Genital warts

You may feel angry with the person you think you caught them from. But in fact that person may not know that he or she had HPV for the following two reasons.

Research among university students in the USA shows that condoms halve the risk of becoming infected with HPV (New England Journal of Medicine 2006;354:2645–54).

 

In the UK, some HPV vaccines are licensed to prevent genital warts (see below) speak to a health care professional for more information.

In women, genital warts usually occur around the opening of the vagina (vulva), but they may occur in the folds of skin alongside the vaginal opening, or between the vagina and the anus, and around the anal opening. The figures (Archives of Dermatology 1984;120:472) are as follows:

In men, genital warts often occur just under the foreskin, but can be anywhere on the penis, on the scrotum, in the groin or around the anus. The figures (Archives of Dermatology 1984;120:472) are as follows:

In women, genital warts begin as small, gritty-feeling growths, which then enlarge and become more frond-like. They can join together so they resemble miniature cauliflowers. Occasionally they are flat, like warts on the fingers. They are not painful, but can feel itchy or vaguely uncomfortable.

 

In men, warts on the scrotum or shaft of the penis usually resemble the ordinary warts that occur on the hands. Under the foreskin and round the anus, they are usually a shiny pinkish-white. A lone wart may also occur inside the opening of the urethra (pee hole); here it will be a pinkish colour and may look speckled. An individual may have dozens of warts, or just one or two.

There are several treatments for genital warts. The usual treatments because they are simple and effective are podophyllotoxin or imiquimod. Other treatments (such as freezing, burning with acid or laser treatment) are sometimes used, depending on the type and size of wart.

 

Annoyingly, whatever the treatment, there is a 30% chance that the warts will come back usually after a few weeks or months. This is because the treatments destroy the wart itself, but cannot get rid of the HPV in the skin beneath the wart.

 

Podophyllotoxin is a plant extract that comes as a liquid or cream. The clinic will show you how to use it and may give you a supply to take home. You usually have to apply it twice a day for 3 days, followed by a break of 4 days. You then repeat this process until the wart disappears (maximum of 4–5 weeks treatment). The cream is easier to use than the liquid for warts in awkward places (such as around the anus). It can sometimes cause redness and a burning sensation, and should not be used if you are pregnant or trying to get pregnant.

 

Imiquimod is a cream that the clinic may suggest if podophyllotoxin does not work. It is applied three times a week before you go to sleep so it can remain on the skin for about 8 hours before being washed off next morning,. It seems to work by stimulating the body's own immune system to destroy the warts. On average, women need 8 weeks of treatment and men need 12 weeks, but it can be used for up to 16 weeks. The disadvantage is that itching, redness and soreness often occur. Its effect is slow and it may be several weeks before you notice any improvement.

 

There are about many different types of HPV, of which about 40 types can infect the genitals. Each type has been given a number to identify it. Visible genital warts are usually caused by HPV types 6 and 11.

 

There is a strong link between HPV types 16 and 18 and cervical cancer. In fact, about 70% of cervical cancers are probably caused by HPV 16 and 18. These types of HPV seem to agitate the cells of the cervix (neck of the womb) and encourage pre-cancerous changes. But HPV 16 and 18 do not usually cause visible warts. Therefore if you have genital warts, you are not at a particularly increased risk of cervical cancer.

 

This also means that people with only the more high-risk type of HPV (types 16 or 18) do not know that they have it, because they probably will not have warts. At present, you cannot be tested under the NHS in the UK to see if you are a carrier of types 16 or 18, but the Department of Health is investigating the possibility.

 

Pregnancy seems to encourage genital warts they often become bigger or more numerous. Unfortunately, podophyllotoxin may harm the baby, and it is not known whether imiquimod is safe in pregnancy. If very troublesome, they can be treated by freezing (cryotherapy). The good news is that, after the baby is born, genital warts often become smaller or disappear.

