Read the Frequently Asked Questions in printable PDF form.
- What is HPV?
- What do genital warts look like?
- What about HPV that causes no visible warts?
- Who gets HPV or genital warts?
- How do you get HPV or genital warts?
- How would I know if I had HPV or genital warts?
- How are genital warts diagnosed?
- What should my partner do if I have genital warts or HPV?
- How are genital warts treated?
- How is subclinical HPV infection treated?
- Can HPV and genital warts be cured?
- What about HPV, genital warts and cancer?
- What about HPV, genital warts and pregnancy?
- How can I avoid getting HPV or genital warts?
- Where can I get further information?
Human papillomavirus (HPV) is the name of a group of viruses that includes more than 150 different types that cause infection on the skin surface. Certain types of HPV cause warts on the hands or feet, while others can cause visible genital warts. However, sometimes HPV infection causes no warts, and many people with genital HPV do not know they have it.
Genital warts are growths or bumps that appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin or thigh. They may be raised or flat, single or multiple, small or large. Some cluster together forming a cauliflower-like shape.
Sometimes HPV causes very subtle changes on the skin that can’t be seen with the naked eye. This is called subclinical HPV. Health care providers can find these “microscopic HPV changes” only with the help of special instruments.
Evidence suggests that the majority of individuals who have ever been sexually active experience one or more genital HPV infections during their lifetime. Most HPV infections clear spontaneously. The most common effects of HPV infection are genital warts or abnormalities in the cervical smear.
Subclinical HPV and genital warts are usually spread by direct, skin-to-skin contact during vaginal or anal sex. It is also possible, but rare, to transmit them to the mouth by oral sex.
Warts on other parts of the body, such as the hands, arecaused by different types of HPV. Contact with these warts does not seem to cause genital warts.
Warts may appear within several weeks after sexual relations with an infected person; or they may take months to appear; or they may never appear. This makes it hard to know exactly when or from whom you got the virus.
It is thought most subclinical HPV infections are transmitted through sexual intercourse, although they are generally believed to be less contagious than genital warts.
In some cases, it’s difficult to know. Sometimes people do not notice warts because they are inside the vagina, or on the cervix, or in the anus. In addition, they are often flesh coloured and painless. Only rarely do they cause symptoms such as itching, pain, or bleeding.
Sometimes warts will be found during a physical examination in men or women. For women, an abnormal cervical smear may be the first warning sign that HPV is present, though a cervical smear is not a test for HPV.
You should go to a doctor or clinic if:
- you notice any unusual growths, bumps, or skin changes on or near your penis, vagina, vulva, or anus; or
- you notice any unusual itching, pain, or bleeding; or
- your sex partner(s) tells you that he or she has genital HPV or genital warts.
If a woman has an abnormal cervical smear she should be examined and followed-up, as advised by her doctor or health care provider.
You can check yourself and your partner(s) for warts, but remember: warts sometimes can be very difficult to see. Also, sometimes it’s hard to tell the difference between a wart and other bumps and pimples. If you think you have warts or have been exposed to HPV, go to a doctor or clinic. The health care provider will check more closely and may use a magnifying lens to find small warts.
Give them this pamphlet to read. Suggest a visit to a doctor or sexual health clinic for an examination for warts, and a general sexual health check up. If one or both people in a long term relationship have either genital warts or HPV, the benefit of using condoms to reduce the risk of transmission is unclear as partners usually share the virus.
Treatment is optional. Most genital wart infections will clear up spontaneously sooner or later. However, many people want to have them treated as they can be unsightly and/or uncomfortable. The following are the recommended treatment options available:
- The goal of treatment should be to remove visible genital warts and relieve annoying symptoms.
- There are several available treatments, and no one treatment is ideal for all people or all warts.
- Podophyllotoxin (Condyline™) solution is a patient applied treatment for external genital warts, recommended for men only as it is too difficult for women to self-apply. For men, it is easy to use and safe if instructions are followed. Contraindicated in pregnancy.
- Imiquimod (Aldara™) cream is a patient applied treatment for external genital and perianal warts. It is easy to use and safe if instructions are followed. If other treatments are unsuitable, Aldara is available by fully subsidised prescription from your doctor through Special Authority application. Not recommended in pregnancy.
