Patient information from BMJ

Verrugas genitales

Last published:Mar 08, 2024

If you have genital warts you might be embarrassed and upset. But genital warts aren't usually serious, and there are treatments.

What are genital warts?

Genital warts are painless bumpy lumps that grow on the skin around your genitals.

Genital warts can be flat or lumpy. They may look like a cauliflower, or be on a stalk. Warts on moist skin (such as the skin near the vagina or on the penis) are usually soft and flesh coloured. Some people have just one wart while others have many.

Genital warts are caused by a virus called the human papillomavirus (HPV for short). This type of virus can also cause warts to grow in other places, such as around your nose or mouth. There are nearly 100 types of HPV. Some types cause genital warts, and some other types of HPV can cause certain types of cancer.

HPV spreads from one person to another by skin contact. The virus can be spread:

• if you have sex (including oral sex and anal sex)

• if your genitals touch your partner's genital area, even if you do not have sex

• if you touch your partner's genital area (for example, with your fingers)

• if your partner touches you after touching his or her genitals.

You can be infected with HPV but have no symptoms. So even though you or your partner might not see any genital warts, the virus can still spread between you.

What are the symptoms of genital warts?

Genital warts often don't cause any symptoms. They can occasionally cause pain or itchiness. They may also make it hard to urinate if they are around the urethra (the thin tube where your urine passes out). Or make it hard to have sex if they block the vagina.

Your doctor will probably decide whether you have genital warts by examining you. He or she might take a sample of tissue (called a biopsy) to make sure that you don't have anything more serious. Genital warts are almost always benign (non-cancerous).

What treatments work?

Genital warts often clear up by themselves. So if you have genital warts that are not causing you any trouble you might want to wait to see if they go away without treatment. But if you are bothered by them there are many treatments that can help.

There is no one treatment that is guaranteed to work for everyone. The type of treatment that you choose or that your doctor recommends will depend on several things including:

• the size and location of the warts

• whether you want to treat the warts yourself or whether you would rather have a doctor or nurse do it

• whether your doctor has a lot of experience in using a particular treatment.

Some treatments can only be done by a doctor or nurse.

Treatments you can use yourself

There are some treatments that you can use yourself at home.

• Imiquimod is a cream that helps get rid of warts and can reduce the chance that they will come back.

• Podophyllotoxin is a cream or liquid that you put on your genital warts. It works to clear warts in many people and can reduce the chance of them coming back.

• Sinecatechins ointment, also known as Polyphenon E, is an ointment that you put on your genital warts.

You will need to follow your doctor's advice about how many times and how often you need to use them. It may take weeks or months for treatments to work. If they are not showing any signs of working after 6 months, you should try a different type of treatment.

These treatments can all cause side effects such as itching and irritation. But these will stop after you stop using the treatment. You shouldn't use any of these treatments if you are pregnant.

Treatments that need to be done by a doctor or nurse

• Trichloroacetic acidor bichloroaceticacid can be used to treat small, moist genital warts. The treatment doesn't seem to be as effective as some other treatments at stopping warts from coming back. The solution needs to be applied carefully by a doctor or nurse as it can damage normal skin.

• Cryotherapy. With this treatment your doctor destroys the warts by freezing them with liquid nitrogen. This can be painful and may need to be done several times.

• Surgery. Some people prefer to have surgery to remove their warts because, unlike with other treatments, this can be done in one session. It can be used on all kinds of genital warts and is usually safe for pregnant women.

  There are various types of surgery. You may have your warts cut out after the area has been numbed with local anaesthetic. Some surgeons use a laser to remove the warts, while other methods include using a mild electrical current to destroy the warts with heat. Surgery can cause scarring and pain. But the pain should go away after a few days.

If you have genital warts and you're pregnant

Genital warts sometimes grow larger during pregnancy. This can make passing urine difficult. If the warts are inside the vagina they can cause problems during birth. If your doctor thinks your genital warts might cause problems during pregnancy or childbirth he or she will probably advise you to have them removed before the birth.

If genital warts are blocking your vagina, or if there's a chance that they will bleed a lot during labour, your doctor may advise you to have a caesarean section to deliver your baby. This is rare.

Most treatments for genital warts are not safe to use during pregnancy. There are some treatments that can be used, but these need to be given by your doctor or nurse. Your genital warts may clear up on their own after you have your baby and your immune system recovers. So if you have genital warts that aren't likely to cause problems during pregnancy and childbirth it might be worth waiting a while before you decide to have treatment.

Can genital warts be prevented?

You can reduce your risk of getting genital warts by using condoms. But condoms don't offer complete protection from the virus that causes genital warts. That's because the virus spreads by skin-to-skin contact.

So although some parts of the genitals are protected by a condom, not all the skin in that area is. Also, it's possible to get the virus on your fingers and spread it to another person that way. Having treatment for genital warts does not stop you passing the virus to others.

A vaccine against HPV is widely used in many countries. The vaccine is designed to help protect against the types of HPV that can cause cervical cancer in women and certain other cancers in both men and women. For example, some mouth and throat cancers or cancers of the anus and genitals. And it can also help protect you against the type of HPV that causes genital warts. The vaccine is mostly given to people between the ages of 9 and 26. For example, in the UK it is offered to all children aged 12 to 13 years old, usually as part of school vaccination programmes. You may also be offered the HPV vaccine if you are a man who has sex with other men, or if you have a weakened immune system.

What will happen?

Genital warts can clear up on their own as your immune system fights off the virus. But this can take many months or years. If you have a weakend immune system you might not get rid of the warts so easily. For example, if you have HIV or AIDS, or if you've had a transplant or have cancer.

Genital warts often come back several months after you've had treatment to get rid of them. This is more likely to happen if your immune system is weakened.

If you have genital warts, you should also be tested for other sexually transmitted infections. Your sexual partners should also get checked. You can find a sexual health clinic near you for more advice.