 

In theory, a vaccine against HPV vaccine could prevent most cervical cancer, so it is very good news that girls aged 12-13 years in the UK (and girls up to 18 years for the first few years of the programme) are now offered the vaccine (British Medical Journal 2008;337:303–4). There are two different vaccines against HPV, Gardasil and Cervarix. Gardasil protects against HPV types 6 and 11 (which cause visible warts) as well as types 16 and 18 (the cancer-causing types). Cervarix is the vaccine used in the UK vaccination programme. It protects against only types 16 and 18 i.e. the cancer-causing types of HPV, but not the types that cause visible warts. The Department of Health will decide later whether boys and older females should receive the vaccine. If you are in the age group for the vaccine, it is very important that you receive all three doses.
 
 

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, February 26th 2010

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Comments on this article

Posted by Optional on 09/03/2010 at 03:02:14 pm

Thank you for your help, the information set my mind at rest

Posted by Optional on 02/03/2010 at 01:18:09 pm

if my partner has visible warts and i dnt does that mean i caught them of him

Posted by Sian =( on 25/02/2010 at 07:37:36 am

Im 21, ive been told a few months ago that ive got the HPV virus which causes genital warts. Im completely gutted and i think my new bf will leave if i tell him....i have slept with him and used a condom but they dont stop the spread of warts....AAAAARRRRRRHHHHH what a pickle!!!! Im really upset =(

Posted by Optional on 24/02/2010 at 12:40:11 pm

I have a limp that has appeared on the enteance of my vagina , it's not sore so much but I am aware of it..its not warts as I have not had sex in about one & half years...any thoughts.(maybe a little sore!)

Posted by Anonymous on 25/01/2010 at 10:42:00 pm

I'm 14 and I have these lumps on the outside lips of my vagina and the are full of blood but it looks like they are full of white stuff and black stuff. I'm to embarrsed to tell my mum and I would be so embarresed to see a doctor about it please help me I don't know what to do .

Posted by Ashleigh levens on 07/01/2010 at 11:19:00 pm

i have genital warts and im scared can you please help me...

Posted by Kathy on 05/01/2010 at 02:37:00 am

Hi there, I have had hpv for eighteen months now. I have had several treatments done, liquid nitrogen, Podophyllin, burning with electrocautery, and about two months ago I had laser done not only on the outside but also inside. None of it seems to work. It keeps on coming back. I am not sexually active. I am aware that my immune system is weak and that HPV stays in your body and it's something I have learned to deal with. I am not a smoker and I do not drink. I also discharge constantly. I have been checked for all the sexually transmitted diseases, and HIV testing all were negative except HPV. Also due to this constant discharge in the last eighteen months and genital warts recurring my question to someone who is knowledgeable about this matter is could it be a problem that is coming from the inner cervix (columnar cells). If anyone can help me out here it would mean a lot to me. Thank you, Kathy

Posted by Jonn on 29/12/2009 at 09:52:00 pm

I'm 13yrs old and I'm positive I have genital warts. I'm so embarresed ,I can't tell my mum and my girlfreind keeps trying to touch my penis and she is wondering why I won't let her. I'm scared that she will get board and leave me. I'm going to try and find a GUM clinic but it so hard to go. I'm sure that if I go to the clinic someone from skool will find out and I would be certanly bullied. I have never had sexual contact exept kissing please someone help.I'm seriously thinking off killing myself. I have never had any sexual contact xept kissing. I'm

Posted by stop worrying on 11/12/2009 at 01:57:00 pm

To the guy who thinks it will end his relationship. Stop worrying. 40% of males and females have HPV of which there are various kinds. Genital visable warts do not cause cancer, that is a different variant of HPV. Get them frozen that way you cant see them and it kills the root of the wart, cider vinegar does not. Unless both of you were virgins either of you could of been in contact with HPV in the past, 60 year old ladies even turn up with them. It can be unnoticed or immune suppressed for years and is no more dangerous than a normal wart.Stop smoking and eat well and help your immune systems get on top of it. After freezing they will probably disappear for good. Dont tell her she will freak and she probably has it anyway.

