Genital warts

In short

  • Genital warts are small, harmless lumps on or around the vagina, labia, penis or anus, caused by the human papillomavirus (HPV).
  • You get them through skin-to-skin contact during sex; they can appear weeks or months later, and a condom does not protect completely.
  • Most genital warts are caused by HPV types 6 and 11 — not the types that cause cervical cancer.
  • They often clear on their own, but treatment can help: creams you apply yourself, freezing, or removal by a doctor. Warts often come back afterwards.
  • A check for warts or an STI test usually runs through your GP or the GGD (the public health service).

What are genital warts?

Genital warts are small, harmless lumps on or around the vagina, labia, penis, anus or groin. They are a common sexually transmitted infection (STI), caused by the human papillomavirus (HPV). Almost everyone comes into contact with HPV at some point in their life, but most people never develop warts from it.

You get genital warts through skin-to-skin contact during vaginal, anal or (less often) oral sex, and by sharing sex toys. The virus can be passed on even when there are no visible warts, and warts can appear weeks to months after you were infected — so it is often impossible to say exactly when or from whom you caught them. A condom lowers the risk but does not protect completely, because it does not cover all the skin.

What do genital warts look like?

Genital warts are small lumps, roughly 1 to 5 mm, pinkish-red or greyish-white, and the top can look a little like a cauliflower. They may be single or grouped together. Sometimes they sit inside the vagina or anus, where you cannot see them yourself.

Many people have no other symptoms. Sometimes the warts cause itching, a burning feeling, mild pain or a little bleeding. Genital warts are not dangerous, but it is completely understandable to want them checked or treated.

How are genital warts diagnosed and treated?

A doctor can usually diagnose genital warts just by looking at them — no test is needed. To check for warts you cannot see yourself, the doctor may also look inside the vagina or anus.

Genital warts often clear on their own once your body clears the virus, but this can take many months to a couple of years. If the warts bother you, treatment can help. Bear in mind that treatment can take weeks or months to work, and warts often come back afterwards because the virus can stay in the skin.

Which treatment suits you depends on how many warts there are and where they sit:

  • Creams or liquids you apply yourself at home, on prescription (for example podophyllotoxin or imiquimod). These are used over several weeks and can cause irritation or a burning feeling.
  • Freezing (cryotherapy) with liquid nitrogen, usually repeated a few times.
  • Dabbing with an acid solution (such as trichloroacetic acid) at the practice.
  • Removal with heat or an electric needle (electrocoagulation), or cutting or laser for larger warts, under local anaesthetic.

No single treatment is best for everyone, and warts can return after any of them. Some wart creams can weaken condoms and diaphragms, so ask your doctor about this.

Genital warts can grow faster or larger during pregnancy because of hormonal changes. Most creams and liquids are not recommended while you are pregnant; freezing is generally considered safe. Warts often shrink again after the birth. Passing warts to the baby during delivery is rare. Always tell your doctor or midwife if you are pregnant, or think you might be, before starting any treatment.

Do genital warts cause cervical cancer?

No. Genital warts are almost always caused by HPV types 6 and 11 — “low-risk” types that do not cause cancer. Cervical cancer is caused by different, “high-risk” HPV types (such as 16 and 18). So having genital warts does not mean you will get cervical cancer.

Because HPV is so common, it is possible to carry a wart-causing type and a high-risk type at the same time. That is why it stays important to take part in cervical screening (the smear test) when you are invited, whether or not you have ever had warts.

The HPV vaccine offered to young people in the Netherlands protects against types 6 and 11 (which cause most genital warts) as well as the high-risk types that cause cervical and other cancers. It works best when given before someone becomes sexually active. Adults can sometimes still choose to be vaccinated, usually at their own cost. The vaccine does not treat warts you already have.

What can Gynaecologie Amsterdam do about genital warts?

In the Netherlands, an STI test or a check for warts usually runs through your GP or the GGD (public health service; in Amsterdam, GGD Amsterdam). As a gynaecology practice, we mainly see genital warts as a finding during an examination, or in women who come to us with related symptoms such as itching, abnormal discharge or pain. If we see genital warts during an examination and you are under our care with a referral from your GP, we can discuss treatment with you or refer you for it. If you only want a check-up or an STI test and have no other symptoms, please contact your GP or GGD Amsterdam.

Frequently asked questions

Do genital warts go away on their own?

Often, yes. Genital warts frequently clear once your body clears the HPV, although this can take many months to a couple of years. Treatment can help if the warts bother you, but they can still come back.

Why do my genital warts keep coming back?

Treatment removes the visible warts, but the HPV can stay in the skin, so warts often return and may need treating again. This is common and does not mean something is wrong.

Can I pass on genital warts if I cannot see any?

Yes. HPV can be passed on through skin-to-skin contact even when there are no visible warts. A condom does not cover all the skin, so it lowers the risk but does not remove it completely.

Do genital warts cause cervical cancer?

No. Genital warts are caused by low-risk HPV types (usually 6 and 11), not the high-risk types that cause cervical cancer. Because HPV is common you can carry both types, so keep attending cervical screening when you are invited.

Related care

Do you have symptoms and a referral from your GP? Make an appointment at Gynaecologie Amsterdam.

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