Genital warts: information for patients

A clear and simple guide to understanding genital warts, their relationship to HPV, and medical management options.

Summary in 60 seconds

• Genital warts are benign lesions that appear in the genital or anal area.
• They are caused by some types of the human papillomavirus, known as HPV.
• Most are related to low-risk HPV types, especially 6 and 11, which are not the main culprits behind cancer.
• They can appear weeks, months or even longer after contact, so it is not always possible to know when the infection occurred.
• They can appear as small skin-colored, pink, brown, or whitish elevations; sometimes they have a “cauliflower” appearance.
• They don’t always hurt; some cause itching, chafing, slight bleeding, or sexual discomfort.
• The treatment removes visible warts, but there is no treatment that immediately “erase” HPV from the body.
• The HPV vaccine helps prevent new infections, but it does not treat existing warts.
• It is advisable to consult with a specialist to confirm the diagnosis and avoid irritating home treatments.
• Using a condom reduces the risk of transmission, although it does not eliminate it completely because HPV can be present on uncovered skin.

What are genital warts?

Genital warts, sometimes also called condylomata acuminata , are growths on the skin or mucous membranes that appear in the genital, anal, or perianal area. They can be single or multiple, small or more visible, smooth or rough.

The cause is infection with certain types of human papillomavirus (HPV ). There are many types of HPV. Some are considered low-risk because they cause warts, and others are high-risk because they can be involved in the development of precancerous lesions or certain cancers. Genital warts are primarily associated with HPV types 6 and 11, which are considered low-risk for cancer. (Gilson 2020)

Having genital warts does not automatically mean having cancer . However, a person can have more than one type of HPV, so gynecological checkups, cervical screening when appropriate, and medical evaluation remain relevant.

Why do they appear?

Genital warts appear after skin or mucous membrane contact with HPV in the genital or anal region. Transmission can occur during vaginal, anal, or oral sex, and also through skin-to-skin genital contact, even without penetration.

HPV is common. Many sexually active people come into contact with the virus at some point in their lives, but not everyone develops warts. In many cases, the immune system clears the infection without the person noticing any symptoms. CDC 2024

A sensitive but essential point: it is not always possible to know when HPV was acquired or from whom . Warts can appear weeks or months after contact, and in some people the infection may remain asymptomatic for even longer. NHS 2024

Factors that can contribute to the appearance, persistence, or recurrence of this infection include smoking, immunosuppression, pregnancy, the presence of other sexually transmitted infections, and microtrauma from friction, hair removal, or scratching. This does not mean the person has done «something wrong»; it is a common and manageable infection.

What do they look like and what symptoms do they cause?

Genital warts can have different appearances:

• Small bumps the color of the skin, pink, whitish, reddish or brown.
• Flat, raised or rough surface lesions.
• Groups that resemble a “cauliflower”.
• Injuries around the vulva, vagina, penis, scrotum, anus, perineum or groin.
• Occasionally, injuries occur inside the vagina, anal canal, urethra, or, rarely, the mouth or throat.

Many are asymptomatic. When symptoms do occur, they may include itching, tenderness, slight bleeding if irritated, discomfort during sexual intercourse, or a rubbing sensation. In specific locations, they may be associated with discomfort when urinating or changes in the urinary stream.

Not every genital lesion is a wart. Molluscum contagiosum, soft fibromas, normal glands, folliculitis, herpes, syphilis, lichen planus, precancerous lesions, or skin cancer can sometimes be mistaken for one. Therefore, medical confirmation is essential.

What can you do today?

The wisest course of action is to schedule a medical evaluation , ideally with a dermatologist, gynecologist, or urologist. Diagnosis is usually made by observing the lesions; in doubtful cases, the doctor may order a biopsy.

While you are receiving feedback:

• Avoid manipulating, cutting, burning, or scratching the lesions.
• Avoid applying acids, home remedies, or products for warts on hands or feet.
• Consider avoiding sexual relations if injuries are unevaluated, bleeding, painful, or under treatment, until you receive professional guidance.
• Use condoms or latex barriers if you have sex; they reduce the risk, although they do not cover all potentially infected skin.
• Talk to your partner or partners calmly, without assuming guilt or setting exact dates.
• Request or update testing for other sexually transmitted infections if your doctor recommends it.
• If you have a cervix, keep up with cervical screening according to your age, history, and local guidelines.

The HPV vaccine can help prevent new infections from the types included in the vaccine. It does not treat existing warts, but it can protect against HPV types to which a person has not yet been exposed . (CDC 2024)

What NOT to do?

Do not use over-the-counter wart treatments on the genital area. Products for hand or foot warts, such as some keratolytic agents, can irritate or burn the more delicate skin of the genital area. The American Academy of Dermatology recommends that genital warts be treated with targeted and supervised approaches (AAD 2025).

Also avoid:

• Apply vinegar, garlic, lemon, essential oils, or caustic substances.
• Cut away the lesions with scissors, blades, or tweezers.
• Shaving directly over the warts can cause irritation and microtrauma.
• Using antibiotics, antifungals, or corticosteroids without a diagnosis.
• Assuming warts indicate recent infidelity is a mistake. HPV can remain silent.
• Delay the consultation if there is bleeding, pain, rapid changes, or pigmented lesions.

When should I consult?

Consult a healthcare professional if any new lumps appear on your genitals or anus, especially if you don’t have a clear diagnosis.

