Genital Warts

What are genital warts and human papillomavirus (HPV)?

Genital warts are flesh-coloured lumps or growths in the genital area. They are caused by human papillomavirus (HPV), the most common sexually transmissible infection (STI).

There are more than 200 different types (strains) of HPV. Around 40 types of HPV can infect the genital area. This includes the skin on or around the genitals (vulva, penis, scrotum and anus), vagina, cervix (top part of vagina) and rectum (anal passage). Most people who are sexually active will be infected with at least one type of HPV at some time.

Most genital warts are caused by HPV types 6 and 11. These are different to the HPV types that can cause warts on other parts of the body (like the hands or feet). These are also different to the HPV types that can cause genital cancers. Having genital warts does not increase your risk of genital cancers.

How do you get genital warts?

HPV that causes genital warts, is mainly passed on during sexual skin-to-skin contact with someone who has HPV. Sexual skin-to-skin contact may be during genital-to-genital contact, vaginal, anal or oral sex or sharing sex toys.

Most HPV infections are passed on when a person does not have symptoms and they are unaware they have the virus. Warts on other parts of the body (like the hands and feet) cannot be passed on to the genital area.

HPV can affect anyone who is sexually active. It can be passed on whether your sexual partner/s are the same sex as you or a different sex.

How would I know if I have genital warts?

Most people with HPV do not know because they do not have symptoms. In most cases the immune system will clear the virus and a person will not know they were infected.

Some people might have symptoms such as:

• a flesh-coloured lump or several lumps in the genital area
• unusual itching or pain in the genital area
• abnormal or irregular bleeding from the vagina or anus (especially after sex)
• pain during sex.

Genital warts can take weeks to years to develop, so it can be difficult to know when you were infected.

Testing for genital warts is not a routine part of a sexual health screen. Usually, you will only be examined if you have symptoms.

What does a test involve?

Genital warts are diagnosed by a doctor or nurse, who will examine any lump or lumps you have noticed. You may choose to test for other STIs or BBVs at the same time you are being checked for genital warts.

More information on STI and BBV testing

Sexual Health Victoria (SHV) provides expert, confidential STI and BBV testing to Victorians. We also provide expert information, healthcare and support on a range of reproductive and sexual health matters. For more information on SHV clinical services, see our clinics or you can book an appointment online.

How are genital warts treated?

Once you have HPV, it stays in your body until it is cleared by your immune system. This can take months to years. However, there are several effective treatment options for genital warts caused by HPV.

Genital warts can be treated with:

• cryotherapy (liquid nitrogen) – to freeze the wart/s
• creams or paints you can apply yourself
• laser therapy or a minor surgical procedure to remove the wart/s.

Because treatment is aimed at the visible warts, rather than the virus itself, warts can come back after treatment. Once your immune system has cleared the virus, the warts will resolve, regardless of treatment.

You may need to avoid sexual contact or use barrier protection (external condoms, internal condoms or dental dams), during genital wart treatment. Some creams or paints used to treat warts can affect the latex in condoms and cause them to break easily. If using condoms – use latex free brands.

Where do I get treatment?

Your doctor or nurse will give you the medications to treat genital warts or a script which you can take to the pharmacy. You cannot buy medications to treat genital warts over the counter without a script. All other treatments for HPV symptoms will be provided in the clinic by your doctor, nurse or a specialist.

What if I do not get treated?

Most HPV infections are cleared by your immune system within 2 years.

Will genital warts come back?

When the body clears infection with a type of HPV, you usually develop immunity to that type. However, you can still be infected with any of the other different types of HPV.

Safer sex, including regular STI (and BBV) testing is the best way to lower your risk of getting HPV.

Do I need to let my sexual partner/s know I have genital warts?

If you have been diagnosed with genital warts you are not obligated to let your sexual partner/s know, although you may choose to inform them. It may be helpful for them to know so they can make informed decisions about ways to lower the risk of transmission and whether to be tested and treated if needed.

There are some great websites to support you informing your sexual partner/s via a phone call, text message, letter or email. There are ways of doing this either personally or anonymously.

