- Genital warts are very common. They are caused by the Human Papillomavirus (also known as HPV).
- Some people may not even know they have genital warts because they can be invisible - meaning you may be carrying HPV and not aware of it.
- In Victoria, the HPV vaccine is most often provided by local councils (free-of-charge) to secondary school students in Year 7. Immunisation is also available free-of-charge for people aged 12 to 25 years through local councils, general practices and some local pharmacies.
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About genital warts and causes
Genital warts are one of the most common sexually transmissible infections (STIs).
They are caused by the human papillomavirus (HPV). There are more than 200 strains of HPV.
Only around 40 types of HPV can affect the genitals. Not all cause visible warts.
Genital warts can appear:
- around the genitals and anus
- sometimes inside the vagina, rectum or urethra.
Signs 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.
Image of genital warts, courtesy DermNet
Genital warts may not have any symptoms
In many cases, HPV is known as a ‘subclinical’ infection. This means you may be carrying HPV on your skin, even though you do not have any visible warts.
Subclinical HPV infection is common in people of all genders It is detected more often in people with a cervix during cervical screening.
How genital warts spread
HPV infection can occur after direct contact with a visible wart or contact with genital skin where the virus is present. This can occur even if there are no visible warts.
HPV can spread by direct skin-to-skin contact during:
- vaginal sex
- anal sex
- oral sex – it is rare to transmit HPV to the mouth through oral sex.
Warts may appear within a few weeks after sex with a person who has HPV.
Sometimes warts may take months to appear, or not at all. This can make it hard to know when you got the virus and who you got it from.
Genital warts treatment
For most people, the body’s immune system will get rid of the virus over time.
It is important to remember that treatment does not get rid of the virus. It only treats the visible warts.
Treatment aims to remove visible warts, usually for cosmetic reasons. Always consult your doctor about any treatments.
Over-the-counter wart treatments are not suitable for genital warts.
Treatment options for genital warts include:
- Cryotherapy – warts are frozen off with liquid nitrogen. Several treatments may be required.
- Podophyllotoxin – this lotion can be applied at home. It is most effective on multiple warts that are easy to get to. Be careful to protect the unaffected skin. (Podophyllotoxin cannot be used during pregnancy.)
- Imiquimod cream – applied once a day, 3 times a week for up to 3 months. (Not recommended for use in pregnancy.)
- Laser or diathermy treatment – 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. (This procedure does not get rid of the virus, it helps to get rid of the visible warts.)
Genital warts recurrence
After treatment for warts:
- The virus may persist on the skin, even though the visible wart has gone. This means that warts may reappear.
- If a 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 system clearing the virus from the body.
HPV and cervical cancer
Certain types of HPV can infect the cervix. These can cause cell changes that may, over many years, increase your risk of cervical cancer if the body doesn’t clear the virus naturally.
The types of HPV that cause visible genital warts do not progress to cervical cancer.
Cervical screening
To reduce your cervical cancer risk, screening is available through the National Cervical Screening for:
- anyone with a cervix aged 25 and 74 years every 5 years
The Cervical Screening Test looks for the presence of HPV. Cervical screening is recommended for those who have been sexually active, even if you have had the HPV vaccine.
To do this test, you can see a doctor or nurse who will give you a swab to self collect a sample from high in your vagina. Or, if you prefer, the doctor or nurse can collect the sample for you.
The cervical screening test is a tool used to detect HPV on the cervix that may lead to cervical cancer.
Most HPV found on the cervix will clear naturally without treatment. If you are at high-risk you may need closer monitoring and treatment to remove them. Seek advice from your doctor.
Some people who have had a hysterectomy may still require cervical screening tests. You should discuss this with your health provider.
Genital warts and HPV vaccines
There are 2 HPV vaccine brands available in Australia to help prevent cervical cancer:
- Gardasil®9
- Cervarix® (not registered for use by males in Australia and is only available on the private market).
These vaccines work by preventing infection with 2 types of HPV – types 16 and 18. These are the types that have been shown to cause 70% of cervical cancers.
Gardasil®9 provides protection against 9 types of HPV. In addition to types 16 and 18, it also protects against HPV types 6 and 11, which cause almost all genital warts, and types 31, 33, 45, 52 and 58, which cause an additional 15% of all cervical cancers.
Gardasil®9 replaces the Gardasil® vaccine (which protected against the four types of HPV – types 6, 11, 16 and 18).
HPV immunisation
HPV immunisation consists of a single dose vaccine schedule for most people.
If you are immunocompromised, you may need 3 doses of the HPV vaccine for protection from the virus
In Victoria, the HPV Gardasil®9 vaccine is available free of charge under the National Immunisation Program for young people:
- 12 to 25 years – ideal age for vaccination is 12 to 13 years, before sexual activity (and therefore exposure to HPV) commences.
The vaccine is usually given to young people in year 7 of secondary school by their local council immunisation service.
It is also available through:
- a local doctor (GP)
- community pharmacy
- council immunisation session.
A catch-up program is available for young people up to 25 years who missed HPV Gardasil®9 vaccination at school.
The vaccine provides the best protection if it’s completed before a person becomes sexually active.
HPV vaccine and over 26 years
The HPV vaccine is not usually recommended for adults aged 26 and older, as they may have been already exposed to HPV.
If you are 26 years and over and you wish to be vaccinated for HPV, speak with your doctor.
Preventing the spread of genital warts
You can help reduce the risk of spreading genital warts by practising safe sex by using internal and external condoms.
Because condoms don’t cover all the genital skin that is exposed during sexual contact, you may still get HPV through skin-to-skin contact.
Transmission of genital warts can occur when a wart is present, but may also occur when there are none.
Genital warts and sexual relationships
If you have regular sexual relationships, especially if you and your partners have genital warts, the benefits of condom use is unclear. Discuss this issue with your doctor or with a nurse at a sexual health clinic.
Where to get help
- Your GP (doctor)
- Your school nurse or school welfare coordinator (Some secondary schools provide access to an adolescent health trained GP on site)
- Your pharmacist (including after hours Victorian Supercare Pharmacies)
- Sexual Health Victoria . To book an appointment call SHV Melbourne CBD Clinic: (03) 9660 4700 or call SHV Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly.
- Melbourne Sexual Health Tel. (03) 9341 6200 or 1800 032 017
- Victorian Sexual Health Network – where to get – visit Melbourne Sexual Health Centre's GP partner clinics for STI check-ups and treatment
- Thorne Harbour (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840
- Ballarat Community Health Sexual Health Tel. (03) 5338 4500
- Bendigo Community Health Sexual Health Tel. (03) 5434 4300 Or (03) 5448 1600
- Gateway Health Clinic , Wodonga Tel. (02) 6022 8888 or 1800 657 573
- Sunraysia Community Health Tel. (03) 5022 5444
- Barwon Health Sexual Health Tel. (03) 5226 7489
- Victorian Aboriginal Health Tel: (03) 9419 3000
- Women's sexual and reproductive health hubs (throughout Victoria)
- Tel:1800 696 784 is a statewide phone service for information about sexual health as well as contraception and pregnancy options
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