Genital warts appear on the skin of the genital and anal area. They’re caused by a virus called human papillomavirus (HPV).

There are over 100 different types of HPV but most genital warts are caused by just 2 types of HPV (types 6 and 11). The types of HPV which cause warts do not usually cause cancer.

Warts on the hands and the soles of the feet (verrucas) are caused by different types of HPV which don’t affect or spread to the genital area.

HPV is easily passed on through sexual contact. Anyone sexually active can get and pass it on.

• HPV can be passed on:
  • during vaginal/frontal or anal sex
  • during any genital contact or skin-to-skin contact with skin that has HPV in it
  • by sharing sex toys
• HPV can’t pass through a condom but if the virus is in any skin that’s not covered by a condom, it can be passed on
• HPV is more likely to be passed on when warts are present but it’s still possible to pass it on in the absence of warts
• It’s possible, but very rare, to get warts in the mouth or throat, or on the lips, from oral sex
• Warts can be easily spread from the genitals to the anal area without having anal sex
• If you’re pregnant and have genital warts at the time, it’s possible to pass HPV to the baby at birth, but this is rare

You cannot get genital warts from hugging, sharing baths or towels, from clothing, from swimming pools, toilet seats or sharing cups, plates or cutlery.

Most people with HPV infection won’t develop visible warts. This means you may not know whether you or a partner have HPV.

If noticeable warts do appear, this can be from 3 weeks to many months, or even years, after coming into contact with HPV.

You might notice small, fleshy growths, bumps or skin changes in or on the genital or anal area, on their own or in groups.

• If you have a vagina/front hole, warts are most likely to appear on the vulva (the external part of the genitals) and may be on the cervix – the entrance to the uterus (womb) – or in the vagina
• If you have a penis, warts are most likely to appear on the penis or scrotum and may sometimes be found on the urethra – the tube where urine (pee) comes out
• Genital warts may also appear on the upper thighs, and around or inside the anus
• They can be flat or smooth small bumps or quite large, cauliflower-like lumps
• They’re usually painless but may occasionally itch or cause some pain or soreness
• They may cause bleeding from the anus or from the urethra
• If your flow of urine (pee) is distorted this may be a sign of warts in the urethra

Not all skin changes around the genitals are genital warts. They may be a common skin condition like pearly penile papules (harmless, non-infectious bumps on the penis) or skin tags.

A doctor or nurse can usually confirm whether you have warts by looking at the affected area.

Even if you’re sure you have genital warts, it’s advisable to have a check-up as soon as you notice signs or symptoms.

There’s no routine blood test for the types of HPV that cause genital warts.

• A doctor or nurse will check for warts. They may do this using a magnifying lens
• You may need an internal examination of the vagina/front hole or the anus to see if warts are inside
• Very rarely, it may be necessary to take a biopsy (small sample) of the wart for closer examination.
• Depending on the area being examined, a local anaesthetic may be used

It’s possible to have more than one sexually transmitted infection (STI) at the same time. A
check-up for other STIs is also advised if:

• you or a partner have a new diagnosis of genital warts or any other STI
• you or a partner have, or think you might have, any other symptoms
• you’ve recently had sex without a condom with a new partner
• you or a partner have had sex without a condom with other partners
• a sexual partner tells you they have an STI
• you’re pregnant or planning a pregnancy

Most warts are easily diagnosed by looking.

There are different services you can go to. Choose the one you feel most comfortable with.

A check for genital warts can only be done when you have visible symptoms on the skin.

A check-up can be done at:

• a sexual health clinic or genitourinary medicine (GUM) clinic
• some GP surgeries
• some contraception clinics and young people’s services

Free online testing services are available in many areas. They can test for some common sexually transmitted infections and in some areas they may offer an online check for genital warts.

All check-ups and treatment are free through NHS services.

A doctor or nurse will discuss treatment options with you. The treatment they recommend will depend on what the warts look like, how many you have and where they are.

Options include:

• Putting cream or a liquid on to the warts. You can usually do this yourself at home, a few times a week for a number of weeks. Some people ask a partner to help. Ask the doctor or nurse if the treatment will affect condoms, diaphragms or caps
• Freezing (cryotherapy)
• Heat (electrocautery), using local anaesthetic
• Surgery, using local anaesthetic
• Laser treatment, using local anaesthetic
• Some people with internal warts may be offered the choice of no treatment, as internal warts can improve without active treatment

Some treatments may be uncomfortable, but they’re not usually painful. Treatments can cause irritation and soreness for a couple of days, so you may be advised to use painkillers.

• Avoid perfumed soap, bath oils, bubble baths, creams and lotions until treatment is completed as these may irritate the skin
• Tell the doctor or nurse if you’re pregnant or think you might be. This may affect the treatment you’re given, and some treatments shouldn’t be used when you’re pregnant
• As genital warts are caused by a virus and not bacteria, antibiotics won’t get rid of warts
• Wart treatments sold at the pharmacy aren’t suitable for genital warts
• Complementary therapies (treatments outside of mainstream healthcare) can’t cure genital warts

How effective the treatment is depends on the size and type of warts, the treatment used and how well your immune system fights the virus.