• Let Them Know
• The Drama Downunder - for men who have sex with men
• Better to know – for Aboriginal and Torres Strait Islander people

Your doctor or nurse can assist with informing your current or previous sexual partners.

What should I do if a sexual partner of mine has been diagnosed with an STI?

You may be notified that a sexual partner has been diagnosed with an STI or a BBV. Notification may be in person or via a phone call, text message, letter or email. You may have an infection too and be unaware as you may not have symptoms. See your doctor or nurse to discuss ways to lower the chances of passing it on, get tested and treated.

Will genital warts affect my pregnancy or breastfeeding?

People who are pregnant or breastfeeding can be infected with the same STIs and BBVs as people who are not pregnant or breastfeeding.

If you become infected with HPV and develop genital warts during pregnancy, it usually does not cause any health complications for you and your baby. Genital HPV may be passed to the baby during birth, but this is rare. HPV infection during pregnancy is not associated with miscarriage, premature (early) birth, low birth weight or other pregnancy complications.

During pregnancy, suppression of the immune system and hormonal changes can increase the symptoms of HPV infection. You are more likely to develop genital warts in response to infection with HPV types 6 and 11, and warts may grow more rapidly and larger. Most warts will resolve when immune function returns after delivery.

If the decision is made to treat genital warts during pregnancy – cryotherapy can have a poor response and some prescribed creams or paints are not recommended.

If you are pregnant or breastfeeding and considering treatment for an STI or BBV, ask your doctor, nurse or midwife about the possible effects of the treatment and/or medicine on your baby or breastfeeding.

If you are planning a pregnancy or already pregnant, testing for genital warts is not a routine part of health care. It is recommended you and your sexual partner/s have other STI and BBV screening tests, even if you have been tested in the past. You can speak to your doctor, nurse or midwife for more information.

How can I lower my risk of getting STIs and BBVs?

You can lower your risk of getting STIs and BBVs by using barrier protection (external condoms, internal condoms or dental dams) correctly during any type of sex (vaginal, anal or oral sex) and when sharing sex toys.

Barrier protection is not 100% effective at preventing STIs and BBVs.

You can also lower your risk of getting a BBV by:

• not sharing injecting equipment, razors, nail clippers
• only getting tattoos and piercing in regulated places
• talking to your doctor or nurse about HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) if you are at risk of HIV exposure.

You can also lower your risk of getting an STI or BBV by both you and your sexual partners having regular STI and BBV testing. To get an STI or BBV test at Sexual Health Victoria, see our clinics or you can book an appointment online.

Human papillomavirus (HPV) vaccines

There are two vaccines to prevent infection with some types of HPV.

Gardasil 9 can prevent infection with nine HPV types (6, 11, 16, 18, 31, 33, 45, 52 and 58) that cause most genital warts and genital cancers.

Gardasil is recommended and free, under the National Immunisation Program (NIP), for people aged approximately 12 to 13 years.

Cervarix can prevent infection with two HPV types (16 and 18) that cause most cervical cancers. It does not prevent infection with HPV types that cause genital warts.

The HPV vaccine does not protect against all types of HPV. After the vaccine, you may still get HPV that causes genital warts or cervical cell changes.

You can discuss your vaccine options with your doctor or nurse.

Where to get more information and support

• Sexual Health Victoria
• Better Health Channel
• The Centre Clinic – a safe and friendly general practice, providing care for LGBTI community members as well as specialist medical care for people living with HIV, and expert sexual health screening and treatment.
• DirectLine 1800 888 236 – support for people affected by alcohol and other drugs including information on where to obtain new needles and syringes.
• Equinox – for transgender services
• Headspace – for young people
• Melbourne Sexual Health Centre – a specialist sexual health clinic.
• Minus 18 – for young lesbian, gay, bisexual, transgender and intersex (LGBTI) people.
• Multicultural Centre for Women’s Health – for culturally and linguistically diverse women.
• PRONTO! – a peer-led service for men who have sex with men.
• Thorne Harbour Health (formerly Victorian AIDS Council)
• TouchBase – information, support and services for LGBTI people.
• A doctor or nurse.
• Your local community health service

If you are using the internet for information, only use reliable and reputable websites. Be aware of websites containing inaccurate and harmful information and imagery.