Genital Wart Treatment

Genital wart treatment aims to remove warts on the skin and mucosal surfaces around the genitals or anus. These lesions, usually caused by low-risk HPV types, can be treated but may recur. Treatment removes visible warts rather than the virus itself. The following information provides an overview and does not replace an individual diagnosis or treatment recommendation.

What are genital warts, or condylomata?

Genital warts are skin and mucosal lesions around the genitals or anus caused by certain human papillomavirus (HPV) types. They may be a single small growth, occur in groups, have a cauliflower-like appearance or be flat. They cause itching, burning or tenderness on contact in some people and no symptoms in others.

Which HPV types cause them?

Current medical guidance indicates that around 90% of anogenital warts are caused by HPV types 6 or 11. These are generally not the cancer-causing types. As more than one HPV type may be present together, having warts does not remove the need for cervical screening.

How is HPV transmitted, and when do warts appear?

Infection spreads through contact between genital skin and mucosal surfaces. Visible warts may develop weeks or months after infection, while many people never develop them. It is therefore often impossible to establish when or from whom the virus was acquired. Warts are not a reason for blame; the virus may remain silent for a long time.

What are the symptoms of genital warts, and how are they diagnosed?

Diagnosis is usually made by seeing a lesion during a gynaecological examination. The doctor assesses number, size and location; the vulva, vagina, cervix and area around the anus may be assessed together. A tissue sample, or biopsy, may be considered for lesions that look unusual, bleed, are ulcerated or show pigment changes. Vulval and anal precancerous lesions require separate assessment, and the doctor refers if needed.

How are genital warts treated?

Treatment aims to remove warts and relieve discomfort. Warts may sometimes regress by themselves, so observation without treatment is acceptable for some people. The number, size and location of warts, possible side effects, convenience and your preference are discussed together.

Are creams used at home suitable for treatment?

For some warts, your doctor may prescribe topical medicines for you to apply on a set schedule. Follow the doctor's and leaflet's instructions about how, where and how long to apply them. Do not try medicines, vinegar, herbal products or acidic solutions yourself; they can irritate or burn sensitive genital skin.

What procedures can a doctor perform?

Methods that may be performed in a doctor's office or procedure room include:

• Freezing with liquid nitrogen, called cryotherapy
• Chemical acid application
• Surgical removal, scraping, electrocautery or laser destruction

The method depends on wart characteristics and medical assessment. Any method may cause temporary pain, irritation, a wound or pigment changes. No single method can be considered preferable in every situation, and results cannot be guaranteed.

Is not treating the warts an option?

Current medical guidance recognises that warts may regress spontaneously and choosing not to treat can be acceptable for some people. Warts that cause discomfort, grow rapidly or increase in number should be discussed with a doctor to plan treatment.

Can warts recur after treatment, and how is follow-up arranged?

Treatment removes visible warts, but the virus may remain in the body for a time, allowing warts to return. Recurrence is particularly common in the first three months. For recurrent lesions or those not responding to treatment, the doctor may change the method or suggest another assessment.

Should my partner be informed, and how can transmission be reduced?

Informing your partner or partners is recommended. HPV testing of partners is not recommended; examination and assessment for other sexually transmitted infections may help. Condoms provide partial protection but do not cover all skin that can transmit infection through contact.

What happens if genital warts develop during pregnancy?

Do not use medicines or creams yourself if warts appear during pregnancy. Some topical medicines are not used in pregnancy; the doctor selects an option according to the stage of pregnancy and wart characteristics. Caesarean birth is not planned solely because of warts; the decision is based on obstetric assessment.

How do genital warts relate to HPV vaccination and cervical screening?

HPV vaccination can reduce the chance of warts in people not yet exposed to the virus; it does not treat an existing infection or wart. Whether and when to vaccinate with warts present should be discussed with a doctor. Having warts does not replace cervical screening with a smear or HPV test; the screening plan continues separately.

What should you consider before and after treatment?

Before treatment, tell the doctor about possible pregnancy, medicines and skin allergies. Ask about the method, aftercare and timing of follow-up. Temporary tenderness, redness or a small wound may occur afterwards; follow the doctor's care instructions. Do not scrape the treatment area yourself, and report new lesions without waiting for the next appointment.

When should you seek medical advice?

• A new wart-like lesion around the genitals
• A rapidly growing, ulcerated or persistently painful lesion
• Treatment that is not working or repeatedly recurring warts
• Large lesions making urination or bowel movements difficult
• Genital warts noticed during pregnancy