What are anal
Anal warts are small warts that can occur inside and around the anus. The
condition is also called condyloma acuminata. Anal warts are a form of genital
The warts do not cause discomfort or pain in most cases. They can become
irritating if they grow large enough, however, and might itch or bleed. People
with anal warts may not even know that the warts exist. Anal warts may be only
in one place, or may spread to different parts of the genitals and anus over
are the symptoms of anal warts?
In many cases, anal warts may remain unnoticed. They often occur without
pain or discomfort.
Anal warts are found inside and around the area of the anus. They start as
small bumps that may be no larger than the head of a pin. Initially, they may
be too small to be noticed. They can develop a cauliflower-appearance as they
grow, or when several are clustered together. They may be flesh-colored,
yellow, pink, or light brown.
The virus that causes anal warts also causes genital warts. Warts may occur
on other parts of the body at the same time. Genital warts in women may appear
on the vulva, vagina, or cervix. Genital warts in men can develop on the penis,
scrotum, thighs, or groin. They may also grow on the mouth or throat of an
Other symptoms of anal warts are rare but can include itching, bleeding, or
discharge from the anus. An infected person may also have the sensation of
having a lump in the anal area.
What causes anal
Genital warts are caused by human papillomavirus (HPV). HPV is a sexually
transmitted infection (STI). In young people, HPV may go away on its own and
might not cause any signs or symptoms. The virus can, however, remain and cause
genital warts. Some types of HPV cause genital warts and others may lead to
cancer, but the type of HPV that causes anal and genital warts does not lead to
Transmission of HPV can occur even if warts are not visible. It is spread by
direct contact with the anus, mouth, penis, or vagina of an infected person.
Intercourse is not necessary to spread the infection. It can be transmitted by
Genital warts can be spread easily. It is most commonly spread through anal
and vaginal sex according to the Centers for Disease Control
and Prevention (CDC). The CDC also states that nearly all men and women who
are sexually active get HPV at some point in their lives.
is at risk for anal warts?
You are at an increased risk for contracting and spreading anal warts if
- participate in unprotected sex with more than one
- participate in anal intercourse
- have had sex or intimate contact with an infected
- have sex at an early age
- have an immune system that is compromised by illness or
However, you can get HPV even
if you are only with one partner, and condoms do not fully protect against HPV.
It is very common, especially in young people, to be exposed to HPV.
How are anal warts diagnosed?
A doctor can diagnose anal warts by visual examination. Some doctors apply
acetic acid (vinegar) to the bumps during the examination. This causes the
bumps to turn white and become more visible. However, this is not necessary to
diagnose anal warts.
An examination for anal warts involves an internal examination with an
anoscope to look for warts inside the anal canal. Your doctor may also conduct
a full examination of the pelvic region to look for other forms of genital
warts. This may include a Pap
smear for women.
Diagnosis also can be made with a biopsy of the warts. This may be used to
confirm a diagnosis when warts don’t respond to initial therapy.
are anal warts treated?
The choice of treatment depends on the number and location of warts, patient
preference, and provider experience.
Treatment with a topical medication may be adequate for warts that are very
small and limited to the outer area of the anus. In this case, a prescription
medication for anal warts must be used. Over-the-counter wart removers are not
intended for use in the anal or genital area.
Some medications to treat anal warts are applied by a doctor in the office.
Others you can apply yourself at home. Regimens typically last for several
weeks or more.
Topical creams include:
- imiquimod (Aldara, Zyclara)
- podofilox (Condylox)
- podophyllin (Podocon)
- trichloroacetic acid (TCA)
- bichloroacetic acid (BCA)
Surgical options may be more effective for larger warts that don’t respond
to topical treatments or anal warts located inside the anal canal. Surgical
treatment is typically performed on an outpatient basis. This means you can go
home the same day as the surgery.
The surgeon will use a special tool to cut off the warts. You will normally
be given a local anesthetic. General or spinal anesthesia may be necessary if
the number and location of anal warts is extensive.
Other treatment options
Additional treatment options depend on the severity and location of anal
warts. These other treatments include:
- Cryotherapy: Liquid nitrogen is used to freeze the
warts. After freezing, the wart falls off.
- Electrocautery: An electric current is used to burn off
- Laser treatments: Energy is transmitted from an intense
light. This technique is often limited to use for difficult cases.
Most patients are uncomfortable for a few days after surgical treatment of
anal warts. Pain medication may be prescribed. Your ability to work or perform
normal activities varies depends on the extent of your treatment.
the long-term outlook for anal warts?
If warts are extensive, treatment may be administered in stages. Recurrent
warts are common. The virus can remain dormant in concealed tissues, only to
appear months later with the growth of a new wart. Follow-up visits and
treatments may be necessary for several months to ensure that no new warts
exist. Warts may be harder to get rid of if you have a suppressed immune
system, like with HIV.
can anal warts be prevented?
Anal warts can come back even after seemingly successful treatment. Your
doctor may recommend reevaluation for recurrent warts at regular intervals
There is no good test for HPV screening, and currently HPV testing is not
The CDC recommends
that boys and girls get vaccinated for HPV at age 11 or 12 in order to be
immune before exposure.
You can reduce your risk of infection with HPV by abstaining from sexual
contact, using condoms, or limiting the number of sexual partners. However,
condoms do not protect completely from HPV, and it is possible to get HPV with
even one sexual partner. HPV is very common and most people get this virus at
some point in their lives.