- Cryotherapy (freezing off the wart with liquid nitrogen) by a trained health practitioner.
- Trichloroacetic acid (TCA) is a chemical applied to the surface of the wart by a trained health practitioner. It is unavailable in some DHBs.
- Laser therapy (using an intense light to destroy the warts) or surgery (cutting off the warts) has the advantage of getting rid of the warts in a single visit. Laser treatment can be expensive and the health care provider must be well trained in these methods. It is only available in a few centres. Recurrences may occur.
Factors that might influence selection of treatment include size, location and number of warts, changes in the warts, your preference, cost of treatment, convenience, adverse effects, and the health care provider’s expertise.
Whatever the treatment, here are some important points to remember:
- It is advisable to seek medical advice before starting treatment for genital warts.
- Ask your doctor for an explanation of the treatment, including the costs and likely benefits.
- Be sure to understand the follow-up instructions, such as what to do about discomfort and when to seek help.
- Be patient – treatment often takes several visits and a variety of approaches.
- If you are pregnant or think you might be, tell your doctor so he or she can choose a treatment that won’t be harmful to you or your baby.
- Don’t use over the counter treatments which are not specifically for genital warts. These are not meant for sensitive genital skin.
- It is recommended to avoid sexual contact with the infected area during treatment, to protect the treated area of skin from friction and help it heal.
There is no proven benefit to treating subclinical HPV.
Treatment of genital warts can be frustrating. The average person may need several treatments to clear genital warts. None of the available treatments is a cure for HPV. The virus can remain in the skin after treatment. Because the virus can lie dormant in the cells, in some cases warts can return months or even years after treatment. In other cases warts never recur.
The types of HPV linked to cervical cancer usually are not the types linked with genital warts. But a woman with genital warts, like any other sexually active woman, should have regular smears as advised by her health professional. HPV vaccination and regular cervical smears are the best safeguard against cervical cancer. Cervical smears detect abnormal cells present on the surface of the cervix. Cancer almost always can be prevented through the early detection and treatment of abnormal cervical tissue.
Genital warts very rarely cause problems during pregnancy and delivery. Because of changes in the body during pregnancy, warts can grow in size and number. A woman with genital warts does not need to have a caesarean-section delivery unless warts are blocking the birth canal, which is extremely rare. Rarely, babies exposed to HPV during birth may develop warts in the throat. If you are pregnant and have genital warts, speak to your health care provider, as some methods of treatment cannot be used during pregnancy.
- Preventive vaccines are now available, which provide protection from some of the most common genital HPV types, including genital warts. Vaccination prior to becoming sexually active is best and is currently available free to females aged between 12 and 20 years.
For more information visit www.cervicalcancervaccine.govt.nz or ask for our HPV Vaccine pamphlet.
Ways to lower your risk of getting any sexually transmitted disease may also be effective for HPV or genital warts:
- You can reduce your risk of getting HPV or genital warts by not having sex with anyone, or by having sex only with one partner who has sex only with you. People who have unprotected sex with many partners are at higher risk of getting sexually transmitted infections.
- Condoms, used correctly from start to finish each time you have sex, provide some protection if they cover the area of the genital warts. However HPV may be present in areas of skin not covered by condoms. Condoms are recommended with all new or casual sexual partners.
- Spermicidal foams, creams, and jellies used as an adjunct to condoms are not proven to act against HPV and genital warts. They are best used along with condoms, not in place of condoms.
- Genital HPV can be managed.
- Cervical cancer can be prevented by early vaccination and having regular cervical smears as per the National Cervical Screening Programme recommendations.
- Informing yourself about HPV will help you to understand and manage the infection.
- You are not alone. It is estimated that over 75% of sexually active people have HPV infection at some stage in their lives. For most, it is a minor problem.
- New Zealand HPV Project Helpline
Tollfree 0508 11 12 13
- Your GP, Family Planning Clinic or Sexual Health Clinic
- National Cervical Screening Programme
Freephone 0800 729 792 or