Diseases and Disorders > STDs/STIs > HPV

The Facts About HPV

Find out how HPV affects your sexual health.

A woman gets a shot of the HPV vaccine in her left arm.

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. It's estimated that more than 42 million Americans are living with HPV, and about 13 million new cases will be diagnosed in 2023.

According to the Centers for Disease Control and Prevention (CDC), there are more than 100 strains of HPV, and it's likely virtually everyone will contract at least one strain at some point in their lifetime.

What is HPV?

HPV is a virus that can be transmitted through skin-to-skin contact and sexual intercourse. This means it doesn't require insertive sex for a person to become infected with the virus, though that is how it is most often spread.

Of the more than 100 strains, more than 40 of them can infect the mouth and throat, as well as the genital area, which can include the anus, cervix, rectum, penis, scrotum, vagina and vulva. These strains are transmitted through sexual activity.

The CDC reports that 9 in 10 cases of HPV resolve naturally within the span of about two years, without treatment and with no co-occurring health problems. However, while HPV is often asymptomatic and naturally resolved, many strains of it can cause genital warts or cause cancers of the anus, cervix, penis, vagina and vulva.

How is HPV spread?

Most often, HPV is spread through anal or vaginal sex. However, it is also easily spread through skin-to-skin contact during sexual activity—even if you're not having insertive sex. An individual can contract HPV when their anus, cervix, penis, vagina or vulva touches an infected individual's genitals, mouth or throat.

Given HPV's prevalence, a majority of individuals who have sex will have an HPV infection at some point, according to the CDC. Because HPV often dissipates without any treatment or symptoms, many people never know they have or have had HPV. As a result, they do not follow any safer sex precautions because they're unaware they could pass the infection to anyone else.

However, the virus has the potential to cause cancer, so it's imperative to undergo regular testing, particularly if you are sexually active or have multiple sexual partners.

Facts, stats and history

HPV was first described in medical literature in 1949. It wasn't until the 1970s, however, that the "Father of HPV Virology" Professor Harald zur Hausen discovered the connection between HPV and cervical cancer, for which he was awarded the Nobel Prize in 2008.

The work of Hausen and other medical researchers has led to the current understanding that the vast majority of cervical cancers as well as a substantial proportion of some other nongenital cancers are linked to HPV (such as mouth and throat cancers).

It's important to note a majority of HPV infections don't lead to cancer.

Causes and risk factors

An individual can get an HPV infection when the virus enters their body through a cut, abrasion or small skin tear. This typically occurs during anal or vaginal sex but can happen during skin-to-skin contact during sexual intimacy.

If a pregnant individual has genital warts caused by HPV during vaginal birth, it is possible they might transmit the infection to the baby. HPV can also be spread through direct contact with a wart caused by HPV.

Warts can appear in the genital area as well as other areas of the body such as the hands and feet. They can be spread when an individual touches something that has been touched by a wart, according to Mayo Clinic.

The following factors put individuals at greater risk for contracting HPV:

  • Age. HPV is most prevalent among individuals ages 15 to 25.
  • Contact. If you come in contact with a wart or do not take precautions—such as wearing protective footwear in public spaces like gyms, public showers—you're at greater risk for HPV.
  • Sexual habits. The more sexual partners an individual has, the greater the risk they have of contracting HPV. The risk is also higher if an individual has sex with someone who has had multiple sex partners.
  • Skin problems. Having open wounds or damaged skin makes you more susceptible to HPV infection upon contact.
  • Weak immune system. Individuals with weak immune systems—they have the flu virus, measles or mono (mononucleosis), or smoke or drink alcohol, or have poor nutrition—are at greater risk of getting HPV.

What are the signs and symptoms of HPV?

Fortunately, most HPV infections are cleared by the immune system before symptoms or complications have time to manifest. However, in cases in which HPV does not naturally resolve, a variety of symptoms can arise. The type and severity of symptoms depend on the type of HPV an individual is infected with.

Some signs and symptoms of HPV include:

  • Common warts. These typically appear as rough, raised bumps on the fingers or hands.
  • Flat warts. These appear as slightly raised, flat lesions. While they can manifest anywhere on the body, children and men typically develop them on the face while women often get them on their legs.
  • Genital warts. These manifest as flat, cauliflower-like bumps. They can appear in clusters. Sometimes they may manifest as small red bumps.
  • Plantar warts. Typically appearing on the heels or balls of the feet, these warts are often hard and cause pain and discomfort.

When left untreated for long enough, certain types of HPV can develop into anal, cervical, mouth, penile, throat or vulvar cancer.

