Genital warts are small lumps found on or around the penis, anus or vagina, caused by the human papillomavirus (HPV). They are passed from person –to person via unprotected sexual contact or close skin-to-skin contact. Some people are asymptomatic but can still transmit the virus without knowing it.

Genital warts usually develop within three months following contact with an infected person.

In females, genital warts may appear on the inside and outside of the vagina, on the cervix and around the anus. In males, they may develop on the tip or shaft of the penis or around the anus. Sometimes they may appear on the scrotum or inside the anus, and they may rarely appear on the inside of the anus.

The warts look like small skin-coloured lumps, and sometimes they develop into small cauliflower like, fleshy growths. Those found on dry hairy skin, such as the shaft of the penis tend to be firm lumps, whilst those found on the moist, warm, non-hairy areas, such as inside the vagina, tend to be softer lumps. The number of warts seen can vary greatly between individuals.

Generally, there is no physical discomfort with genital warts, although they can cause a certain amount of irritation and soreness especially if they develop around the anal region. Any problems seen relating to the flow of urine, or bleeding from the urethra or anus may indicate internal lesions.

Generally most warts will eventually heal and fade away if left alone. However, they are contagious and many patients will seek treatment due to the unsightly and embarrassing nature of the infection.

There are two different types of treatment available. These are:

• chemical treatments – chemicals which are applied to the warts which ‘burn’ or destroy the wart
• physical treatments – methods used to physically remove the wart tissue.

Different examples of chemical treatments include:

• podophyllotoxin – a cream or lotion, a weaker version of the strong chemical podophyllin (no longer used), which may be applied at home by the patient. Must not be used during pregnancy
• other chemical treatments, such as Aldora cream, which works on the immune system.

Examples of physical methods include:

• freezing – liquid nitrogen is applied to the warts to destroy them
• surgical removal – warts are removed with a scalpel under local anaesthetic
• laser treatment – warts are burned off.

Published guidelines on the management of genital warts include:

• National guideline for the management of anogenital warts

Not a notifiable disease. Contact your local policy document for further information.

Genital warts can have serious complications, as certain subtypes of HPV have been linked to cervical cancer. Individuals with HIV have a greater risk of contracting forms of cancer linked to HPV due to their suppressed immune system.

The best way to prevent the spread of genital warts is to avoid direct contact with the virus. The risk of infection is reduced by consistent and correct use of a condom and by reducing the number of sexual partners.

None.

Some of the chemicals used in the treatment of genital warts are harsh and toxic. Great care should be taken when treating genital warts in pregnant women as some treatments are contraindicated during pregnancy.

BMJ PUBLISHING GROUP (2004) HIV Infection (AIDS). Human papillomavirus infection [on-line].
Available at: www.besttreatments.co.uk/btuk/conditions [Accessed 3 May 2005].

CHIN J, ed (2000) Control of communicable diseases manual. 17th ed. Washington: American Public Health Association.

HEALTH PROTECTION AGENCY (2004) General information – genital warts [on-line].
Available at: www.hpa.org.uk/infections/topics_az/hiv_and_sti/sti-warts [Accessed 3 May 2005].

MAW R, et al (2002) National guideline on the management of anogenital warts [on-line]. London: British Association of Sexual Health and HIV.
Available at: www.bashh.org/guidelines/2002/hpv_0302b.pdf [Accessed 3 May 2005].