Overview

Genital warts are one of the most common types of sexually transmitted infections. Nearly all sexually active people will become infected with at least one type of human papillomavirus (HPV), the virus that causes genital warts, at some point during their lives.

Genital warts affect the moist tissues of the genital area. They can look like small, flesh-colored bumps or have a cauliflower-like appearance. In many cases, the warts are too small to be visible.

Some strains of genital HPV can cause genital warts, while others can cause cancer. Vaccines can help protect against certain strains of genital HPV.

Symptoms

In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, the anal canal, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or the anus.

Genital warts can also develop in the mouth or throat of a person who has had oral sexual contact with an infected person.

The signs and symptoms of genital warts include:

  • Small, flesh-colored, brown or pink swellings in your genital area
  • A cauliflower-like shape caused by several warts close together
  • Itching or discomfort in your genital area
  • Bleeding with intercourse

Genital warts can be so small and flat as to be invisible. Rarely, however, genital warts can multiply into large clusters, in someone with a supressed immune system.

When to see a doctor

See a doctor if you or your partner develops bumps or warts in the genital area.

Causes

The human papillomavirus (HPV) causes warts. There are more than 40 strains of HPV that affect the genital area.

Genital warts are almost always spread through sexual contact. Your warts don't have to be visible for you to spread the infection to your sexual partner.

Risk factors

Most people who are sexually active get infected with genital HPV at some time. Factors that can increase your risk of becoming infected include:

  • Having unprotected sex with multiple partners
  • Having had another sexually transmitted infection
  • Having sex with a partner whose sexual history you don't know
  • Becoming sexually active at a young age
  • Having a compromised immune system, such as from HIV or drugs from an organ transplant

Complications

HPV infection complications can include:

  • Cancer. Cervical cancer has been closely linked with genital HPV infection. Certain types of HPV also are associated with cancers of the vulva, anus, penis, and mouth and throat.

    HPV infection doesn't always lead to cancer, but it's important for women to have regular Pap tests, particularly those who've been infected with higher risk types of HPV.

  • Problems during pregnancy. Rarely during pregnancy, warts can enlarge, making it difficult to urinate. Warts on the vaginal wall can inhibit the stretching of vaginal tissues during childbirth. Large warts on the vulva or in the vagina can bleed when stretched during delivery.

    Extremely rarely, a baby born to a mother with genital warts develops warts in the throat. The baby might need surgery to keep the airway from being blocked.

Prevention

Limiting your number of sexual partners and being vaccinated will help prevent you from getting genital warts. Using a condom every time you have sex is a good idea, but won't necessarily protect you from genital warts.

Vaccination

Three HPV vaccines have been approved by the Food and Drug Administration. The most recent, Gardasil 9 is approved for use in males and females ages 9 to 45 to protect against cervical cancer and genital warts.

The Centers for Disease Control and Prevention (CDC) recommends routine HPV vaccination for girls and boys ages 11 and 12, although it can be given as early as age 9.

It's ideal for girls and boys to receive the vaccine before they have sexual contact.

Side effects from the vaccines are usually mild and include soreness at the injection site, headaches, a low-grade fever or flu-like symptoms.

The CDC now recommends that all 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart, instead of the previously recommended three-dose schedule. Younger adolescents ages 9 and 10 and teens ages 13 and 14 also are able to receive vaccination on the updated two-dose schedule. Research has shown that the two-dose schedule is effective for children under 15.

Teens and young adults who begin the vaccine series later, at ages 15 through 26, should continue to receive three doses of the vaccine.

The CDC now recommends catch-up HPV vaccinations for all people through age 26 who aren't adequately vaccinated.

Nov. 20, 2019
  1. Cohen J, et al., eds. Papillomaviruses. In: Infectious Diseases. 4th ed. Elsevier; 2017. https://www.clinicalkey.com. Accessed Oct. 17, 2019.
  2. AskMayoExpert. Anogenital warts. Mayo Clinic; 2019.
  3. Scheinfeld N. Condylomata acuminata (anogenital warts) in adults: Epidemiology, pathogenesis, clinical features and diagnosis. https://www.uptodate.com/contents/search. Accessed Oct. 17, 2019.
  4. Genital warts: A fact sheet from the Office on Women's Health. U.S. Department of Health & Human Services. https://www.womenshealth.gov/a-z-topics/genital-warts. Accessed Oct. 17, 2019.
  5. Grennan D. Genital warts. JAMA patient page. JAMA. 2019; doi:10.1001/jama.2018.20181.
  6. HPV vaccine scheduling and dosing. Centers for Disease Control and Prevention. https://www.cdc.gov/hpv/hcp/schedules-recommendations.html. Accessed Oct. 21, 2019.
  7. FDA approves expanded use of Gardasil 9 to include individuals 27 through 45 years old. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-expanded-use-gardasil-9-include-individuals-27-through-45-years-old. Accessed Oct. 21, 2019.
  8. Genital warts. U.S. Department of Health & Human Services. https://www.womenshealth.gov/a-z-topics/genital-warts. Accessed Oct. 21, 2019.
  9. Human Papillomavirus (HPV) infection. Merck Manual Professional Version. https://www.merckmanuals.com/professional/infectious-diseases/sexually-transmitted-diseases-stds/human-papillomavirus-hpv-infection. Accessed Oct. 17, 2019.
  10. Pap and HPV tests. U.S. Department of Health & Human Services. https://www.womenshealth.gov/a-z-topics/pap-hpv-tests. Accessed Oct. 21, 2019.
  11. Human Papillomavirus (HPV). Vaccinating boys and girls. Centers for Disease Control and Prevention. https://www.cdc.gov/hpv/parents/vaccine.html. Accessed Nov. 8, 2019.

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