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JAMA Patient Page
February 5, 2019

Genital Warts

JAMA. 2019;321(5):520. doi:10.1001/jama.2018.20181

Genital warts are one of the most common sexually transmitted infections in the United States and are caused by some types of human papillomavirus (HPV).

Genital warts—also known as anogenital warts or condylomata acuminata—are raised lesions that develop on the skin and mucous membranes after infection with some types of HPV, a virus transmitted through contact during sexual activity.

Most commonly, genital warts appear clustered as a few small, raised lesions, but their appearance varies. They can be flesh-colored, light and pearly, or dark purple, gray, or brown. There may be many or only one. They may be small and difficult to see or they may enlarge and combine into masses. They can be rounded bumps or flat plaques; they may be smooth or rough. They can be hidden in hair or folds of skin. They are generally painless but may itch or become irritated.

In men, genital warts may be found on the scrotum, on the shaft of the penis, and in and around the tip of the penis. In women, genital warts may be found on the vulva, in the vagina, and on the cervix. In both men and women, warts can be found in the groin and in and around the anus. Oral sex can result in warts around the mouth, in the mouth, on the tongue or gums, and in the throat.

Human Papillomavirus

There are more than 100 types of HPV, and more than 40 types infect the genitals. They are highly contagious. Types 6 and 11 cause most genital warts. Other types of HPV increase a person’s risk of cervical, anal, and oropharyngeal cancer. Others cause warts found on the hands and feet. Many people infected with HPV have no symptoms but can still transmit the infection to others. There is no treatment for the virus, but the infection can go away on its own. Most people are infected with HPV at some time during their lives.

Who Is at Risk?

People who have unprotected sex or multiple partners or who start having sex at a younger age; people between 16 and 25 years old; and those who are infected with other sexually transmitted infections (STIs) are at increased risk. Extreme cases may be seen in immunocompromised patients.

Treatment

Genital warts often eventually go away on their own, but some cases need treatment. There are multiple treatment options. Topical treatments that are applied at home and topical treatments that are applied in the doctor’s office both require repeated applications. Other in-office options include freezing, burning, laser treatment, or cutting away the warts. Warts sometimes return after treatment and need to be treated again; removing the warts does not eradicate the HPV infection. Patients with genital warts should also be screened for other STIs, and women should be up-to-date on Papanicolaou tests.

Prevention

The HPV vaccine in the United States protects against types 6 and 11, as well as 7 types of HPV associated with cancers; it is recommended for male and female individuals and has recently been approved for people up to age 45 years.

Monogamy and condom use reduce but do not eliminate the risk of HPV transmission.

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For More Information

To find this and other JAMA Patient Pages, go to the For Patients collection at jamanetworkpatientpages.com. A Patient Page on HPV infection and cancer was published in the March 13, 2018, issue of JAMA.

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
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Article Information

Source: Yanofsky VR, Patel RV, Goldenberg G. Genital warts: a comprehensive review. J Clin Aesthet Dermatol. 2012;5(6):25-36.

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