Genital Warts (venereal warts, HPV)

What are genital warts?

This sexually transmitted disease (STD) infects the skin. Genital warts are also called venereal warts or HPV.

What causes genital warts?

Genital warts are caused by one of the most common viruses in the United States - the human papillomavirus (HPV). There are more than 100 types of HPV. Over 40 types can infect the genital area, mouth or throat.

How is HPV spread?

HPV is spread when infected skin touches an area of uninfected skin (called skin-to-skin contact). You can get HPV from someone who has warts on his or her mouth, skin or genitals. The virus can still rub off a person's skin even when he or she has no warts that you can see. Remember: You can get or give warts even when both of you have no signs or symptoms.

HPV cannot be spread by touching hard surfaces, like a doorknob or toilet seat. It also cannot be passed by sharing clothes or towels.

What problems can HPV cause?

Certain types of HPV can lead to cervical cancer (the cervix is the narrow, open end of the uterus) in females, or cancer of the penis in males. Some types of HPV may also lead to anal cancer.

More commonly, HPV causes genital warts, which are soft, fleshy bumps that vary in size and shape. They can appear on or around the penis or the scrotum (the pouch of skin that contains the testicles). They can also appear on or around the vagina, anus, mouth or inside the body where they cannot easily be seen. The warts will be the color of your skin and cauliflower-shaped. Most people with genital warts do not have warts that can be seen with the naked eye.

In some pregnant females, or people with HIV, warts can become quite large. Some pregnant females with large warts may need a Cesarean delivery (C-section).

If a pregnant female has genital warts when she gives birth, the virus can sometimes infect the infant. It is very rare, but the infant may get warts inside their mouth or throat a few weeks after birth. This is most common in infants of young females who get HPV for the first time late in their pregnancies.

What are the signs and symptoms?

Most people with the genital wart virus (HPV) have no signs or symptoms of infection. When someone does have signs of infection, the warts:

  • Usually appear 1 to 3 months after someone is exposed, but it may take longer.
  • Begin as small red bumps that may grow larger.
  • Can appear on any damp or moist areas of the body. This includes the vagina or vulva, penis, and anus.
  • Are usually painless, but if the warts are injured, they may become painful or tender when touched.

Sometimes the virus may cause an unusual fluid (discharge) from the vagina or an itchy vulva. The vulva is the outer part of a female's genitals.

How will I know if I have genital warts?

If you have warts or red bumps on your genitals, you should visit your health care provider for a checkup. Your provider can usually look at the area and tell you if they are genital warts. Your provider may do additional tests based on your age.

How can I prevent HPV?

Not having sex (abstinence) is the only sure way to avoid infection. If you are sexually active, you can lower your chances of giving or getting genital warts by limiting the number of people you have sex with. Latex or polyurethane condoms should be used each time you have oral, vaginal or anal sex. Another option is using a female condom during vaginal sex or dental dams during oral sex. You should not use a male and a female condom at the same time.
           
Using condoms will not totally stop the risk of giving or getting genital warts because HPV may appear on parts of the body not covered by the condom. Condoms also help prevent the spread of other STDs including HIV, the virus that causes AIDS.

There is currently a vaccine (Gardasil®) that protects against genital warts. This vaccine protects against 2 types of HPV that cause most genital warts. It also protects against the 2 types of HPV that cause most cervical cancers in females. The vaccine is given in 3 doses. It is available for males and females age 9 through 26 years. Doctors recommend that the vaccine be given before someone becomes sexually active (before they can be exposed to HPV).The vaccine does not prevent or treat genital warts or cervical cancer if someone is already infected.

Another vaccine (Cervarix®) protects against the 2 types of HPV that cause most cervical cancers in females. This vaccine does not protect against genital warts. It is recommended for females age 9 through 26 years. It is not currently available for boys and young men.

Is there a cure?

No. HPV is a chronic, lifelong infection. However, as many as 1 out of every 3 people with genital warts find that they go away on their own - usually within 2 years. If you want your warts removed, do not do it yourself. A health care provider may be able to:

  • Freeze the warts with liquid nitrogen, or
  • Use laser surgery, or
  • Destroy the warts with a chemical or acid medicine.

Your provider may prescribe a medicine that you can apply yourself. It is called imiquimod (I mi kwi' mod) or Aldara™ cream. Aldara™ helps your body to destroy the virus. You can apply the medicine directly to the warts. However, you should not use Aldara™ for warts on the cervix or inside the vagina or anus.

These options only treat the warts. They do not destroy the virus or the infection. Even if your warts disappear, they may return because the virus may be hidden in nearby, normal looking skin.

What about my partner(s)?

HPV is an STD. Because of this, your sex partner(s) should be checked for symptoms. Even though your partner(s) may not have symptoms that can be seen, he or she still needs to be checked for HPV and other STDs.

When can I have sex again?

You should wait to have sex for 2 weeks after the warts have gone away and the area has healed. You should also tell your current and future sex partner(s) that you have genital warts. Remember: you can spread HPV even when you do not have any symptoms or cannot see any warts.

Am I at risk for other STDs including HIV?

You may be at risk for other STDs, including HIV, because they can all be passed from person to person during sex. If you are sexually active, you and your partner(s) should get a full physical checkup. This includes a complete sexual history and testing for common STDs. You should be checked for gonorrhea, Chlamydia, syphilis, genital herpes, genital warts, trichomoniasis, viral hepatitis and HIV.

The test results and any treatment will be kept absolutely confidential. No one can find out your results, except you. If you are under 18, you can be checked and treated without getting your parent's permission.

To learn more

If you have any more questions about genital warts, or you want to know how to get tested, call your local health department or family planning program.

You can also find a testing center near you at www.findSTDtest.org or by calling 1-800-541-2437.

For more information on HPV and men, visit the CDC's "HPV for Men" fact sheet.