Genital warts: symptoms, causes and which treatment to choose

A lump has appeared and you're fairly sure what it is. Or you're not sure at all, and an hour of looking at pictures online has made it worse. Maybe a cream from another clinic has done half the job, and you'd like the rest gone.

Here's the short version. Genital warts are common, they're caused by HPV, and they're treatable. There's no single best treatment: the right one depends on the warts themselves, what you've tried and what you'd prefer.

If you already know you want them removed, Dr Naoum treats men and women at 117a Harley Street on Fridays. Book wart removal at least a day ahead, with no GP or urologist referral. The first session is £450, and a follow-up, if you need one, is £150.

What do genital warts look like?

Genital warts are small flesh-coloured or greyish bumps. They can be flat or raised, on their own or in a cluster, and some people describe a cauliflower-like texture. NHS pages describe them as a common sexually transmitted infection.

They can appear on the penis, vulva, scrotum, groin or around the anus, and sometimes inside, on the cervix, in the vagina or in the anal canal. Most cause no symptoms at all. Some itch, feel uncomfortable or bleed a little, particularly after sex.

Many people with HPV never get a visible wart, so a partner without warts can still carry the virus.

How do you catch genital warts?

Warts are usually caused by low-risk HPV types, commonly 6 and 11, and BASHH estimates those two types are behind around 90% of anogenital warts. HPV spreads by skin-to-skin contact during vaginal, anal or oral sex, and also through genital contact without penetration.

Condoms lower the risk but can't remove it, because the virus can sit on skin a condom doesn't cover. HPV also spreads when no wart is visible, and NHS advice is that warts can take weeks or months to appear after contact.

Because of that delay, you usually can't tell when you caught it or who from, so a diagnosis says nothing about your partner's fidelity or your own. HPV is so common that most sexually active people will have it at some point.

Is there a test for genital warts?

The test is an examination. BASHH says looking at the area is normally enough to diagnose warts, sometimes with a bright light or magnification. NICE CKS keeps a biopsy for lesions that look unusual. For women, a cervical screening test or colposcopy may be suggested if there's a concern about warts inside.

An examination matters because several things look like warts and aren't. Skin tags, molluscum contagiosum and normal variations in genital skin can all fool the untrained eye, and comparing yourself with pictures online is unreliable.

Two other tests answer different questions. A typed HPV swab, £225 with results in 2 to 3 working days, shows which of 28 HPV types you carry. A sexual health screen checks for the infections a wart can't tell you about, such as chlamydia, gonorrhoea, syphilis and HIV.

Can genital warts lead to cancer?

No. Types 6 and 11, the ones behind most warts, are low-risk types and don't cause cancer. Cervical, anal and throat cancers are linked to high-risk types, mainly 16 and 18, which behave differently. Having warts doesn't mean you'll develop cancer, though it's a good reason to keep up with cervical screening if you have a cervix.

Do genital warts need treating?

Not always. Warts sometimes go away on their own within six months, and NICE CKS puts that at about one third of visible warts. Treatment makes sense when they persist, bother you, catch, bleed, or sit where clothes or sex keep irritating them.

It helps to know what treatment can do. It removes the tissue you can see. HPV itself has no cure, so treatment won't clear the virus from every patch of skin or make a partner immune. NHS pages say treatment can take weeks or months to work and that warts may come back. Recurrence is most common in the first three months, and becomes less likely as your immune system brings the virus under control.

Which treatment: cream, freezing or removal?

BASHH's 2024 national guideline describes two broad approaches: treatments you apply yourself, and treatments a clinician applies, which either work on the skin or destroy and remove the tissue. The choice depends on the number and position of the warts, how you've responded so far and what you prefer. Trials are built too differently to compare clearance rates fairly, so no option wins on paper.

Common options at a glance

NHS sexual health clinics also treat genital warts, often starting with creams or freezing. NHS advice is that pharmacy wart treatments aren't made for genital warts, so keep them off genital skin.

What is hyfrecation, and what happens on the day?

Hyfrecation uses a fine probe and a controlled electrical current to remove wart tissue once the area is numbed with local anaesthetic. It's a clinician-applied treatment, and all wart removal here is consultant-led. The same service is offered as genital warts treatment at our sister clinic.

Dr Naoum treats genital, anal and perianal warts, and other HPV-related lesions in the anogenital area, including vulval, penile and scrotal sites, when removal is clinically appropriate. Sessions run on Fridays, 10:00 to 16:00, by appointment with at least one day's notice and subject to capacity. A chaperone is available throughout.

He examines the area first and agrees with you how much to treat in one session. Local anaesthetic goes on before the hyfrecator is used, he explains each step as he goes, and you can ask him to pause at any point. Most people tolerate it well. A session typically lasts 15 to 30 minutes, and healing usually takes 7 to 10 days, though those are typical timings rather than guarantees.

Afterwards you'll get wound-care instructions, and you should keep the treated area dry for 24 hours unless advised otherwise. Extensive or recurrent warts may need a follow-up session at £150. Your visit stays private and isn't shared with your NHS GP or anyone else unless you ask. We've been at 117a Harley Street, London W1G 6AT, since 1984, and we're CQC-registered.

What should I tell the doctor?

• If you've already used a prescription wart cream such as podophyllotoxin, tell Dr Naoum. He'll examine the area and advise whether removal in clinic is suitable.
• If you've tried a pharmacy wart treatment, bring the name if you still have the box.
• If you're pregnant or planning a pregnancy, say so at the start. Some creams aren't used in pregnancy; BASHH, for example, advises against podophyllotoxin.
• If you take medicines that affect healing or immunity, or you've been told you have HIV or another condition that slows skin recovery, bring a medicine list and mention it.
• If what you have doesn't look like an ordinary wart, say so when you call.

Where do vaccination and HPV testing fit in?

They're separate appointments, and both are worth knowing about. The vaccine, Gardasil 9, protects against types you haven't met yet, including 6 and 11 and several high-risk types. It won't clear a wart that's already there, but it can protect you from the other types it covers. If you missed the school doses, adults can still have it: the first dose is £325 and the second and third are £225 each, £775 for the course, seven days a week. You'll find both the vaccine and the swab on the HPV testing and vaccination page.

A partner can ask a doctor whether testing or vaccination would help them. NHS advice is to consider getting current partners checked, and to use condoms, though a condom can't cover every patch of skin.

Booking a full STI screen or a gynaecology visit alongside

Wart removal treats the warts, so if you'd also like to know about other infections, book the sexual health clinic. NICE CKS treats checking for other infections as part of good care, especially for younger people and anyone with other genital symptoms. The Bronze screen, £250, includes a doctor consultation, an examination and tests for chlamydia, gonorrhoea, syphilis and HIV.

For pelvic pain, abnormal bleeding, a fertility question or an early-pregnancy concern, see consultant gynaecology. Dr Naoum will also tell you if anything he sees needs a specialist assessment beyond a planned clinic session, as NICE CKS advises for warts inside the cervix, urethra or anal canal, or where the diagnosis is uncertain.

If you have heavy bleeding, can't pass urine, or have a fever that's making you unwell now, call NHS 111, or go to A&E or call 999 if it's severe.

Related guides: adult HPV vaccination with Gardasil 9 and STI window periods and when to test.