Genital warts are a common sexually transmitted infection (STI) caused by a virus called human papillomavirus (HPV). They show up as small bumps or growths on the skin in the genital area.

What Causes Genital Warts?

Genital warts are caused by certain types of HPV. There are many types of HPV, but the types called 6 and 11 are the ones that make most genital warts. These types are known as low-risk types because they rarely lead to cancer.

HPV is a virus that can be passed from one person to another. It spreads mostly through skin-to-skin contact during sexual activities, including vaginal, anal, and oral sex. You can get the virus even if the person you are with does not show any signs of warts. This is because HPV can be active without causing any visible bumps. In rare cases, a mother can pass the virus to her baby during childbirth.

What Do Genital Warts Look Like?

Genital warts may look different from one person to another. They are usually small, soft bumps that can be flat or raised. Sometimes, the bumps group together and form a shape that looks like a cauliflower. They are usually flesh-colored or light gray and can appear on the penis, scrotum, groin, or around the anus in men. In women, they might appear on the vulva, inside the vagina, on the cervix, or near the anus.

Most of the time, genital warts do not hurt. However, they might cause some itching, discomfort, or even slight bleeding if they are rubbed during sex or by clothing. Some people might not notice any symptoms at all and only see the warts when they are checked by a doctor.

How Are Genital Warts Diagnosed?

Doctors can usually tell if you have genital warts by looking at them during a physical exam. They look for the small bumps in the genital area. Sometimes, a doctor might use a special magnifying tool called a colposcope to look more closely at warts on the cervix or other areas.

In some cases, the doctor may apply a mild vinegar solution to the area. This solution can make the warts turn white, which helps the doctor see them better. If the appearance of the warts is not clear, the doctor might take a small piece of the tissue (a biopsy) and send it to a lab for testing.

Women are advised to have regular Pap tests (or Pap smears). A Pap test can show if there are any changes in the cells of the cervix that might be caused by HPV. This is important because while the types of HPV that cause warts are usually not linked to cancer, other types of HPV can cause cervical cancer.

How Are Genital Warts Treated?

There is no cure for the HPV virus itself, so treatment focuses on removing the warts and relieving any discomfort they cause. Many genital warts go away on their own over time, but treatment can help get rid of them faster and reduce the chance of spreading the virus to others.

Topical Medications

Doctors can prescribe creams or solutions that you apply directly to the warts. Some of these medicines include:

Imiquimod Cream: This cream helps your immune system fight the virus. It is used a few times a week. Some people might notice redness or irritation where the cream is applied.
Podofilox (also called Podophyllotoxin): This medicine destroys the wart tissue. It comes as a gel or solution that you apply at home. It should not be used by pregnant women.
Trichloroacetic Acid (TCA): A doctor applies this acid to the warts during an office visit. It works by burning off the wart tissue. It may cause a stinging feeling when used.
Sinecatechins Ointment: Made from green tea extract, this ointment is used on external warts. It helps reduce the size of the warts but may cause some skin irritation.

Cryotherapy and Other Procedures

If topical treatments are not enough, doctors may use other methods:

Cryotherapy: This treatment freezes the warts with liquid nitrogen. The frozen wart will blister and eventually fall off. You might need more than one treatment.
Electrocautery: In this method, an electric current burns off the wart tissue.
Surgical Excision: The doctor may cut out the warts if they are large or not responding to other treatments.
Laser Therapy: A laser can be used to destroy wart tissue. This is usually reserved for hard-to-treat or widespread warts.

After treatment, warts may come back because the virus stays in the skin. If they return, more treatments may be needed.

How Can You Prevent Genital Warts?

Preventing genital warts means lowering your chance of getting HPV. There are a few important ways to do this:

HPV Vaccination

The most effective way to prevent genital warts is to get vaccinated against HPV. Vaccines like Gardasil protect against the types of HPV that cause most genital warts (HPV 6 and 11) and some high-risk types that can lead to cancer. Health experts recommend that boys and girls get vaccinated at ages 11 or 12. Even if you are already a teenager or young adult, getting the vaccine can still help protect you from new HPV infections.

