What are genital warts?

Updated on:
September 20, 2021

Genital warts, also known as condylomata acuminata (CA), or anogenital warts, often appear as flesh-colored bumps that are small or large, raised or flat, and can sometimes be cauliflower-shaped. They are most commonly found in the genital area including around or on the anus, penis, vagina, and groin. Less commonly they can also be found around or in the mouth and throat. 

Genital warts are caused by a group of viruses often referred to as HPV, which stands for human papillomavirus. Genital HPV is a viral infection and one of the most common sexually transmitted infections (STIs) globally. In most cases the body clears the infection without any medical treatment (usually within two years) and without developing any genital warts symptoms. When the infection does not clear on its own, HPV can cause health issues like genital warts weeks to months after exposure. Rarely, warts can show up years after contact with HPV.

There are many different types, or strains, of the HPV virus, but only two types (HPV 6 and HPV 11) cause most cases of genital warts. 

The history of genital warts

How our understanding of genital warts has evolved

Genital warts are one of the earliest known clinical signs of sexually transmitted infections, dating back to the time of Hippocrates in 460-370 BC. The scientific name for genital warts “condylomata acuminata” comes from the Greek “condyloma” which means round growth and the Latin “acuminata” meaning sharp points. Genital warts were some of the first infections to be described in medical literature. 

It wasn't until the 1983 Nobel Prize-winning work of virologist Harald zur Hausen that multiple strains of HPV were recognized. Since then, more than 200 unique HPV strains have been identified. 

Genital, or mucosal, HPV types, which affect the genital and anal area, are divided into two categories: high-risk and low-risk. Low-risk HPV types cause genital warts, included in this category are types 6 and 11, which are responsible for 90% of all genital warts. High-risk HPV types can cause lesions or cancer. 

Fortunately, HPV vaccines which have been available since 2006 protect against high-risk and low-risk strains responsible for cancers and genital warts. 

The highest occurrence of HPV is found soon after people first become sexually active. Thanks to HPV vaccination programs, the rate of genital warts in young people is dramatically decreasing.

Factors that can increase your risk of HPV transmission include: 

  • Inconsistent condom use
  • Having a new sexual partner
  • Having multiple sexual partners
  • Having anonymous sexual partners
  • Being a man who has sex with other men and/or trans women
  • Being a sex worker 
  • Being a young adult
  • Drug use
  • Lower socioeconomic status
  • Experiencing violence and/or discrimination
  • Having previously contracted STIs

Genital wart myths

There is a cure for genital warts

Currently, there is no cure or specific treatment designed for genital HPV itself. However, the symptoms that some types of the virus can cause, such as genital warts, can be treated by a healthcare provider using creams, cryotherapy, laser-therapy, or surgical resection. These treatments aim to remove the warts and relieve symptoms of genital HPV but do not cure the infection.  

You only get genital warts through having sex

Unlike most other STIs, HPV is highly contagious and transmitted by direct intimate skin-to-skin contact. Even people who have not had sexual intercourse can still contract HPV and develop genital warts.

If you have HPV you will get genital warts

With over 200 different types of HPV, contracting HPV does not necessarily mean you will get genital warts. There are about 40 types of genital HPV. Some of those types have a high risk of causing genital warts, while many others do not.

You'll know you have HPV by your symptoms 

Most individuals infected with HPV will not experience or show any symptoms. Although not everyone who carries the strains of HPV that cause genital warts will develop visible signs of warts, the infection can still be passed on to a partner.

If you got the HPV vaccine, it is impossible to get genital warts

The HPV vaccine is extremely effective against the types of HPV that are known to cause 90% of genital warts. However, in rare cases, other strains not covered by the vaccine can still lead to genital warts. Additionally, the vaccine prevents HPV but does not remove the virus from the body, so it must be given before exposure to the strains covered by the vaccine to be effective.

I will know right away if I have genital warts 

Genital warts often go unnoticed. In some cases, they are painful, itchy, or bleed, but most of the time they cause no discomfort. Genital warts can be hidden in skin folds or out of sight in the mucus membranes like the inside of your mouth, anus, urethra, or vagina. You could have genital warts without knowing it. Sexually active individuals can regularly self-screen to check for any new lesions or bumps in the anogenital region and consult with a healthcare provider to double-check them. During regular genital or STI screenings, your healthcare provider will look for and identify any genital warts you might have. 

Genital warts are common and nothing to be ashamed of, especially with treatment options available to easily remove them! 

How are genital warts transmitted? 

Genital warts themselves are not transmitted, but the virus that causes genital warts, HPV, is very contagious. HPV is passed by direct skin-to-skin contact, and anyone who has had sexual skin-to-skin contact is at risk for HPV infection. 

The majority of genital HPV infections are spread through direct sexual contact during oral, anal, or vaginal sex. Transmission can occur during penetrative or non-penetrative sexual contact, including:

  • Genital-genital contact
  • Oral-genital contact
  • Anal-genital contact 
  • Oral-anal contact 

Studies also suggest that HPV transmission can potentially occur through genital contact without sex (such as hand-genital contact), but this route is unlikely.

HPV is still transmissible even when a person shows no signs or symptoms. 

How to protect yourself from transmission of genital warts

The best protection against developing genital warts is to get vaccinated against infection by the HPV virus which causes genital warts.

There are currently three highly effective Health Canada approved HPV vaccines that protect against a wide range of HPV types. Two of these vaccines are designed to protect against the HPV strains that are known to cause most cases (90%) of genital warts.

Although vaccination will not get rid of an existing HPV infection, vaccines can still be taken after an HPV infection to help prevent infection by other types of HPV. 

Prevention of HPV infection, along with many other STIs, can include a multitude of methods, including:

  • Correct and consistent use of condoms for penetrative sex and of dental dams and condoms for oral sex.
  • Speaking to your sexual partners about their STI and testing history.
  • Avoiding having sexual contact if you or your sexual partner notices any unusual discharge, pain or burning (especially when urinating), or discomfort in the genital or anal region.
  • Getting tested (and treated) for STIs regularly
  • If you test positive for HPV (or other STIs), notify your sexual partners. 

Since HPV strains that can generate genital warts are able to live outside of the body for short durations, genital HPV transmission can potentially occur by touching something (i.e. hands) that has come into contact with the virus. However, hand-genital transmission is unlikely to occur and other non-sexual forms of genital HPV transmission remain unclear.

Are genital warts treatable and curable?

Currently, there is no cure or treatment for genital HPV itself. Fortunately, HPV-related health issues including genital warts have treatments available. Treatment usually involves removal of the genital wart using surgical excision, freezing, or laser ablation.

Resources:
https://www.cdc.gov/vaccines/pubs/pinkbook/hpv.html
https://www.who.int/en/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer
https://www.cdc.gov/vaccines/vpd/hpv/hcp/safety-effectiveness.html
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30655-8/fulltext

Reviewed by:
Emeline Mugisha

Emeline’s expertise stems from over a decade of community/public health practice among marginalized communities in the U.S. and abroad, with a clinical focus on HIV and infectious diseases.

Using a social justice lens, she is a fierce advocate for empowerment-based practice, trauma-informed care, and cultivating rest as tools for advancing towards whole-life wellness.

She holds a Master of Science in Nursing and a Master of Public Health from Johns Hopkins University.