Posted by dont know what to do on 26/11/2009 at 11:40:00 pm

im 14 and im really embarrassed to go to the doctor about it! :(, i haven't had sex only oral, I've have these tiny little bumps on the whole of my penis and they have multiplied. what should i do? :'(

Posted by paula on 12/11/2009 at 10:19:00 pm

i have recently developed bums around the area of my vagina and near my clitiris. Im unsure if i have warts wat should i do im rather ashamed and embarressed.

Posted by WOWweird on 10/11/2009 at 02:12:00 am

i have a hard tiny ball kinda thing in my scrotem like on the edge and one like on my shaft please help IDK wat 2 do

Posted by roger hind on 23/10/2009 at 06:51:00 am

i cant get rid of my warts wot can i do.

Posted by poppy on 29/09/2009 at 11:34:00 pm

It is such a comfort to know that there are good reliable web sites out there. Its put my mind at rest to know that HPV type 6 and 11 are non cancerous as I had visible genital warts which after two years have now completely gone away. The best advice I can offer any one who thinks they might have this, is to honestly go to your doctor or walk in clinic. As embarrising as it is, it will make you feel so much better once its done. They do go away eventually and you can put it down to one of life's horrible experiences.

Posted by Mitch19 on 24/09/2009 at 11:53:00 am

Hi, I'm a 14 year old kid, and i cant really speak to anyone bout this coz it's inda embarassing, but im worried i might have genital warts. but im not sure. I have a sort of rough piece of skin on the end of my forskin, it's sort of like a scab, i've peeled it off a little at times, it's been there for about 4 days. I'm really worried.

Posted by lovely on 17/09/2009 at 08:11:00 am

hi!you can clearout the warts by applyin toothpaste on the warts surface.Trust me,i av tried and now almost gone and hapi.Do not worri,everything wil be alryt.Do not get tensed and try not to have sex as yet.people,this is jus normal!

Posted by frantic on 14/09/2009 at 12:34:00 pm

i think i have genital warts! i have been living with my boyfriend for 17 months and he has no signs, my last partner was 2 yrs before him and i havent spoken to him about this, they seem to be higher than other pics ive seen and on the underside of my flaps.........the thing is im not sure how this has happened! i had surgery for heavy periods (novasure and ablation) in march with many infections following afterwards and ive also got underactive thyroid problems and gastric problems, seems my health has hit rock bottom and now theses mysterious lumps have appeared, im worried my relationship will fall apart if i have warts............and the thought of telling him dreads me! help please and quickly as this worry is making me feel very ill!

Posted by Anonymous on 10/09/2009 at 07:10:00 pm

I have there bumps in the inside of my penis forskin..i'm scared I don't know what to do..Please someone help me.

Posted by Anonymous on 26/08/2009 at 05:41:00 am

Check out apple cider vinegar, it's cheap and clears up most warts within 7-14 days. There are a bunch of references on the web.

Posted by Anonymous on 21/08/2009 at 09:06:00 am

Um..I just noticed a red dot on my lower shaft near my scrotum it turned white a day after i noticed it and pink around the base it doesn't hurt itch or burn what could it be i'm freaking out so bad help me someone please

Posted by Anonymous on 27/07/2009 at 02:12:00 pm

Hi all, just been to doctors and they said i have warts down below. its so embarrisin but so much better to get them sorted, im now off to the hospital to see what they say, im sooo scared but oh well, at least it will be sorted, i have to tell my boyfriend aswell....oh dear :(

Posted by Anonymous on 14/07/2009 at 10:54:00 am

I noticed I had genital warts in February this year. I went to the GUM clinic and they were most kind, helpful and reassuring. They gave me Imiquod cream to use. The warts cleared up and I started a new relationship. After a month in my new relationship the warts started to come back, so I had to tell my new partner. He's a worrier and got rather anxious and angry with me. He said if he got them it was the end of our relationship. This morning he found a spot on the head of his penis and now thinks he has warts. He's angry and disappointed in me. And he's scared of going to the GUM clinic, even tho I said I'd go with him. I'm sick with worry, and also disappointed in his reaction. I guess the relationship is going to end. :-(((

Posted by koolman on 03/07/2009 at 08:44:00 pm

i have genital warts. and im really embrassed to tell any1 :(. i have a few, and i have had them a for about a year now. i really dont no what to do :(. can someone say a cream or something i could use that i can get from a shop? thanks

Posted by Anonymous on 11/05/2009 at 10:04:00 am

Iv got genital warts....iv been with my partner for 18 months. He isn't showing any signs! How do I have these?? They are very uncomfortable and we havnt had intercourse in a long time. Please some one help me!

