What Do Genital Warts Feel Like?

Though they're often the subject of stigma, judgment and misunderstanding, genital warts are common occurrences that people of all backgrounds and identities experience. But what do genital warts feel like and what causes them?

The small, fleshy bumps, growths and skin changes that comprise genital warts are caused by the most common sexually transmitted infection (STI) in the world: the human papillomavirus, or HPV.

"Genital warts have the potential to affect all sexually active people," said 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.

HPV and genital warts

There are more than 40 strains of HPV that can impact a person's genitals, but Mayo Clinic says only some of these cause genital warts. At some point in your life, it's likely you will be exposed to and contract HPV, according to Daniel Atkinson, M.B.B.S., the United Kingdom-based general practitioner clinical lead at online healthcare provider Treated.

"It's estimated that over 50 percent of sexually active people ages 15 to 49 have been infected with an HPV strain that causes genital warts, and around 85 percent of people will be infected with some kind of HPV at some point in their life," he said.

What is it like to experience genital warts as they develop and clear? What are the risk factors contributing to the condition? What are some of the common, flare-causing triggers?

What are genital warts?

Genital warts, also known as anogenital warts or condyloma acuminatum, receive their name from the body areas on which they commonly appear.

"In women, genital warts typically involve the area around the opening of the vagina. However, they may also occur inside the vagina and on the cervix," Zeno said. "In men, they tend to occur on the penile shaft or under the foreskin."

This common skin condition can take several forms, according to Atkinson.

"Genital warts look like small, fleshy growths or bumps, and depending on your skin tone, they can be pink, white or dark," he said. "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, the warts can be too small to see.

Symptoms often correlate to the shape of your warts, Zeno explained.

"The noticeable warts tend to be raised and can cause discomfort if they catch on clothes or rub against the skin," she said. "They may cause itching or skin roughening if the lesions are flat. Genital warts may also go unnoticed and can be asymptomatic."

Other symptoms you may experience with genital warts include inflammation of the area and bleeding during intercourse if the warts are disturbed, according to Atkinson.

How do you contract genital warts?

About 90 percent of genital warts are caused by just two noncancer-causing HPV strains: types 6 and 11, according to the Centers for Disease Control and Prevention (CDC). The vast majority of HPV infections, Atkinson said, are contracted through sexual contact, which isn't limited to just insertive sex.

"Anyone can get genital warts if they've had skin-to-skin contact with someone who has a strain of HPV that causes them," he explained. "This could be through vaginal or anal sexual intercourse, sharing sex toys, or if HPV has spread to other areas of the body and there's been contact with the affected skin.

"The infection affects and occurs in the top layer of the skin. The virus enters the outer layer of the skin, usually through a cut or scratch, and causes rapid growth of skin cells, which creates a wart-like growth."

Atkinson noted four factors that can raise the risk of contracting and becoming infected with HPV which, in turn, could create genital warts:

• The number of sexual partners
• Age
• A weakened immune system
• Skin injuries

One of the most confounding aspects of contracting genital warts is the unpredictability of their timing and appearance. Even if you haven't been sexually active with a partner for many months, you may experience the development and new growth of genital warts, which may change their shape throughout the duration of a flare-up that typically lasts several months.

"The average time between HPV infection to wart development is six to 10 months," Zeno said. "Typically, genital warts are slow growing. The average time to clear the infection is less than one year."

Infections take an average of nine months to clear in women and about seven months in men.

"When they do appear, you'll first notice them as a slight skin color change, which then develops into a raised or flat growth," Atkinson added. "They can then spread and grow if left untreated, if you scratch them or if you have a weakened immune system. Your immune system will fight the wart cells, and after a time, the warts may clear up, but you'll usually need a topical wart treatment to help this process along."

What triggers a flare-up of genital warts?

Since genital warts are caused by a virus, symptoms will alternate between periods of activity and dormancy until your body clears the virus. It usually takes up to two years for HPV to completely exit your body, but it may take longer, especially in the presence of stress or a weakened immune system, according to the CDC.

"Even if you've had topical treatment or wart removal, genital warts may flare up again after several months because the underlying HPV infection is still in your body," Atkinson said.

Atkinson and Zeno identified a host of factors and behaviors that may trigger a new flare-up and the accompanying symptoms:

• Overall poor physical health
• Not finishing treatment
• Other infections
• Smoking

Consider the HPV vaccine

As food for thought, consider that HPV is responsible for most cases of cervical and penile cancer later in life. Most cases of the STI clear on their own, but those that don't can and do cause complications later.

The HPV vaccine is recommended for males and females starting around age 11 and up to 26. It's a two- or three-dose vaccine, depending on age, and works best in people who receive it before they ever contract a case of the virus.

In certain cases, people up to age 45 may get the vaccine, according to the CDC, though they don't make it a recommendation.