Genital warts are soft bumps that grow upward from the skin. Their color is similar to a person’s skin color. They first grow alone but can eventually appear in clusters. Such clusters can take on a greyish tone and look like cauliflower in terms of surface shape and texture.
Genital warts differ in shape and size and not all genital skin lesions are genital warts. Syphilis for example, may also cause wart-like lesions, and is a more serious STI. It is therefore, a good to see a doctor and confirm the diagnosis.
Genital warts are caused by a sexually transmitted infection (STI) with the human papillomavirus (HPV) virus. HPV infection is the most common STI globally, and almost all adults get at least one HPV infection during their lifetimes. Typically, the infections don’t have any symptoms and remain undetected. Warts may spontaneously disappear after a year or two. It is possible to be infected by multiple different HPV strains at the same time — there are some 40 sexually transmittable HPV strains. However, only two strains, HPV 6 and 11, are responsible for most genital warts.
Like many other STIs, HPV is transmitted via contact with body fluids and infected skin parts during sex with an infected partner. It’s not just vaginal or anal intercourse that poses transmission risk. Oral sex also can give you an HPV infection.
While HPV is widespread in the human population, only 1% of sexually active U.S. adults actually have genital warts, mostly because their immune system is too weak to fight the virus. Women are more likely to develop genital warts than men. However, men are just as contagious as women, even without warts. HPV can be passed on to your partner even if you don’t have any warts or other symptoms yourself.
In 80% of cases, warts will completely go away within two years. In rare cases, they can reappear — especially if the immune system is weak — because the virus stays inside the body. Normally, after the immune suppresses the first outbreak, warts will not recur in the future, and the virus is no longer contagious.
Fortunately, the HPV strains that cause genital warts do not cause cancer. There are about 13 HPV types with potentail to cause cancer of the cervix, vagina, vulva, anus, penis or mouth. But these 13 strains don’t include the ones that can give you warts.
In fact, almost all HPV-associated cancer is due to HPV strains 16 and 18. Several vaccines are target these two types and a few other strains, and provide reasonable, lifelong protection. For maximum effectiveness, the vaccine is given before a person becomes sexually active. So, the U.S. CDC recommends that the vaccine is given in two shots over six months during ages 11-12. For older teenagers and young adults, three doses will be needed. As an additional benefit, several available HPV vaccines also include immunization against strains 6 and 11 and thus can protect a person from genital warts.
Getting the HPV vaccine at a young age, ideally before turning 13, is the best protection next to sexual abstinence. If it’s too late for you to get vaccinated, sexual abstinence is the only reliable safeguard. Male condoms offer some protection, but unfortunately, it is still possible to get infected through skin-to-skin contact. In fact, female condoms are a little bit more effective because there’s less skin-to-skin contact than with male condoms.
If found early, specialized prescription creams can treat genital warts effectively. Imiquimod is a popular choice and it works by guiding your body’s immune cells to attack abnormal skin growth like warts. After three to four weeks of treatment, genital warts will disappear. Speak to your doctor to find out more about available treatments.
Without treatment or spontaneous disappearance, genital warts may develop to a stage where it will be necessary to remove them with a minor surgery procedure (laser, freezing, or chemical removal).
Reviewed by Dr Roy Kedem, MD
Information last reviewed 10/13/21