Posted by goodie on 19/04/2009 at 03:49:00 am

any idea how long takes 2 cure and quickest

Posted by Anonymous on 16/04/2009 at 12:47:00 am

If you are tested for any sexual diseases and you have genital warts that are dormant can these be detected during the tests

Posted by Worried! =( on 15/04/2009 at 03:30:00 am

I am 29 weeks pregnant and i have genital warts, most of them are very small warts but aare quite painfull after sex!! i have then a very large fleshy wart which is in the way of where the midwife will have to cut me open a little bit maybe when i am giving birth, but this is in the way and she will not be able to do this with it there!!! has anyone had the same problem with the big fleshy warts before?? and what treatment did u have to get rid of it??? HELP!!

Posted by Anonymous on 04/04/2009 at 03:33:00 pm

i had warts over 7yrs ago too. I have just had a baby and think they may be back - from reading this is unusual. I am going to the doctor on tue. I am not sure it is a wart as it is large, like a boil almost but it is grey and has no head. I have been getting a few boils since giving birth under my arms so maybe it is just another one of them due to the stress of giving birth and all the sleepless nights! I'll post back my result for anyone going through same thing. Also, really scared of telling my partner of 4 yrs. Due to his ignorance of the virus he may think I have cheated, which I haven't and never would. Really hope its just a boil.

Posted by Anonymous on 01/03/2009 at 04:34:00 am

I am one heck of a sad case. I wasn't taught properly about the important concepts of safe "sex". I didn't realize how easy it is to contract an std. I've only had sex with two guys... and the first guy I had sex with, guess what, gave me genital warts. Now I am hpv positive and the medicine seems to make them hurt a whole lot. Ever since i've used the medicene they have increased in numbers as well. Is that normal? I think i'm going to call my doctor on monday. The point is... don't have one night stands without a condom! In fact I'm just going to state another obvious point here and say... wait until you know it's going to be long term, and you know his sex history, before you go without the condom. seriously, they hurt, this SUCKS.

Posted by loveydovey on 26/02/2009 at 11:23:00 pm

i have recently noticed genital warts between my anus and vagina, i have noticed the warts slowly spreading forwards, i tried not to worry about it and consulted my doctor. i have been treated for the warts in 3 weeks and feel alot more confident with my boyfriend of 2 years. i have recently found out i am pregnant and feel happier than ever, my advice to people with genitl warts is to see a doctor as soon as possible, and dont worry everything will be fine!! xxx

Posted by peter on 16/02/2009 at 03:25:00 am

I think i have the start of genital warts. I have a brownish raised area on upper part of the penis with very small white pimply type cluster of spots well under the skin. i had contact 40 days ago, i am going to the gu clinic tomorrow. my long term partner is returning in a weeks time she has been away for 3 months, if we have intercouse will i be infectious.if i use a condom she will be suspicous as we never use them,it will probaly end our relationship if i tell her. have you any advice how long a cure takes etc?

Posted by loopy on 15/01/2009 at 12:24:00 am

ive been diagnosed with genital warts ive started using my treatment but they seem to be getting worse n hurting me ive only been using cream for 3 days is this normal?

Posted by Little women on 07/01/2009 at 01:59:00 am

Ive had genital warts on my anus for 13 yrs now they disapear an come bk can they become cancerous as i have neva treated them as am 2 scared an embarresd 2 c a doctor please hel sum1 cm x x

Posted by Anonymous on 04/01/2009 at 09:11:00 pm

over 10 years ago i had gential warts and i have had treatment and was cured and recently 1 appeared and im worried that they are coming back