Genital warts are one of the most common sexually transmissible infections (STIs). They are caused by the human papillomavirus (HPV). Condoms reduce the risk of HPV transmission and an effective vaccine is available. The types of HPV that cause visible genital warts do not progress to cervical cancer. Treatment removes the visible wart, but not the virus.
Genital warts are one of the most common sexually transmissible infections (STIs). They are caused by the human papillomavirus (HPV). There are over 100 strains of HPV, but only some affect the genitals and not all cause visible warts. Genital warts can appear around the genitals and anus or, sometimes, inside the vagina, rectum or urethra.
Appearance of genital warts
Genital warts appear as painless growths and may be:
- flat or raised
- single or multiple
- clustered together with a cauliflower-like appearance.
Genital warts can be invisible
In many cases, HPV is a ‘subclinical’ infection. This means that you may be carrying HPV on your skin, even though you do not have any visible warts. Subclinical HPV infection is common in both women and men, but is detected more often in women, as the HPV may cause cell changes on the cervix detected by a Pap test.
Risk factors for genital warts
HPV is spread by direct skin-to-skin contact during vaginal or anal sex. It is also possible, but rare, to transmit HPV to the mouth by oral sex. Infection may occur after direct contact with a visible wart or contact with genital skin where the virus is present.
Warts may appear within a few weeks after sex with a person who has HPV, or they may take months to appear, or they may never appear. This can make it hard to know when or from whom you got the virus.
Treatment for genital warts
It is important to remember that treatment does not get rid of the virus. It only treats the visible warts. For most people, the body’s natural immunity will get rid of the virus over time. Treatment aims to remove visible warts. Always consult your doctor about any treatments. Over-the-counter wart treatments are not suitable for genital warts.
Treatment options include:
- Cryotherapy – the warts are frozen off with liquid nitrogen or dry ice. Several treatments may be required.
- Podophyllotoxin – this lotion can be applied at home. It is most effective on multiple warts that are easily accessible. Pregnant women should not use podophyllotoxin.
- Imiquimod cream – this is applied once a day, three times a week for up to three months. This treatment is not recommended for use in pregnancy.
- Laser or diathermy treatment – this is used for larger numbers of warts or when other treatment options have not been effective. Laser or diathermy treatment is administered in hospital under general anaesthetic.
Genital warts can reappear after treatment
After treatment for warts, remember:
- The virus may persist on the skin, even though the visible wart has gone. This means that warts may reappear.
- If the wart reappears, it does not necessarily mean that you have caught the infection again.
- In most cases, the wart will eventually disappear for good. This is due to the body’s natural immune response clearing the virus from the body.
HPV and cervical cancer
HPV can infect the cervix and cause cell changes that may, over many years, increase your risk of cervical cancer. The types of HPV that cause visible genital warts do not progress to cervical cancer.
The value of pap tests
Pap tests, or smears, are a screening tool used to detect cell changes on the cervix that may lead to cervical cancer. Australian women are recommended to have Pap tests every two years.
Most cell changes found on the cervix will resolve naturally without treatment. However, some higher-level cell changes require closer monitoring and may need treatment to remove these cells. Your doctor will advise you about this if necessary.
Genital warts and HPV vaccines
Two types of HPV vaccine are currently available from your doctor. Both vaccines protect against the two HPV strains (16 and 18) associated with cervical cancer, but only Gardasil® protects against the two HPV strains (6 and 11) that cause most genital warts.
In Australia, girls in year 7 of secondary school, or those aged 12 to 13 years, are offered free vaccination against HPV. From 2013, the vaccine program was extended to include boys, so both boys and girls in year 7 are offered Gardasil® vaccine through an ongoing school-based program. In 2013 and 2014, boys in year 9 of secondary school, or those aged 14 to 15 years will be offered the Gardasil® vaccine as part of a time-limited catch-up program.
The vaccine provides best protection if it is completed before a person becomes sexually active. The three-dose course of Gardasil® vaccine should be completed. Dose two is given two months after dose one and dose three is given four months after dose two.
Preventing the spread of genital warts
You can help reduce the risk of spreading genital warts by using condoms during anal or vaginal sex. However, condoms only protect the area of skin that they cover. This is because condoms do not cover all the genital skin that is exposed during sexual contact.
Condoms for men can be bought from supermarkets, pharmacists and other outlets. Female condoms are available through Family Planning Victoria and may be available from selected shops. Latex-free condoms are also available from some outlets. Male condoms and lubricant are available free from the Melbourne Sexual Health Centre, along with female condoms on request.
Remember that transmission of genital warts can occur when a wart is present, but may also occur even if there are no genital symptoms.
Genital warts and sexual relationships
The benefits of condoms are less clear if you are in a regular sexual relationship, especially if you and your partner have warts. You should discuss this issue with your doctor or with a nurse at an STI clinic.
Where to get help
- Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
- Your doctor
- NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
- Victorian AIDS Council/Gay Men's Health Centre Tel. (03) 9865 6700 or 1800 134 840
- Education and Resource Centre, Alfred Hospital Tel. (03) 9276 6993
- The Centre Clinic, St Kilda Tel. (03) 9525 5866
- Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100
- The Action Centre (for young people less than 25 years) Tel. 1800 013 952 or (03) 9654 4766
- Albury Wodonga Sexual Health Clinic Tel. (03) 6051 7111
- Ballarat Sexual Health Clinic Tel. (03) 5338 4500
- Bendigo Community Health Tel. (03) 5434 4300
- Geelong Sexual Health Tel. (03) 5202 9333
- Traralgon AIDS/STD Clinic Tel. (03) 5173 8111
- Warrnambool Community Health Care – Sexual Health Tel. (03) 5563 1666
Things to remember
- Genital warts are caused by the human papillomavirus (HPV).
- People with HPV can spread the infection, even if they do not have visible warts.
- Warts may reappear after treatment, but most disappear for good eventually.
You might also be interested in:
- Genital herpes.
- Human papilloma virus - immunisation.
- Infections - bacterial and viral.
- Pap tests.
- Sexually transmissible infections - avoid the risk.
- Sexually transmissible infections (STIs).
- Vulval conditions.
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This page has been produced in consultation with and approved by:
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Melbourne Sexual Health Centre
Last reviewed: November 2013
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