Genital warts

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

If warts do appear, this can happen 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. These may appear anywhere in or on the genital or anal area, on their own or in groups.

• If you have a vagina, warts are most likely to appear on the vulva (the external part of the genitals), and may sometimes be found on the cervix (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 be found on the upper thighs, and around or inside the anus.
• You might see or feel warts, or a partner might notice them. Often, they’re so tiny, or so difficult to see, that you don’t know you have them.
• They can be flat or smooth small bumps or quite large, cauliflower-like lumps.
• Genital warts are usually painless but may occasionally itch and cause some inflammation (pain, redness 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.

How will I know if I have genital warts?

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

Even if you or a partner feel sure you have genital warts, it’s still advisable to have a check-up to confirm this.

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

• you or a partner have a new diagnosis of genital warts
• 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 have another STI
• you're pregnant or planning a pregnancy.

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 which can affect different parts of the body.

Approximately 30 types of HPV can live in and around the genital and anal areas, but most genital warts are caused by just two types of HPV (types 6 and 11). The types of HPV which cause warts do not usually cause cancer (see Do genital warts cause cancer in the Other things to know section below).

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

HPV is easily passed on through sexual contact. Anyone who’s sexually active can get the virus and pass it on.

• HPV can be passed on during vaginal or anal sex.
• It can also be spread by skin to skin contact, so it can be passed on by any close genital contact even if you don’t have vaginal or anal sex.
• HPV can’t pass through a condom but as condoms don’t cover the whole genital area it’s possible to infect genital skin that’s not covered by the condom.
• 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 develop warts in the mouth or throat, or on the lips, from oral sex.
• Warts can be easily spread from the genital area to the area around the anus 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. See What if I get genital warts when I’m pregnant? in the Other things to know section below.

You can’t get genital warts from kissing, hugging, sharing baths or towels, from swimming pools, toilet seats or sharing cups, plates or cutlery.

How soon after sex can I be checked for genital warts?

You can get a check-up for genital warts as soon as you notice any signs or symptoms (see the Signs and symptoms section above). There’s no routine test for the types of HPV that cause genital warts.

What does the check-up involve?

The main check for genital warts is for a doctor or nurse to look at the warts. They may do this using a magnifying lens.

• You may also need an internal examination of the vagina or anus to see if there are any warts 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.
• There’s no routine blood test for HPV.

How accurate is the check-up?

Most warts are easily diagnosed by looking at them.

Where can I get a check-up?

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

A check-up can be done at:

• a sexual health clinic or genitourinary medicine (GUM) clinic
• some general practices; ask a doctor or practice nurse
• some contraception clinics and young people's services.

For information on how to find a service see Where to get help.

Will I have to pay for the check-up and treatment?

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

Do I need to have a check-up to see if the warts have gone?

If you're having treatment for the warts at a clinic or general practice, 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.

What's the treatment for genital warts?

There are a variety of ways to treat genital warts. A doctor or nurse will discuss the different choices with you. The treatment they recommend will depend on what the warts look like, how many you have and where they are. The 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 apply the cream or liquid for them. 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 wart treatments may be uncomfortable but they’re not usually painful. Treatments can cause irritation and soreness for a couple of days, so the doctor may recommend you use some pain-relieving drugs.

• 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.

What happens if genital warts aren't treated?

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 the way your immune system works, making it difficult to fight off infection.

It's not usually harmful to your health if the warts aren't treated but you may find them uncomfortable and may not like the way they look. Treating the warts may reduce the risk of you passing them on to someone else.

How quickly will the warts go away?

How effective the treatment is depends on the size and type of warts, the treatment that’s used and how good your immune system is at fighting 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 a number of times. 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 about this. 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 come back (see below).

Will the warts come back?

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 you’re told that 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.

Will I know how long I've had genital warts?

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

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 general practice.

How soon can I have sex again?

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 risk of passing on HPV to a partner. Avoiding sex or using condoms while the warts are present, and for the first 3 months after they’ve gone, may help to reduce the risk of passing on HPV. 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.

Will genital warts affect my fertility?

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

What happens if I get genital warts when I'm pregnant?

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.

Do genital warts cause cancer?

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 website.

Is there a vaccine against genital warts?

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 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.

It's possible to get a sexually transmitted infection (STI) by having sex with someone who has an STI, even if they have no symptoms.

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

If you have a sexually transmitted infection they’ll also help prevent you from passing it on to someone else.

• Use condoms or internal condoms every time you have vaginal or anal sex. They help protect you from other STIs and may give some protection from getting, or passing on, genital warts, particularly if they’re used while warts are present and for the first 3 months after they’ve gone.
• If you have oral sex (going down, giving head), use a condom to cover the penis, or a dam (latex or plastic square) to cover the vulva (external female genitals) or anus.
• How to use condoms.
• Avoid sharing sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them.