When to see a doctor

If you have warts of any kind that are bothersome and cause embarrassment or physical pain, talk to your doctor right away. Through examination and testing, your doctor will determine the cause of the warts.

If they are caused by HPV, your doctor will talk to you about how best to manage the virus and go over precautions you should take to prevent its spread.

Diagnosis and testing

Sometimes, a doctor can diagnose an HPV infection based on the appearance of an individual's genital warts. However, if no warts are visible, doctors can run several tests to detect HPV or confirm an HPV diagnosis.

Pap test

During this (typically routine) exam, a doctor will collect a sample of cervical or vaginal cells to be tested in a lab. The results will reveal abnormalities in cells and detect precancerous cells.

Vinegar (acetic acid) solution test

This test involves a doctor applying a vinegar solution onto the genital areas of someone with HPV to help identify hard-to-see lesions. The solution makes warts more visible by turning them white.

DNA test

A DNA test is conducted by collecting cells from the cervix and testing them to determine whether an individual has any high-risk strains of HPV that have been linked to genital cancers. This test is typically recommended for women age 30 and older, in addition to routine Pap smears.

Treatments

Warts caused by HPV usually resolve on their own, though they can reappear later in the same spot or in a new location altogether. HPV is incurable, but there are treatments available to manage symptoms and address complications.

Topical medications include salicylic acid, imiquimod, podofilox and trichloroacetic acid. You should consult with your doctor to determine which treatment is best for you.

In the event that medications prove ineffective, your doctor may recommend alternative treatments such as cryotherapy (freezing warts off with liquid nitrogen), electrocautery (burning warts off with an electrical current), laser surgery or other surgical removals.

A colposcopy and/or a loop electrosurgical excision procedure may be performed to closely examine and remove abnormal cells from the cervix, as such cells can be precancerous.

Prevention and aftercare

The most effective way to mitigate the risk of HPV is to limit the number of partners you have sex with. Practicing safer sex is another way to significantly lower your risk for HPV, as contracting other STIs or sexually transmitted diseases (STDs) such as chlamydia can nearly double your risk for developing HPV.

Living with HPV can take a toll on your mental and physical health and general well-being—but doesn't have to. Practicing safer sex, getting the HPV vaccine, managing symptoms and getting Pap tests regularly can lower your risk for HPV and help make the condition extremely manageable if you are already infected.

Does HPV cause cancer?

HPV is responsible for more than 90 percent of anal and cervical cancers, 70 percent of vaginal and vulvar cancers, and about 60 percent of penile cancers, according to the CDC. This is why it is so important to consider getting the HPV vaccine, to practice safer sex, and to do your absolute best to mitigate your risk of getting HPV in the first place.

Screening for other HPV-related cancers

Presently, the U.S. Food and Drug Administration (FDA) has not approved any tests capable of detecting HPV infections or HPV-caused cell changes in the tissue of the anus, penis, vagina, vulva or throat. Despite this, researchers continue to develop tests that could effectively detect precancers in these areas so that HPV-caused cancers in these areas could be detected and treated early.

Populations at higher risk for getting HPV, such as men who have sex with men and individuals living with HIV, can benefit from anal Pap smears to detect early cell changes or precancerous cells, according to the National Cancer Institute.

Clinical trials and research

There are many active clinical trials underway with the goal to discover better ways to treat and prevent conditions such as HPV and the cancers it can cause.

If you're interested in participating in a clinical research trial to further medical understanding in these areas, be sure you read about what's involved, consult with your doctor and loved ones, and consider what's going to be best for you.

To find more information about privately and publicly funded active and upcoming clinical trials for HPV, you can visit this government database.

Resources for patients and caregivers

Learning more about HPV is recommended for everyone, and there are some online destinations that can help you. Here are five links to begin that journey:

FAQs

How do you get HPV?

You can be infected with HPV when the human papillomavirus enters your body through a cut, abrasion or a small skin tear. This typically occurs during anal or vaginal sex but can happen during skin-to-skin contact during sexual intimacy.

Can you get rid of HPV?

Most HPV infections resolve naturally within a year or two, and you may be asymptomatic during the entire process. There is no cure for HPV, so if you have symptoms—common warts, flat warts, genital warts or plantar warts—you should make an appointment with your doctor who will suggest treatments to manage symptoms and address potential complications.

How do you know if someone has HPV?

Most people who have HPV are unaware of their infection. However, someone may discover they have an HPV infection if symptoms such as warts appear or if they get abnormal results from a cervical cancer screening called a Pap test.