Genital Warts

Expert Diagnosis and Treatment

Genital warts usually appear 2-3 months after infection, but gaps up to 1 year have been reported.

Genital warts are small fleshy lumps or growths that appear around your genitals or anal area. They are the result of a viral skin infection, the human papilloma virus (HPV), and are the second most common sexually transmitted infection in the UK after chlamydia.

They pose no risk to your health and are generally painless, although may be unsightly and itchy.

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What causes Genital Warts?

You can catch genital warts from vaginal or anal sex, or skin to skin contact with someone who has them, or has had them in the past.

Symptoms do not usually arise immediately, and you may have the virus for months or even years before the warts first appear. Although you are most contagious when the warts are present on the skin, you can still catch and pass on genital warts before, or after, the warts are present.

Genital warts are the result of a viral skin infection, the human papilloma virus (HPV), which can affect many different parts of your body depending on the strain. There are 100 different strains of HPV, 40 of which can affect the genital area.

There are two main types of the strain that cause these visible warts, these are type 6 & 11, which cause 90% of all genital warts. These are not the strains that cause genital cancer.

Who is at risk of Genital Warts?

Any individual who is sexually active is at risk of developing genital warts, however they are most common in teenagers and young adults aged 15 to 30. They affect equal numbers of males and females.

It is estimated that 75% of sexually active adults have been infected by some form of anogenital HPV at some point.

If you are vaccinated against HPV as a child you are unlikely to contract genital warts.

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What are the symptoms of Genital Warts?

Genital warts usually appear 2- 3 months after first becoming infected with HPV. They are small fleshy, and sometimes hard, lumps will appear on your genital and anal area.

For women these can appear inside or outside of the vagina, as far inside as the cervix, and as far outside as the upper thighs and around the anus. For males they generally appear anywhere on the penis, scrotum, inside the urethra, on the upper thighs and around the anus. They can appear as individual warts, or in clusters.

Although they are mostly painless, they can cause itchiness and irritation, which can lead to soreness and tenderness.

Images of Genital Warts

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How does a dermatologist diagnose Genital Warts?

A clinical diagnosis is usually required to confirm that they are viral warts, and a biopsy may sometimes be needed to rule out other possibilities.

How does a dermatologist treat Genital Warts?

Dermatologists treat genital warts typically with either topical medication or freezing with liquid nitrogen (cryotherapy) or a combination of treatment.

Topical medication tends to be better at removing softer warts, but the treatment can last for months.

For smaller clusters of warts you may be prescribed Podophyllotoxin, administered in cycles of 3 days in drops which effectively uses toxins to break down the warts.

For small, very hard warts you may be prescribed a course of Trichloroacetic Acid which breaks down the protein in the warts, although this will be administered by a medical professional due to the potential damage to healthy skin.

Imiquimod is more likely to be prescribed for larger warts, and is left on for 6-10 hours 3 times a week.

Depending on the size and number of warts it may be necessary to use a physical ablation method to remove the warts. This includes cryotherapy which involves freezing warts off with liquid nitrogen. Healing time is 1 -3 weeks for this treatment.

Cautery is sometimes used for surgical treatment of genital warts. Laser surgery tends not to be effective for treating genital warts.

Warts are persistent, treatment may need to be repeated, and they can reoccur.

Where can I find more information on Genital Warts?

LSAH Links – Cryotherapy

Where can I get patient support for Genital Warts?

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