How do you get Anal Genital Warts?

The virus is passed on by sexual contact. You need close 'skin to skin' contact to pass on the virus. This means that you do not necessarily need to have penetrative sex to pass on infection. Sharing sex toys may also pass on infection. Very rarely, anogenital warts may be passed on from hand warts. They may also rarely be passed on to a baby when a woman gives birth.
 

It can take weeks or months to develop warts after being infected with HPV. Also, most people infected with HPV do not develop warts. You can be a 'carrier' of the virus without realising it, and you may pass on the virus to others who then develop warts. It is also possible to pass on the virus after warts have been treated or gone. 

Because it can take some time to develop warts after being infected with HPV, if you have just developed noticeable anogenital warts, it does not necessarily mean that either partner has been recently unfaithful. You may have had HPV for a long time without developing warts.

Also note that you may get anal warts even if you have not had anal sex.

How common are anal genital warts?

They are common and are one of the most commonly diagnosed sexually transmitted infections in the United States. Many more people are infected with the virus, but do not develop visible warts (they are 'carriers').

An individual has over a 5 in 10 chance of having HPV infection in their lifetime. However, most people do not know that they have been infected because they have no symptoms. Only about 1-2 in 100 people with HPV infection develop anal genital warts.

Where do anal genital warts develop?

In men the warts usually develop on the outer skin of the penis. In women the warts usually develop on the vulva, just outside the vagina. Warts may also develop on the skin around the anus in both men and women.

Sometimes warts develop inside the vagina, on the cervix, on the scrotum, inside the urethra (the tube that drains urine from the bladder to the outside) or inside the anus. Rarely, they occur in the mouth or nose.

What do anal genital warts look like?

They look like small, skin-coloured lumps on the skin (similar to the common warts that many people have on their hands). Warts that develop on skin that is warm, moist, and non-hairy (such as the vulva) tend to be soft. Warts that develop on skin that is dry and hairy (such as the shaft of the penis) tend to be firm.

The number of warts that develop varies from person to person. Some people have just a few that are barely noticeable. Some people have many around their genitals and anus.

What are the symptoms of anal genital warts?

In most cases, the warts cause no physical discomfort. They sometimes cause irritation and soreness, especially if they occur around the anus. Sometimes anal genital warts can bleed or cause pain on intercourse. If you have warts inside your urethra or anus, this can sometimes cause bleeding when you pass urine or bleeding from the anus.

They are benign; that is, they cause no serious physical illness. However, the warts look unsightly and some people become distressed by this.

Do I need any tests?

Anal genital warts can usually be diagnosed by their typical appearance when you are examined by the doctor.  The Doctor will examine your external genitalia to look for warts. 

So, tests are not usually needed to confirm the diagnosis of anogenital warts. However, up to 1 in 4 people with anal genital warts also have another sexually transmitted infection. Tests such as 'swabs' are commonly advised to check for other infections - even if you do not have any symptoms.

What are the treatment options for anogenital warts?

There are a number of different treatments that can be used to treat anal genital warts but the best treatment is freezing the warts (cryosurgery). Whatever the treatment, it usually takes several weeks of treatment to clear the warts. Sometimes it can take up to eight months of treatment.

Treatment may be a little uncomfortable and cause some irritation of the skin around the area that is being treated. Also, smokers tend to respond less well to treatment, so stopping smoking may be beneficial to your treatment. 

Sometimes one treatment may not be successful. If this is the case, another treatment may be advised. There is also a chance that anal genital warts can return after treatment. This is because the treatments do not clear the human papillomavirus itself but just tend to treat the warty lesions. 

Physical treatment

• Freezing warts with liquid nitrogen is a common treatment. This is called cryosurgery. Liquid nitrogen is sprayed on or applied to the wart. Liquid nitrogen is very cold. The freezing and thawing destroys the wart tissue. To clear the warts fully you may need several treatments, a week or so apart. This treatment may be used if you have a small number of warts.

What about my sexual partner?

Current sexual partner(s) may wish to be checked to see if they have warts or other sexually transmitted diseases.

Is there a link between anogenital warts and cervical cancer?

The types of HPV that most commonly cause anogenital warts (types 6 and 11) do not increase your risk of cervical cancer. HPV types 6 and 11 cause over 9 out of 10 cases of anogenital warts. However, some other types of HPV do increase your risk of developing cervical cancer. You may have more than one type of HPV infection at the same time (one type that causes anogenital warts and one type that may increase your risk of cervical cancer). 

So, it is important that women with anogenital warts (the same as every woman) have cervical screening tests at the usual recommended times and do not 'put it off'. You do not need to have cervical screening tests more regularly if you have anogenital warts. 

Prevention of anogenital warts

Condoms

Condoms (male or female) may prevent HPV from being passed on to new sexual partners who are not infected. However, they do not completely protect you from getting anal genital warts as the skin that is not covered by a condom can become infected. But condoms do help to protect against other sexually transmitted infections such as chlamydia and HIV. You should also use condoms whilst having oral sex and you should not share sex toys.

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