For most people, warts go away within a few weeks or months of starting treatment.

Sometimes the warts can be stubborn, and treatment may have to be repeated. It can also take a while for the treatment to start working. If you feel your warts aren’t responding to treatment, speak to your nurse or doctor. They may recommend a change in treatment.

Evidence suggests that smokers respond less well to treatment than non-smokers.

If the first treatment doesn’t work, another treatment may be tried. Sometimes the warts go but then come back – see below for Will the warts come back?

If you’re having treatment for the warts at a clinic or GP surgery, it’s important to return regularly for treatment. This is so the doctor or nurse can check that the treatment is working or advise if a change of treatment is needed.

Many clinics don’t ask you to return if you think the warts have cleared up. They’ll always be happy to see you if you want advice or to be checked.

Some people only ever get one episode of genital warts. For many others, the warts can come back.

If you do get new genital warts, it’s not possible to say if these are due to the original infection or a new infection.

If left untreated, genital warts may disappear, stay the same, or grow larger in size or number.

Over time, most warts will eventually go away without treatment. For some people this may take a long time, particularly if you have an illness that affects your immune system.

It’s not usually harmful to your health if warts aren’t treated but you may find them uncomfortable and dislike how they look.

Treating the warts may reduce the likelihood of you passing them on to someone else.

You may be advised to avoid sex until the warts have cleared up to help protect the affected area.

Sex without a condom when you have warts can increase the likelihood of passing on HPV to a partner. To reduce the likelihood, use condoms or avoid sex while the warts are present, and for the first 3 months after they’ve gone.

The condom needs to cover the affected area of skin.

If you’re using a cream or liquid to treat the warts, don’t have sex straight after applying the treatment, and ask your doctor or nurse if the treatment will affect condoms.

It’s not possible to tell how long you’ve had HPV for.

If you feel upset or angry about having genital warts and find it difficult to talk to a partner or friends, don’t be afraid to discuss how you feel with the staff at the clinic or GP surgery.

If you have genital warts, then it’s a good idea for your current or most recent sexual partner(s) to have a check-up for sexually transmitted infections and to see if they have any warts that they haven’t noticed. The staff at the clinic or GP surgery can discuss this with you.

Tell the doctor or nurse that you’re pregnant as this may affect the treatment they can offer you.

• During pregnancy, warts often grow in size and number. They may appear for the first time or they can appear again after a long time of having no warts
• They can be treated safely during pregnancy, though treatment may be delayed until after you’ve given birth
• If the warts get very big, they may be removed to avoid problems during birth. If this isn’t possible, you may be advised to have a caesarean delivery but this is very rare
• HPV can be passed to the baby during a vaginal delivery but this is rare
• Warts may clear by themselves during the first few months after giving birth

No. Your fertility won’t be affected by having genital warts (or the HPV that causes them).

It’s extremely rare for genital warts to cause cancer. The types of HPV (types 6 and 11) that cause most visible genital warts are only very rarely associated with cancer.

Some other types of HPV can cause cell changes that may lead to cancer. For more information about HPV and cervical cancer see the Jo’s Trust – JosTrust.org.uk.

Yes. The HPV vaccine protects against HPV 6 and 11 (which cause genital warts) and HPV 16 and 18 (types of HPV that can cause cell changes that lead to cancer).

In the UK, all 12-13-year-olds (11-12-year-olds in Scotland) are routinely offered the HPV vaccine at school.

Young people who were eligible to be vaccinated at school but missed the vaccine can be vaccinated for free up to the age of 25.

Men who have sex with men and are aged up to and including 45 can be vaccinated for free at sexual health and HIV clinics.

Some other people, including some trans people, sex workers, and people living with HIV may be able to have the vaccine for free – ask your doctor or nurse.

Use external condoms or internal condoms (female condoms) every time you have vaginal/frontal or anal sex. They help protect you from other STIs and may give some protection from getting or passing on genital warts, particularly if used while warts are there and for the first 3 months after they’ve gone.

The following measures will help protect you from getting and passing on genital warts and herpes and most other sexually transmitted infections (STIs), such as HIV, chlamydia and gonorrhoea.

• Use external condoms or internal condoms (female condoms) every time you have vaginal/
  frontal or anal sex. They help protect you from other STIs and may give some protection from
  getting or passing on genital warts, particularly if used while warts are there and for the first 3
  months after they’ve gone
• If you have oral sex (going down, giving head), the advice is to use a condom to cover the
  penis, or a dam (latex or plastic square) to cover the vulva (external female genitals) or the anus
• If you’re not sure how to use condoms correctly – see our guide to using condoms
• Avoid sharing sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them
• Before having sex without a condom, make sure you and any new sexual partner both get tested for STIs.