What causes genital warts?
Genital warts are caused by an infection of the skin of the genital and anal area with the human papilloma virus (HPV).
There are over 100 different types of HPV which can affect different parts of the body, including the hands and feet (a wart on the foot is called a verruca). Approximately 30 types of HPV can live in and around the genital and anal areas but most genital warts are caused by just two types of virus (types 6 and 11).
How are genital warts passed on?
The virus that caused genital warts is easily passed from one person to another through sexual contact. Anyone who is sexually active can get the virus. Both men and women can have the virus and pass it on.
- Genital warts can spread from one person to another during vaginal or anal sex.
- The viral can be spread by skin to skin contact so it can be passed on by close genital contact – you don’t need to have penetrative sex (vaginal or anal) to pass it on.
- The virus will not pass through a condom but as condoms do not cover all of the genital area it is possible to infect genital skin that is not covered by the condom.
- The virus is most likely to be passed on when warts are present but it is still possible to pass the virus on after warts have disappeared.
- It is possible, but very rare, to develop warts in the mouth or throats, or on the lip from oral sex.
- Warts can spread from the genital area to the area around the area around the anus without having anal sex.
- It is possible for warts on the hand to be passed to the genitals, but this is very rare.
- It is possible for a pregnant woman who has genital warts at the time to pass the virus to her baby at birth, but this is rare.
- You cannot get genital warts from kissing, hugging, sharing baths or towels, from swimming pools, toilet seats or from sharing cups, plates or cutlery.
What are the signs and symptoms?
Most people with HPV infection will not develop visible warts and the virus will go away on its own. This means you may not know whether you or your partner have the virus.
If warts do appear, this can happen from three weeks to many months or even years, after coming into contact with the virus. You might notice small, fleshy growths, bumps or skin changes which may appear anywhere in or on the genital or anal area.
- In women, warts can be found on the vulva (the lips around the opening to the vagina), cervix (entrance to the uterus (womb)) and upper thighs, and on or inside the anus.
- In men, warts can be found on the penis, scrotum, urethra (tube where urine comes out) and the upper thighs, and on or inside the anus.
- You might see or feel them, or your partner might notice them. Often they are so tiny, or so difficult to see, that you don’t even know you have them.
- They can be flat or smooth small bumps or quite large, pink, cauliflower-like lumps.
- Warts can appear on their own or in groups.
- Genital warts are usually painless but may occasionally itch and cause some inflammation.
- They may cause bleeding from the anus or the urethra.
- If your flow of urine is distorted this may be a sign of warts in the urethra.
How will I know if I have the virus?
You can usually only be certain you have genital warts if the doctor or nurse looks at the warts and confirms you have the infection. Even if you or your partner feel sure you have genital warts, it is still advisable to have a check-up to confirm this.
You could still have genital warts even if your partner doesn’t have any visible warts.
It is possible to have more than one sexually transmitted infection at the same time. You may wish to have a check-up for infection if:
- You, or your partner have, or think you might have, symptoms
- You have recently had unprotected sex with a new partner
- You, or your partner, have had unprotected sex with other partners
- A sexual partner tells you they have a sexually transmitted infection
- You have another sexually transmitted infection
- You are pregnant or planning a pregnancy
How soon after sex can I be checked for genital warts?
You can be checked as soon as you think you might have been in contact with the virus. As visible warts don’t always develop straightaway you will be advised on how to check yourself for any warts that develop and what to do if you notice any.
What does the check-up involve?
The main check for genital warts is for the doctor or nurse to look at the warts. They may do this using a magnifying lens.
- You may also need an internal examination of the vagina or anus to see if there are any warts inside.
- Very rarely it is necessary to take a small sample (biopsy) of the wart for closer examination. Depending on the area being examined, local anaesthetic may be used.
- There are new tests that look for some types of the virus itself but these are not used as a routine test for genital warts.
- There is no blood test for the wart virus.
How accurate is the check-up?
Most warts are easily diagnosed by looking at them.
How quickly will the warts go away?
In some people the warts go away quickly but for others the warts are stubborn and treatment may have to be repeated a number of times. It can also take a while for the treatment to start working. Evidence suggests that smokers respond less well to treatment than non-smokers. If the first treatment doesn’t work, another treatment, or a combination of treatments, may be tried.
Do I need to have a check-up to see if the warts have gone?
If you are having treatment for the warts at a clinic or general practice it is important to return regularly for treatment. This is so that the doctor or nurse can check that the treatments are working or advise any change of treatment. Many clinics do not ask you to return if you think the warts have cleared up. They will always be happy to see you if you want advice or to be checked.
Will the warts come back?
Some people only ever get one episode of genital warts. For many others, the warts can come back. If you do get new warts it is not possible to say if these are due to the original infection or a new infection from a partner.
What happened if genital warts are not treated?
If left untreated genital warts may disappear, stay the same, or grow larger in size or number. Over time most warts will eventually go away without treatment. For some people this may take a long time, particularly if you have an illness that affects the way your immune system works, making it difficult to fight off infection.
It is not usually harmful to your health if the warts are not treated but you may find them uncomfortable and may not like the way they look. Treating warts may reduce the risk of you passing them on to someone else.
How soon can I have sex again?
You may be advised to avoid sex until the warts have cleared up. This is mainly to protect the treated area of skin from friction and to help it heal.
Using condoms may help to prevent the spread of this virus if they are used while the warts are present and for the first three months after the warts have gone.
Will I know how long I’ve had genital warts?
If you have had more than one sexual partner it can be difficult to know which partner you got genital warts from. It is not possible to tell how long you have had the virus by the appearance of the genital warts.
If you feel upset or angry about having warts and find it difficult to talk to your partner or friends, don’t be afraid to discuss how you feel with the staff at the clinic or general practice.
Should I tell my partner?
If you are told that you have genital warts then it is a good idea for your current or most recent sexual partner(s) to have a check-up to see if they have any warts that they have not noticed.
Will genital warts affect my fertility?
No. There is no evidence that your fertility will be affected by having genital warts or the virus that causes them.
What happens if I get genital warts when I’m pregnant?
You should tell the doctor or nurse that you are pregnant as this may affect the treatment they can offer you.
- During pregnancy warts often grow in size and number, they may appear for the first time or they appear again after a long time of having no warts.
- They can be treated safely during pregnancy, though treatment may be delayed until after delivery.
- If the warts get very big, they may be removed to avoid problems during birth. If this is not possible, you may be advised to have a caesarean delivery but this is very uncommon.
- The virus can be passed to the baby during a vaginal delivery but this is rare. This can cause an infection in the baby’s throat or genital area.
How can I help protect myself from genital warts and other sexually transmitted infections?
It is possible to get genital warts and other sexually transmitted infections by having sex with someone who has the infection but no symptoms. The following measures will help protect you from genital warts and most other sexually transmitted infections, such as HIV, chlamydia and gonorrhoea. If you have a sexually transmitted infection without knowing it they will also help prevent you from passing it on to your partner.
- Use condoms (male or female) every time you have vaginal or anal sex. They can help protect you against other sexually transmitted infections and may provide some protection against getting, or passing on, genital warts, particularly if they are used while the warts are present and for the first three months after the warts have gone.
- If you have oral sex, cover the penis with a condom or the female genitals and male or female anus with a latex or polyurethane (soft plastic) square.
- If you are a woman and rub your vulva against your female partner’s vulva one of you should cover the genitals with a latex or polyurethane square.
- Avoid sharing sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them.