Individuals who have the misfortune of getting warts in or near their sex organs (genitalia) often discover that the warts have spread to their anus. Others will develop warts only in the anal area.Wherever they are, they can be itchy and uncomfortable. And they’re definitely unsightly, making them a hindrance to satisfying sexual activity. Over-the-counter anal wart creams are described below. Other treatments to remove warts, including prescription creams, are also described. While removing warts can sometimes be a challenge, solutions are available.

What Causes Anogenital Warts?

Diagram of anal warts

Diagram of anal warts

Papilloma is the medical name for warts in general. A virus is the cause of most warts as well as certain cancers. It’s been given the name human papillomavirus, or HPV. The HPV group includes more than 150 kinds of viruses, each of which has an identifying number. Approximately one-third of the HPV types can cause genital and anal warts in individuals. Those types are not the types that can cause cancer. Some individuals may have several types of HPV.

The virus that causes warts and examples of the anal warts that result from infection

The virus that causes warts and examples of the anal warts that result from infection

HPV is highly contagious and infects almost everyone who is sexually active. Because it often doesn’t have noticeable symptoms, infected people can unknowingly spread HPV to their sexual partners. Often symptoms don’t develop until years after the initial exposure, which makes it difficult, if not impossible, to determine who was first infected.

Process by which HPV leads to warts

Process by which HPV leads to warts

HPV requires intimate skin-to-skin contact and is most commonly transmitted by anal, oral, or vaginal sex with an infected person. Sometimes it can be passed on without intercourse when an infected person has very close skin contact with another. Unlike HIV (AIDS), it is not transmitted by an exchange of body fluids. HPV is treatable, but not curable.

Women with HPV can infect their children while giving birth.

How Do Anal Warts Grow and What Do They Look Like?

Anal warts are a form of genital warts and are sometimes called anogenital warts. The medical name is condyloma acuminata. It’s possible to have warts in or around the anus and not be aware of them. They can be very small and often don’t hurt. Other times, the warts can grow quite large and uncomfortable.

Perianal warts

Perianal warts

Anogenital warts are very contagious and easily spread to surrounding skin. The perineum is the area between the anus and the vagina in women, and between the anus and the scrotum in men. Perianal warts are those that grow in the areas around the anus and may also spread to the perineum.

Anal warts can be flesh-colored, light brown, white, or gray. They may be pedunculated, which means they grow at the end of a stalk so that they protrude outward. They can be slightly dome-shaped and look like any other wart. A group of warts can be shaped like a cauliflower.

The warts in women usually first appear on the vulva, which are the external parts of the female genitalia, then spread to the perineum and perianal regions and invade internal organs. If you develop vaginal warts, look here for suggestions for treating them.

Men may find warts on their penis and scrotum as well as their anus and perineum. The warts can grow inside the urethra, which is the tube that carries urine from the bladder to outside the body. In men, the urethra also carries semen. Anal warts can develop inside the anus in men and women. Both sexes can develop warts in their groins.

Examples of where anal warts can develop

Examples of where anal warts can develop

How Do I Know for Sure If I Have Anal Warts?

If you feel discomfort in or around your anus, you are well advised to consult a health care professional. Anogenital warts will sometimes bleed or itch. Some individuals may experience a mucous discharge from their anus.

Diagnosis of anal warts is usually made by visual inspection. Doctors may sometimes dab vinegar on areas where warts are suspected. That turns the warts white and makes even the tiniest ones visible. If internal warts are suspected, the doctor will examine the inside of the anus with an instrument called an anoscope. Women should expect a Pap smear and men can expect a digital rectal exam.

An anoscope is a finger-sized tube with a light.

What Are My Chances of Getting Anal Warts?

Anal warts result from an HPV infection. HPV is a sexually transmitted infection or STI. Nearly everyone who is sexually active has HPV, although most individuals don’t realize it. It doesn’t usually have noticeable symptoms, especially in the early stages. HPV can remain dormant in the body for years. Warts may appear right after infection, many years later, or sometimes not at all.

Even when warts aren’t noticeable or have been removed, HPV remains contagious and can infect others.

Individuals who are at the highest risk of contacting anogenital warts are those who:

  • Engage in unprotected sex, especially with more than one partner.
  • Engage in anal sex.
  • Have skin-to-skin contact with an infected person.
  • Become sexually active at a young age.
  • Have a compromised immune system.

Although condoms can be helpful, they do not offer full protection against HPV.

Gardasil is a vaccine that can protect against some types of HPV if used before the person becomes sexually active. The role of Gardasil in preventing warts is still unknown. There is currently no cure for HPV once it’s been contracted.

