Genital Warts and HPV: Diagnosis, Treatment, and More

Health Professional

Human papillomavirus (HPV) is a collection of 150 different types of viruses, according to the Centers for Disease Control and Prevention (CDC). Some of these viruses cause cancer in both men and women, including cervical cancer and some oral cancers. Other types of HPV can cause genital warts — growths around the anus, vulva, penis, or vagina.

HPV is the most common sexually transmitted infection (STI) in the United States. There are 14 million people infected every year in the United States alone. In fact, it’s so common that almost everyone will get HPV at some point if they haven’t vaccinated, according to the CDC.

The virus is spread through sexual contact, like oral, anal, or vaginal sex. However, it can also be spread with just skin-to-skin contact, according to the American College of Obstetricians and Gynecologists (ACOG). It can be spread even if the person you’re having sex with does not have any symptoms. In fact, you may have HPV and not know it for years.

What are genital warts?

HPV is so named because of the warts or papillomas that form with some types of the virus. These growths of tissue can appear years after you have been infected. The actual warts can be big or small, raised or flat, and even cauliflower-like in shape. They are not painful in general, or to the touch, which can lead some people to discount them. Your doctor or nurse will usually make a diagnosis by looking at them during an exam.

In women, the most common places to find these warts include the labia, the vagina, and the anus. The warts may be flesh-colored or slightly discolored, and the texture may be slightly rough. Men may have warts on their penis or inside or around their anus.

Treatments for genital warts

There are treatments available for genital warts. These can include topical medications applied over the course of several months, like imiquimod and podophyllotoxin. These medications provoke an immune response to treat the warts and kill the infected tissue.

Surgical treatment of warts is often only used for more complex cases, depending on where the warts are located (for example, if they're in an area like the urethra or cover areas too large to be treated with medications alone), whether they have other cancerous signs, and whether they've been resistant to medical therapy.

There are various types of surgical treatments available. For example, cryotherapy (freezing the warts) can be done in the office. However, you will usually go to the operating room and use some form of anesthesia for cautery (burning the warts), excision (cutting the warts), or laser treatments (light energy to destroy the warts). Each of these methods is slightly different and used in different cases. Your doctor can explain the choices and help you understand which is best for your case.

Even with treatment, the warts may come back again. This is because the doctor can only treat what is seen, and sometimes the virus is not active during the time of treatment. For this reason, some patients will choose not to treat the warts.

The emotional impact of genital warts

No one is thrilled to learn they have genital warts. It can be distressing to try to figure out when and how you were infected. Some research has found that having genital warts can increase women’s risk of having a lower health-related quality of life. It can also impact the sexual activity of those infected; however, women were more likely to be impacted and the level of impact depended on their age, the number of warts, and relationship status.

One study showed that only about 81 percent of men diagnosed with genital warts sought treatment. Because men were less likely to experience a negative impact on their quality of life, they were more likely to spread HPV rather than seek treatment, often due to embarrassment.

Protecting yourself from genital warts: The HPV vaccine

The best way to treat genital warts is to avoid HPV, and, luckily, there is a clear way to reduce your risk of getting the virus. Since 2006, there have been HPV vaccines available. These vaccines are considered safe and effective at preventing the transmission of HPV. Generally, vaccines are used for men and women between the ages of 9 and 26. The number of shots in a series to help prevent HPV varies based on your age.

Because there are many types of HPV, it’s important to know that the vaccinations are aimed at specific viruses that create the most risk of cancer along with the types that cause the most cases of genital warts. For example, the most recent vaccine, Gardasil 9, protects against seven high-risk cancer-causing types along with the two types that cause 90 percent of genital warts cases, according to the American Cancer Society.

The side effects related to the vaccination are fairly typical of any vaccine, according to the CDC. They can include:

  • Pain or redness at the site of the injection
  • Tiredness
  • Headache
  • Nausea
  • Muscle or joint pain
  • Fever

Doctors also recommend that you limit the number of sexual partners you have and wear male or female condoms when having sex, according to ACOG. They also acknowledge that this will not be 100 percent effective at preventing the spread of HPV. Additionally, the World Health Organization recommends circumcision for men as a preventive measure.

In the end, it’s important to realize that STIs like HPV are rampant. You don’t know who is and who is not infected simply by looking. This means that you should consider long-term protection with the use of one of the HPV vaccines, and always use condoms during sexual activity.