Genital warts

What are genital warts?

Genital warts, also called condyloma acuminata, anogenital warts or HPV, are warts found on or near the genitals or anal area that are linked to infection by a virus from the human papillomavirus (HPV) family. 

Genital warts can be found:

• On and inside the genitals

• In the anus and the anal canal

• In the throat

There are lots of different subtypes of HPV. Some of these subtypes cause genital warts, while others can be a risk factor for cancer of the cervix, anus and throat. The same person can be infected with several types of HPV during their life, sometimes by the same type multiple times. 

In about 10-30% of people, infections resolve on their own in a few months, but in others the infection persists and causes visible lesions or ‘warts.’

What are the symptoms of genital warts?

Genital warts usually cause no symptoms at all. Often it’s the appearance that prompts people to get them checked out. 

What do genital warts look like?

They usually look like small growth resembling a cauliflower. They are typically quite small but can group together so they appear larger. Sometimes they can become irritated, bleed or itchy if they rub or, if they are located in the urethra they can cause problems with urinating. 

Complications linked to genital warts

Genital warts usually don’t lead to any other issues. It’s important to be tested for other STIs as they can co-exist. 

The HPV virus can also sometimes lead to changes in the cells that can lead to cancer, most commonly cervical cancer. 

Cervical screening is offered to all those with a cervix between the ages of 25 and 64 years old. This tests for the presence of the types of HPV that can cause cancer. You’ll usually be offered screening every 3-5 years.

What causes genital warts?

HPV, the virus causing genital warts, can be spread several different ways. 

During sex

HPV viruses can be transmitted through any direct skin contact during sex, for example through:

• Oral sex (contact of the mouth with the penis, vulva, vagina or anus)

• Vaginal sex 

• Anal sex Rubbing genitals together

• Sharing sex toys

Once you have the virus, it can also spread from one part of your body to another part.

In pregnant women

A mother can transmit the infection to her child during childbirth, but this is very rare.

How are genital warts diagnosed?

The appearance of genital warts alone is often enough to make a diagnosis. Your doctor might ask you some personal questions. It’s important for them to understand your current and previous sexual partners, any contraception you use and your symptoms. 

Sometimes, your doctor might need to examine you. If the genital warts are inside your body, you may be advised to have a proctoscopy (a look inside the anus) or a meatoscopy (a look inside the urethra) to make sure nothing is missed. If you have female genitals you may have an examination with a speculum. 

How are genital warts treated?

The treatment for genital warts aims to completely get rid of them. There are a few different ways that this can be achieved.

Watch and wait

Overall, genital warts are usually cleared by the body within 2 years. In 30% of people, the warts will resolve within 6 months.

Medication

A doctor can prescribe you a cream to apply to the affected area. 

STI testing

Genital warts can co-exist with other STIs so your doctor may refer you to a specalist sexual health clinic for more testing.

How can I prevent genital warts?

Condoms

Condoms can help prevent HPV transmission, but they don’t cover the entire genital area, so there’s still a risk of catching the virus. 

Vaccination

There’s an effective vaccine to prevent HPV infections. The NHS has an HPV vaccination programme for girls and boys 12-13 years old. 

In 2022, the NHS is using a vaccine called Gardasil 9 which not only protects against HPV 6 and 11, the strains which cause genital warts, but also 16 and 18, which cause most cases of cervical cancer. 

For maximum protection, a booster vaccine is needed 6-24 months after the first jab. If you missed the vaccination, get in touch with a doctor as there may be a catch-up programme available. 

When should I see a doctor about genital warts?

If you suspect you might have genital warts, make an apppointment with a doctor or a sexual health clinic. 

It’s also important to get regular cervical screening appointments. If you have a cervix and haven’t been offered an appointment, speak to a doctor. 

How can Livi help?

A Livi doctor can talk to you about your symptoms. Examination on video is not possible, given the location of genital warts so you might be advised to visit a sexual health clinic for further diagnosis.