The Best Ways to Treat Warts on Anus

HPV anal warts can go away without treatment, but may or may not reappear later. Treatment is usually advised and involves removal of the warts in one of several ways. There is no cure for anogenital venereal warts.

Choosing whether to treat anal warts and selecting the type of treatment depends on:

  • The location of the warts.
  • The size of the warts.
  • The preferences of the patient.
  • The costs of the different options.
  • The side effects and discomfort associated with each option.

There isn’t one particular treatment that’s superior to the others or appropriate for everyone or for all types of warts.

Rectal warts that are uncomfortable may be removed by various skin creams, surgery, or by freezing or burning them. Most removal techniques require consulting a medical professional. If the warts are not removed, they tend to increase in size and number. Regardless of how they’re removed, it’s common for the warts to grow back, sometimes years later, and repeated treatment may be necessary.

External and small warts may be treated with an anal wart cream. The cream usually must be applied regularly for several weeks.

The most common prescription creams are:

  • Aldara 5% cream5-FU (5-fluorouracial),
  • Aldara (imiquimod),
  • BCA (bichloroacetic acid),
  • Condylox (podofilox),
  • Podocon (podophyllin),
  • TCA (trichloroacetic acid),
  • Zyclara (imiquimod).

Some of the prescription creams can be applied at home and others must be applied by a doctor in his or her office.

Experts generally advise against using over-the-counter wart removal creams as they can irritate or burn sensitive anal skin. In the worst case, the skin may become ulcerated and require additional treatment. For numerous reasons, many individuals prefer to try non-prescription creams on external warts, such as those in the groin or on the thighs. There’s more information here for treatments, including creams, for warts on buttocks.

These include:

  • H-Warts FormulaH-Warts Formula: A homeopathic remedy that includes essential oils that remove warts gently and naturally. Available on the internet from the manufacturer for about $35.00.
  • NaturasilNaturasil: A brush-on liquid made from essential oils. Available on the internet from the manufacturer and numerous vendors and from pharmacies and drugstores for about $60.00.
  • Somxl Wart FormulaSomxl Wart Formula: Contains salicylic acid, which helps dissolve warts and oxygen to help heal skin. Available on the internet from the manufacturer for about $25.00.
  • TerrasilTerrasil: Contains homeopathic ingredients combined with minerals and moisturizers to remove warts painlessly and heal skin. Available on the internet from the manufacturer for about $25.00 – $60.00, depending on size ordered.
  • Wartie: Freezes wartsWartie: Freezes warts. Presently available only in Europe at pharmacies and drugstores.
  • Salicylic/20 Gel PeelPharmacies and drugstores carry numerous products containing salicylic acid in a range of prices.

Home remedies that people have found to be an effective anal wart cure include apple cider vinegar, castor oil, and tea tree oil. These are applied daily to the warts and covered. Application is repeated until the warts disappear, which can take weeks to months.

If the creams or home remedies aren’t successful, or when there are internal anal warts, then surgery may be necessary. Surgery is usually done on an outpatient basis and patients return home that day. Patients will probably experience some discomfort after a surgical procedure, but they are frequently able to resume normal activities quickly. Most anal warts can be removed using only a local anesthetic. However, depending on the location, size, and extent of the warts, a general anesthesia may be required. A biopsy of removed warts is rarely necessary.

Important Information

Anal warts and anal dysplasia

Anal warts and anal dysplasia

Sometimes a medical professional believes that a removed wart appears abnormal and accordingly sends it to a pathologist for analysis. Abnormalities are called dysplasia and can be precursors to anal or cervical cancer. They aren’t cancer, but need to be monitored. Individuals who are at increased risk of anal dysplasia are those who:

  • Have an HPV infection,
  • Have a history of anal sex,
  • Test positive for HIV,
  • Smoke,
  • Have a weakened immune system.

If dysplasia invades normal skin cells, then a malignancy can develop.

The extent and severity of anal warts may require additional measures to remove them. Medical professionals can spray liquid nitrogen on the warts. This process is known as cryotherapy. The warts are killed by freezing and they’ll fall off. Burning off the warts is called electrocautery. That process uses an electric current to kill the growths. In extremely difficult cases, a specialist will use laser treatments to remove the warts. None of the treatments will cure the underlying HPV infection.

Anal warts can be embarrassing, but it’s important to treat them to avoid infecting future sexual partners. Even though condoms don’t offer 100% protection 100% of the time, they can help prevent transmission of HPV and the resulting warts. Seeking treatment and using protection is a win/win situation for everyone.

You can find further details of Genital warts here.