Genital warts: what you need to know

In her latest online article, renowned specialist doctor in sexual and reproductive healthcare Dr Georgina Forbes offers her expert insight into genital warts. Dr Forbes explains what causes genital warts, how they are diagnosed and the different treatments available.

What are the sign and symptoms of genital warts? When should you see a doctor? 

Genital warts are a viral skin infection. You may notice some unusual lumps or bumps on your genitals. If you get any new lumps on your genitals and they don't get any better, it's always worth going to see a clinician.

Genital warts can look different on different people. So sometimes they can be flat or raised, smooth or rough, they can look a bit like a skin tag or like a little cauliflower.

Are genital warts a kind of sexually transmitted infection?

Genital warts are caused by a virus called the human papillomavirus. They are most commonly caused by types 6 and 11 of the virus.

This virus is transferred from skin-to-skin contact during sex. It is a sexually transmitted infection, but you don't have to have had penetrative sex to catch genital warts.

How is this condition diagnosed?

Genital warts are a clinical diagnosis. There is no specific test. An experienced clinician will look at the lesions and make the diagnosis based on what they see and then give you treatment if appropriate.

If the treatment then doesn't work and we think it might be something else rather than genital warts, that would be the time to investigate.

When do genital warts require treatment? Can genital warts go away on their own?

Some genital warts will resolve by themselves. Your body's immune system will often recognise the virus and deal with it.

If you leave the warts without treatment long-term, they may get better by themselves or they may not, but it's not going to cause you any long-term health damage.

However, most people prefer to have them treated because they're not very nice to think about or to look at, and they're worried about their partners and the psychological impact.

How are genital warts treated?

There are a variety of treatments available, and no one method is any better than the other. 

We tend to start with the simpler things. One option is cryotherapy, which you might know as freezing therapy.  This treatment requires a visit to a clinic every one to two weeks.

There can cause some scarring, which is one of the downsides. It can be a little bit uncomfortable but some patients really like seeing the progress of the freezing.

There are some at-home options as well, including different topical treatments. One is a medication called podophyllotoxin toxin, which comes as either a blue liquid or a cream. You apply this topical treatment for three days every week, morning and evening, and then you have a four-day break. You continue doing this until they get better.

The last option that we commonly use is a drug called Imiquimod and that's something that you use for three nights every week but not consecutive nights. You apply this drug and then you wash it off in the morning. This can take up to 16 weeks to work but does tend to work very well and stop them coming back in the future.

Can genital warts recur following treatment?

It is possible to contract the HPV virus again. As previously mentioned, it's commonly caused by types 6 and 11. You might have contracted type 6 the first time, and your immune system is now wise to that, but you then later come into contact with type 11.

The other possibility is that you have had some treatment for your genital warts and on the surface, the genital warts have completely gone. However, there may be some virus particles left behind. This can cause warts to recur at a time in your life when you might be very stressed or your immune system is busy fighting something else. Women may see warts recur during pregnancy, for example.

If warts come back after treatment, it doesn't matter whether you've contracted a different type or whether there was a little bit of virus left behind. You can just come back and see us and get some more treatment.

Dr Georgina Forbes is a highly-experienced specialist doctor in sexual and reproductive healthcare based in Cardiff. If you would like to book a consultation with Dr Forbes you can do so today via her Top Doctors profile.