Diagnosing and Treating Genital Warts

Have you seen a small, fleshy growth or bump on your genitals? A medical professional, such as your primary care provider or a practitioner at a sexual health clinic, can provide a diagnosis, which may turn out to be genital warts.

This skin condition is caused by the most common sexually transmitted infection (STI) in the world: the human papilloma virus, or HPV. The Centers for Disease Control and Prevention (CDC) states that around 13 million Americans are infected with HPV each year.

"Genital warts look like small, fleshy growths or bumps, and depending on your skin tone, they can be pink, white or dark," explained Daniel Atkinson, M.B.B.S., the United Kingdom-based general practitioner clinical lead at online healthcare provider Treated "They can be raised or flat, and they may be scattered or clustered with a cauliflower-like texture. They can also affect the throat area when passed on through oral sex. Occasionally, warts can be too small for us to see."

Depending on your case of genital warts, you may not experience any symptoms or even notice your warts, or you may feel itch, discomfort, skin roughening, inflammation of the surrounding genital area and bleeding during intercourse, according to Atkinson and Aldene Zeno, M.D., a urogynecologist and urogynecological surgeon with Woman's Health Excellence, an OB-GYN practice with locations in Arcadia and Glendale, California.

Receiving a genital warts diagnosis from a medical professional will help you heal faster and may prevent you from recurrent flare-ups while HPV remains in your body, Atkinson and Zeno said, which is usually a few months to a couple of years.

How do you diagnose genital warts?

Receiving a genital warts diagnosis might not even require making an appointment, Atkinson said, as many sexual health clinics offer walk-in services.

"The health practitioners at these clinics specialize in treating medical problems with the genitals. They also tend to receive test results quicker than a primary care doctor," he explained. "A diagnosis can quickly be made after a doctor or nurse looks at your skin. They'll ask about your symptoms and sexual partners, inspect closely around your genitals and anus, and possibly inside your vagina, anus or urethra."

In many cases, genital warts can be diagnosed by sight in just a couple of minutes, but Zeno said that your provider may require further testing.

"In patients not responding to usual treatment, or for those with lesions that don't appear typical, the warts may warrant a biopsy," she said. "In most cases, people receive treatment without biopsy due to the classic appearance and symptoms of genital warts."

Both women and men can be screened for HPV, so your doctor may offer this test to confirm your genital warts diagnosis, Atkinson said. Women receive a cervical cancer screening and men receive an anal cancer screening.

For men, routine screening for HPV-related anal cancer is not as common as cervical cancer screening in women. However, some healthcare providers may offer anal cancer screening to men who are at higher risk, such as men who have sex with men or those with a history of anal HPV infection. This screening may involve anal Pap smears or anal HPV tests.

After your healthcare provider confirms the diagnosis, Atkinson recommends having an honest, open conversation with your current sexual partner or partners, as genital warts are most commonly contracted through sexual contact.

"It's not always easy to say who you got HPV from or how long you've had it, but it's a good idea to let your recent sexual partners know so they can get checked out, too," he said. "As genital warts can appear six to 12 months after coming into contact with the virus, they can go unnoticed for long periods of time."

Genital warts can look like any other wart that appears elsewhere on the body. It can resemble several other common skin conditions as well, so a medical diagnosis is an important step in preventing the spread of HPV.

"As genital warts can look like common warts or skin tags, some people might not necessarily think of HPV straight away, especially if they don't have other symptoms like itching, or if they believe they've been safe with their sexual partners," Atkinson said.

A few health conditions that you may confuse for genital warts include the following, according to Zeno and Atkinson:

• Genital herpes
• Skin tags
• Vulvar epidermal inclusion cysts (small sacs containing tissue from the vulva's surface)
• Vulvar or vaginal intraepithelial neoplasia

How to treat genital warts

If left undiagnosed, genital warts may clear up on their own or they may continue to spread, in which case treatments are available, Atkinson said.

"Sometimes, genital warts can clear up by themselves, and the HPV virus can go into remission for a long time without causing further flare-ups, but genital warts can also often persist, grow in size or spread further," he explained. "Even if warts disappear, which can take many months, the virus is still present in your body and may cause subsequent episodes. Getting medical advice and treatment will help you to get rid of warts quicker and help you to treat recurrent flare-ups."

There's no cure for HPV, but there are a few treatment options for patients looking to remove their warts. Bear in mind, your warts may grow back at any time while HPV is still present in your body.

Zeno and Atkinson offered a few treatment modalities to remove genital warts:

• Topical treatments
• Surgery
• Cryotherapy

HPV vaccine will stop the spread of genital warts

The most important tool in eradicating genital warts is vaccination against HPV. The CDC now recommends the HPV vaccine for everyone up to 26 years old, and children are recommended to begin vaccination at age 11 or 12, with a schedule of two doses within one year.

Adults ages 27 to 45 may also choose to get the vaccination, the CDC says.

"Getting the HPV vaccine when you're young is the best way to prevent genital warts and high-risk HPV infections that can cause cancers like cervical cancer. It's a preventative treatment, meaning it can help stop you from getting HPV in the future, but it won't kill the virus if you've already been infected with HPV," Atkinson said. "It's also better to have the vaccine when you're younger because your immune system response changes as you get older."