Safe Sexual Practices

Using condoms every time you have sex can lower your risk of getting HPV. However, condoms do not cover all the skin in the genital area, so they are not 100% effective. Limiting the number of sexual partners and being in a mutually monogamous relationship can also help reduce your risk.

General Health and Hygiene

Keeping your immune system strong can help your body fight off infections, including HPV. This means eating well, getting enough sleep, and avoiding smoking. If you notice any changes in your skin or any unusual bumps, see a doctor right away.

Who Is at Risk for Genital Warts?

Anyone who is sexually active can get HPV and develop genital warts. However, some people have a higher risk, including:

People with Multiple Sexual Partners: The more partners you have, the higher your chance of being exposed to HPV.
People Who Do Not Use Protection: Not using condoms or other protection during sex increases the risk of getting HPV.
Young People: Those who become sexually active at a young age have a longer time to be exposed to the virus.
People with Weakened Immune Systems: Individuals with conditions like HIV or those taking drugs that suppress the immune system may have a harder time fighting off HPV.
Smokers: Smoking can weaken the immune system, making it easier for HPV to cause warts.
Unvaccinated Individuals: People who have not received the HPV vaccine are more likely to get infected by the virus types that cause warts.

What Problems Can Genital Warts Cause?

Most of the time, genital warts do not lead to serious health problems. However, they can cause some issues:

Recurrence: Even after treatment, genital warts often come back because the HPV virus remains in the body.
Emotional Distress: Having visible warts in the genital area can be upsetting and may lead to anxiety or low self-esteem.
Physical Discomfort: In some cases, warts can cause itching, pain, or bleeding, especially during sex.
Pregnancy Issues: In pregnant women, warts may grow larger due to hormonal changes. In rare cases, a baby can get warts during birth.
Cancer Risk: The HPV types that cause warts are not known to lead to cancer. However, other types of HPV can cause cancers, especially cervical cancer in women. That is why regular Pap tests are important.

Important Facts and Numbers

HPV is one of the most common infections in the world. Here are some key facts:

Most people who are sexually active will get HPV at some point in their lives.
In the United States, about 79 million people have HPV, and there are about 14 million new cases every year.
Around 360,000 people in the U.S. are diagnosed with genital warts each year.
Studies show that after the HPV vaccine was introduced, the number of genital wart cases in young people dropped by 50% to 70% in some countries.
Regular screening, like Pap tests for women, helps catch changes early, even if genital warts themselves are not dangerous.

What You Should Do

If you think you might have genital warts or have been exposed to HPV, it is important to see a doctor. Early diagnosis can help you get treatment faster and lower the risk of spreading the virus to others. Your doctor can examine you, make a diagnosis, and recommend the best treatment for you.

Even if you do not have symptoms, getting the HPV vaccine is a good choice. The vaccine not only helps prevent genital warts but also protects against other types of HPV that can cause cancer. Safe sexual practices and regular health check-ups are also key to protecting your health.

Summary

Genital warts are a common STI caused by HPV types 6 and 11. They appear as small bumps in the genital area and are spread through close skin-to-skin contact during sex. Although they are not dangerous and rarely lead to cancer, they can cause discomfort and emotional stress.

Doctors diagnose genital warts by looking at the bumps during an exam. They can treat them with creams, freezing techniques, or other procedures. Because the HPV virus stays in your skin, warts can come back even after treatment.

The best way to prevent genital warts is by getting the HPV vaccine, using condoms, and practicing safe sex. Anyone who is sexually active is at risk, but having multiple partners, a weak immune system, or not being vaccinated can increase your chance of getting the virus.

Even though genital warts are usually not serious, they can sometimes lead to problems like repeated outbreaks or emotional distress. It is important to have regular check-ups and follow your doctor’s advice if you notice any changes.

Sources: Centers for Disease Control and Prevention (CDC), National Library of Medicine, MedlinePlus, World Health Organization (WHO), and Mayo Clinic