Genital Warts

Genital Warts are a form of HPV

What Is HPV?

HPV stands for human papilloma virus. There are more than 100 types of HPV. Some produce warts — plantar warts on the feet, common hand warts, juvenile warts, butcher's warts, and genital warts.

About 30 types of HPV can infect the genital area — the vulva, vagina, cervix, rectum, anus, penis, or scrotum.

• Some types may cause genital warts.
• Some types may cause changes in cells. These types increase the risk of cervical and certain other cancers.
• Most types seem to have no harmful effect at all.

This brochure is about the types of HPV that cause genital warts.

How Many People Have Genital Warts?

Between 500,000 and one million new cases of genital warts occur every year.

How Are Genital Warts Spread?

Vaginal, anal, and oral sex play spread genital warts. Genital warts often grow more rapidly during pregnancy or when a person's immune system is weakened by

• diabetes
• HIV/AIDS
• chemotherapy
• Hodgkin's disease
• taking anti-rejection drugs after an organ transplant

How Long Does It Take For Genital Warts To Appear After A Person Gets Infected?

Warts usually develop three weeks to six months after infection. But it may take longer.

How Can I Avoid Getting Genital Warts?

• Abstinence is the only 100 percent-effective way to avoid infection.
• Use condoms every time. They can reduce the risk of genital warts but they are not as effective against HPV as they are against more serious infections, such as HIV.
• Protect your immune system with a healthy lifestyle.
• Stop smoking. Smokers may be more likely to develop genital warts than nonsmokers. They are also more likely to have warts recur.

How Can People With Genital Warts Avoid Spreading Them?

People should stop having intimate contact as soon as they think they have genital warts. They should seek treatment immediately.

What Do Genital Warts Look Like?

They often are flesh-colored, soft to the touch, and look like miniature cauliflower florets. Usually they grow in more than one place and may cluster in large masses. Genital warts usually are painless but may itch.

You might see or feel genital warts in your vagina, vulva, cervix, penis, anus, or urethra. Although less likely, it is possible to have them in your mouth, on the lips, tongue and palate, or in the throat.

Not all bumps are warts
Checking yourself is not the best way to find out if you have warts. Other infections that look like genital warts are treated differently.

Secondary syphilis, hemorrhoids, skin tags, and, rarely, certain skin cancers, can look like genital warts.

Conditions on the penis that resemble warts include

• Tyson's glands
• lymphoceles
• Fordyce spots
• pearly penile papules, which appear in one out of three men

Podofilox and imiquimod are prescribed for use at home. A clinician applies other treatments, such as podophyllin, TCA, and BCA. Some treatments can cause discomfort. And some cannot be used during pregnancy.

Genital warts also may be removed with cryotherapy (frozen off). They may be electrocauterized (burned off). Or they may be removed with surgery or with lasers. Less commonly, they are treated with injections of interferon or 5-fluorouracil/epinephrine.

How Are Genital Warts Diagnosed?

Only clinicians can correctly diagnose genital warts. In women, genital warts are often seen during a pelvic exam. Unfortunately, men are seldom examined for sexually transmitted infection, unless they complain of symptoms. Women and men with more than one sex partner — or whose partners have more than one sex partner — should have regular exams for sexually transmitted infections, including genital warts.

Diagnosing Other HPV Infections

HPV infections that cannot be seen with the naked eye may be seen with a variety of clinical instrument

• Pelvic exam: a colposcope may be used to magnify cervical and vaginal tissue.
• Pap test: may reveal precancerous conditions of the cervix that are caused by HPV. Early treatment can prevent cancer of the cervix.
• Microscopic examination of tissue sample: a new type of test — Hybrid Capture II® — can find very small amounts of HPV in fluid or tissue samples. Only a clinician can give the test, and some health insurance policies will pay for it. This test is not needed routinely for most people. Even a test that shows the presence of HPV does not necessarily mean there is any health risk. A person who has HPV but no symptoms does not usually need treatment — unless there is an abnormal Pap test or genital warts.

In some cases, an HPV test may help clinicians judge a woman's risk of HPV-related cervical disease, especially if her Pap test is abnormal. Testing for HPV in certain situations is being studied to see if it can help screen for cervical cancer.

How Are Genital Warts Treated?

Very often, genital warts fade away by themselves. But sometimes they need to be removed. Warts can be removed with various treatments. There are several chemicals that can be applied directly to genital warts:

• podofilox
• imiquimod
• podophyllin
• trichloroacetic acid (TCA)
• biochlroacetic acid (BCA)

Podofilox and imiquimod are prescribed for use at home. A clinician applies other treatments, such as podophyllin, TCA, and BCA. Some treatments can cause discomfort. And some cannot be used during pregnancy.

Genital warts also may be removed with cryotherapy (frozen off). They may be electrocauterized (burned off). Or they may be removed with surgery or with lasers. Less commonly, they are treated with injections of interferon or 5-fluorouracil/epinephrine.

Is There A Cure For Genital Warts?

Most people are cleared of warts by the first series of treatments. Warts recur for some people, however, during several months after treatment — especially if they smoke cigarettes. And some people continue to have recurrences after long periods of time.

What Happens If Genital Warts Are Not Treated?

They can disappear, stay the same, or grow in size and in number. Genital warts can cause sores and bleeding — which can increase the risk of HIV infection.

Do Genital Warts Cause Cervical Cancer?

No. The types of HPV that cause genital warts do not cause cancer. But people sometimes have more than one HPV infection at a time. And warts may be a sign of infection with more serious types of HPV. Pap tests are essential for women whether or not they have warts.

What If A Pregnant Woman Has Genital Warts?

If a pregnant woman has ever had genital warts, she should tell her clinician. A clinician can remove warts before the birth to keep them from bleeding during delivery. A cesarean section may be needed if warts are likely to bleed heavily.

Very rarely, women transmit genital warts to the fetus during vaginal delivery. This can result in serious medical conditions for the newborn, including problems with breathing and severe, sometimes fatal, developmental disabilities.

Where Can I Get More Information About HPV?

Contact your doctor, clinician, public health department, or local Planned Parenthood center for information and/or referral. A newsletter for people with genital HPV infection, HPV News, is available from

The American Social Health Association
P.O. Box 13827
Research Triangle Park, North Carolina 27709

You can also call the CDC National Sexually Transmitted Disease Hotline at 1-800-227-8922.