Look for priority ratings if available:

• Lesions that grow rapidly or change color.
• Spontaneous bleeding or significant pain.
• Ulcers, blisters, or open wounds.
• Genital discharge, foul odor, fever, or pelvic pain.
• Difficulty urinating or persistent changes in the urinary stream.
• Injuries inside the anus, vagina, or urethra.
• Pregnancy.
• Immunosuppression, HIV, transplantation, or use of immunosuppressant drugs.
• History of precancerous lesions due to HPV.
• Doubts about whether the injury could be another sexually transmitted disease.

What does a dermatologist usually do?

The dermatologist usually begins with a clinical interview and examination of the affected area. They may ask about the duration of the condition, symptoms, previous treatments, pregnancy, immune status, HPV vaccination, and previous tests for sexually transmitted infections.

In many people, the diagnosis is clinical. For atypical lesions, such as those that are pigmented, hardened, ulcerated, bleed, unresponsive to treatment, or cause doubt, a biopsy may be indicated. This allows differentiation between warts and inflammatory, precancerous, or cancerous lesions.

Treatment depends on the number, size, location, symptoms, patient preferences, pregnancy, availability, and the practitioner’s experience. CDC guidelines state that there is no single ideal treatment for all warts, nor is there definitive evidence of one option being absolutely superior to all others. CDC 2021

Medical options include:

• Treatments applied by the patient , when the lesions are external and accessible: imiquimod, podophyllotoxin/podofilox or sinecatechins, according to local availability and medical criteria.
• Treatments performed in consultation: cryotherapy with liquid nitrogen, trichloroacetic acid, electrocoagulation, surgical excision or laser in selected cases.
• Follow-up: More than one session may be required. Recurrences are possible, especially in the first few months.

Treating visible warts can improve symptoms, reduce lesion size, and facilitate clinical management. However, treatment does not guarantee that HPV will disappear immediately, nor does it completely eliminate the risk of transmission.

Frequently Asked Questions

Are genital warts cancerous?

• Generally not. Most genital warts are associated with low-risk HPV types, especially types 6 and 11. Even so, a person can have other types of HPV, so it’s advisable to keep up with the recommended gynecological or anal checkups.

Can they disappear on their own?

• Yes, some may shrink or disappear without treatment. Others persist, grow, multiply, or cause discomfort. The decision to treat depends on the size, symptoms, location, patient preference, and medical judgment.

Does the treatment eliminate HPV?

• The treatment removes or reduces visible warts, but there is no treatment that immediately eradicates HPV from the body. In many people, the immune system controls the infection over time.

Can I transmit the virus if I don’t have visible warts?

• Yes, it is possible to transmit HPV even without visible lesions. The risk is usually more evident when there are active warts, but the absence of lesions does not mean zero risk.

Should I tell my partner?

• It’s advisable to discuss it honestly and calmly. It’s not always possible to determine when HPV was acquired. The conversation should focus on care, medical evaluation, prevention, and testing for other infections if applicable.

Does the condom provide complete protection?

• Not completely. Condoms reduce the risk of transmission, but they don’t cover all the genital or anal skin where the virus may be present. Even so, they remain an important preventative measure.

Is the vaccine effective if I’ve already had warts?

• It can help prevent future infections from HPV types included in the vaccine to which the person has not yet been exposed. It does not treat existing warts. Its use depends on age, medical history, and local recommendations.

Bibliography and sources

• Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. Available at: https://www.cdc.gov/std/treatment-guidelines/anogenital-warts.htm
• Gilson R, Nugent D, Bennett K, Doré CJ, Murray ML, Meadows J, et al. 2019 IUSTI-Europe guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol. 2020;34(8):1644-1653. Available at: https://pubmed.ncbi.nlm.nih.gov/32735077/
• Yanofsky VR, Patel RV, Goldenberg G. Genital warts: a comprehensive review. J Clin Aesthet Dermatol. 2012;5(6):25-36. Available at: https://pubmed.ncbi.nlm.nih.gov/22768354/
• Barton S, Wakefield V, O’Mahony C, Edwards S. Effectiveness of topical and ablative therapies in treatment of anogenital warts: a systematic review and network meta-analysis. BMJ Open. 2019;9(10):e027765. Available at: https://pubmed.ncbi.nlm.nih.gov/31676644/
• Gilson R, Nugent D, Bennett K, Doré CJ, Murray ML, Meadows J, et al. Imiquimod versus podophyllotoxin, with and without human papillomavirus vaccine, for anogenital warts: the HIPvac factorial RCT. Health Technol Assess. 2020;24(47):1-86. Available at: https://pubmed.ncbi.nlm.nih.gov/32975189/
• Centers for Disease Control and Prevention. HPV vaccine recommendations. CDC; 2024. Available at: https://www.cdc.gov/hpv/hcp/vaccination-considerations/index.html
• Centers for Disease Control and Prevention. About HPV. CDC; 2024. Available at: https://www.cdc.gov/hpv/about/index.html
• World Health Organization. Human papillomavirus and cancer. WHO; 2024. Available at: https://www.who.int/news-room/fact-sheets/detail/human-papilloma-virus-and-cancer
• American Academy of Dermatology. Genital warts: diagnosis and treatment. AAD; 2025. Available at: https://www.aad.org/public/diseases/az/genital-warts-treatment
• American Academy of Dermatology. Genital warts: tips for managing. AAD; 2025. Available at: https://www.aad.org/public/diseases/az/genital-warts-self-care
• National Health Service. Genital warts. NHS; 2024. Available at: https://www.nhs.uk/conditions/genital-warts/
• National Cancer Institute. HPV and cancer. NCI; 2025. Available at: https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer