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Genital Warts (cont.)

What Are the Signs and Symptoms of Genital Warts (HPV)?

Although genital warts are painless, they may be bothersome because of their location, size, or due to itching.

  • The size may range from less than one millimeter (1 mm = 0.039 inches) across to several square centimeters (1 cm = 0.39 inches) when many warts join together.
  • Men and women with genital warts will often complain of painless bumps, itching, and discharge.
  • Rarely, bleeding or urinary obstruction may be the initial problem when the wart involves the urethral opening (the opening where urine exits the body.)
  • Warts in more than one area are common.
  • There may be a history of previous or concurrent sexually transmitted diseases (STDs).

Specific descriptions

  • In men, genital warts can infect the urethra, penis, scrotum, and rectal area. The warts can appear as soft, raised masses with a surface that can be smooth (on the penile shaft) or rough with many fingerlike projections (anal warts). Others may appear pearly, cauliflower-like, or rough with a slightly dark surface. Most lesions are raised, but some may be flat with only slight elevation above the skin surface. Sometimes lesions may be hidden by hair or in the inner aspect of the uncircumcised foreskin in males.
  • In women, genital warts have a similar appearance and usually occur in the moist areas of the labia minora and vaginal opening. Lesions visible on the outer genitals warrant a thorough examination of the vaginal canal, cervix, and anorectal area. Most vaginal warts occur without symptoms. Rarely, women may experience bleeding after sexual intercourse, itching, or vaginal discharge.

Is There a Vaccine to Prevent Genital Warts?

  • In 2006, an HPV vaccine (Gardasil) was approved by the FDA. It is currently recommended for both males and females aged 9 to 26 years. This vaccine has been shown to be safe and highly effective in preventing infection with the four most common HPV types (6, 11, 16, and 18) in women who have had no previous exposure to the virus. However, it is less effective in those who have already been infected with HPV, and it does not protect against all types of HPV infection. Studies are underway to determine whether the vaccine is safe and effective in older women.
  • Gardasil 9 has activity against the four viral types in the basic Gardasil, but also against virus types 31, 33, 45, 52, and 58 (for a total of 9 viral types, hence the name). It also is approved for both males and females aged 9-26 years of age.
  • Another vaccine against HPV types 16 and 18, Cervarix, was been approved by the FDA for females aged 10 to 25 years, but was withdrawn from the US market in 2016.
  • Because no treatment is 100% effective, it is important to prevent the spread of HPV, which causes genital warts and some cancers whenever possible. Transmission of genital warts can be decreased if condoms are used and the infected individual refrains from sexual activity until therapy is completed.

When to Seek Medical Care for Genital Warts (HPV)

If you have genital warts, see a health-care professional and discuss treatment options.

Bleeding warts that cannot be controlled with direct pressure should be seen by a health-care professional. Warts that obstruct the urethral opening and don't allow you to urinate are an emergency and should be treated as soon as possible.

Medically Reviewed by a Doctor on 10/2/2017

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Read What Your Physician is Reading on Medscape

Warts, Genital »

Until the 19th century, genital warts (GWs) were believed to be a form of syphilis or gonorrhea.

Read More on Medscape Reference »


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