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Reviewed by Dr David Delvin, GP and psychosexual expert

What are genital warts?

Genital warts are transmitted through sexual contact.

Genital warts are a sexually transmitted infection. They are caused by various strains of the human papilloma virus (HPV), which is transmitted by sexual activity.

Genital warts are small projections of flesh that grow on the male and female genitalia and sometimes round the anus.

Warts can vary in colour, from pink to brown, but generally look like small pink or red growths.

Genital warts have become practically endemic in the United Kingdom during the first decade of the 21st century.

The number of new cases seen in British genitourinary medicine (GUM) clinics has increased by 30 per cent since 1999. Indeed, this is the most common viral sexually transmitted disease in the UK.

In the last year for which figures are available, there were 92,525 new cases seen at GUM clinics, plus 69,935 recurrent cases. In addition, an unknown number of patients were treated by private doctors or by GPs.

The highest rates were among women aged 16 to 19 and men aged 20 to 24.

What are the signs of genital warts?

Genital warts do not appear until at least two to four weeks after infection, and sometimes months pass before the warts become visible.

Genital warts do not usually hurt, but they can sometimes be itchy – causing inflammation, which can then bleed. They have varied appearances, from completely flat warts to rough cauliflower-like projections. They can appear on their own or in groups.

In males, genital warts often appear on the penis or underneath the foreskin. The warts can also be situated in the urethra (the urinary pipe), in most cases at the outer end of it, and the area around the anus.

In females, genital warts appear on the lips of the vulva, in the vagina or near the urethral (urinary) opening. Genital warts can also appear in and around the anus.

Genital warts can be so flat that they become invisible to the naked eye, but they can make themselves felt through an itchy and burning sensation.

'Invisible' genital warts can be detected by a doctor as described below.

Who is at risk?

People with multiple sexual partners.
People who do not practise safe sex.

But anyone who has sex can get genital warts.

Good advice

Use a condom – it will partially protect you against genital warts.
Anyone in doubt as to whether they have warts, should contact their local GUM clinic.
A sudden and strong eruption of genital warts could suggest a defect in the immune system, possibly caused by HIV – anyone affected should contact a doctor immediately.

How does the doctor make the diagnosis of genital warts?

Through a clinical examination.
To detect 'invisible' genital warts the doctor will swab the skin with acetic acid. The genital warts will then show as white patches.

How are genital warts treated?

It's important that both partners, if possible, are treated. Make sure you follow the treatment – genital warts are easy to treat when they are small and few.
The warts can be treated by swabbing them with a wart-dissolving solution or cream containing, podophyllotoxin (Condyline).
If this fails, the clinic may remove the warts under local anaesthesia using surgery, freezing or laser treatment.
Recurrent and 'difficult' warts can sometimes be treated with a cream containing a newer drug called imiquimod.

Outlook

Anyone who has previously been infected with genital warts run the risk that they will return. However, often there's only one outbreak.
The treatment can last for months.
Some wart types are thought to be connected to the occurrence of cell changes in the cervix and cancer in the sexual organs. It's therefore a good idea for women with genital warts around the vagina to have regular smear tests.
There have been suggestions that some strains of HPV might be linked to cancer of the mouth and throat in later life. But this remains unproven at the moment.

Based on a text by Dr Finn Rasmussen and Ulla Søderberg

Last updated 05.08.2010