The virus can remain in your body even if no visible warts remain after treatment.

    Talk to your doctor if you have any lesions on your genital area that look like genital warts. Moreover, it’s vital to discuss them with your partner. This can help protect your partner from getting the infection.

    History of updates

    Current version (24 December 2019)
    Reviewed by Olga Adereyko, MD, Primary Care Physician, General Practitioner, Medical Consultant
    Published (24 December 2019)

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