Anal warts

Anal warts

What are anal warts?

As the name implies, anal warts are warts occurring inside and around the anal region. Clinically, the condition is referred to as condyloma acuminate. Anal warts are a kind of genital warts.

Anal warts do not cause pain or discomfort in most cases. However, if they grow very large, they might get irritating, or bleed or even itch. Some people may not even know that they have anal; warts until the symptoms show up. Anal warts may be confined to one spot or may spread to different regions of the anus and genitals over time.

The symptoms of anal warts

Anal warts are found around the area of the anus or inside the anus itself. Initially, they appear as small bumps whose size may be no larger than the head of a pin. At first, they may be so small that noticing them would be a herculean task. As they grow, they develop a cauliflower-like appearance. A cluster of anal warts also has the same appearance. Warts may have a yellow color. Others may be peach, light brown, or pink colored. Some warts even blend with the complexion of the sufferer.

In most cases, pain or discomfort does not accompany anal warts. Other symptoms of anal warts are rare but can include bleeding, itching, or anal discharges. A person suffering from anal warts may also have a sensation of lumps in his or her anal area.

A person suffering from anal warts may also have warts in other areas of the body. For instance, genital warts may appear on the vulva, cervix or vagina. In men, genital warts may develop on the thighs, scrotum, groin, or the penis. Warts may also develop in the throat or mouth of a person with HPV. A person may also be infected if he or she has a deep kiss with someone who has throat warts. The same applies to those who engage in oral sex with a sufferer of genital warts.

What causes anal warts?

Anal warts and other forms of genital warts are caused by the Human Papillomavirus (HPV). HPV is transmitted during sexual intercourse. In young people, the infection may heal on its own. In fact, there may be no signs or symptoms of an infection. However, the virus can linger in the body and cause genital warts. It should be noted that the strain of HPV that causes anal and genital warts does not necessarily lead to cancer.

HPV generally spreads from one person to another via direct contact with the anus, mouth, vagina or penis of a person with the virus. Intercourse is not the only way by which the infection spreads. It may even be transmitted via skin contact. Transmission may occur even if the warts are invisible. A study by the Centers for Disease Control and Prevention (CDC) has found that the most common ways by which genital warts spread are through vaginal and anal sex. It also states that nearly all women and men who are sexually active get the HPV at some point in their lives.

Who is at risk for anal warts?

The following factors increases a person’s risk for anal warts:

  • Unprotected sex such as not using a condom, or a dental dam
  • Having anal sex
  • Maintaining multiple sex partners
  • Having intercourse with a person who has the infection
  • Having a compromised immune system
  • Early sex

Using condoms does not guarantee total protection from genital warts. One can also get warts even if he or she maintains one sex partner.

Diagnosis of anal warts

Visual examination may be employed for the diagnosis of anal warts. Some physicians apply vinegar (acetic acid) to the bumps while examining. This gives the bumps a white coloration, thus increasing their visibility. However, this is not necessary to diagnose anal warts.

An anoscope may be used to carry out an internal examination. The device helps the physician to search for warts inside the anal canal. The doctor may also carry out a full examination of the pelvic region to search for other forms of genital warts. For women, this may include a pap smear.

A biopsy may also be used to conduct a diagnosis. Biopsy confirms a diagnosis if warts do not respond to initial therapy.

Treatment for anal warts

There are many ways by which anal warts may be treated. The choice of treatment depends on the location of warts, the number of warts, and of course, healthcare provider and experience.

Topical medications: Topical medications are best suitable for warts that are not much in number or those that are limited to the outer area of the anus. In such cases, a prescription medication for the anal warts must be used. Readers are advised NOT TO USE OVER-THE—COUNTER WART REMOVERS in the genital or anal area.

Some medications used for the treatment of anal warts may be applied by the doctor in his or her office. You may also apply it at home by yourself. Regimens usually last for a few weeks.

Topical creams that may be used include:

  • Bichloroacetic acid (BCA)
  • Trichloroacetic acid (TCA)
  • Podofilox (Condylox)
  • Imiquimod (Aldara, Zyclara)
  • Podophyllin (Podocon)

Other treatment options…

Other options that may be used to treat anal warts (depending on the location and severity of the condition) include:

  • Cryotherapy: Here, liquid nitrogen is used to freeze the warts. The warts fall off after they’ve been freeze.
  • Laser treatments: These treatments makes use of energy that have been transmitted from an intense light. It is only used in complex cases.
  • Electrocautery: This involves the use of electric current to burn off the warts.

If the warts are at an advanced stage, then treatment may be given in stages. In some cases, there may be need for surgery.

Surgery for anal warts

Surgery is best used for warts that are too large, or for warts located deep within the anal canal. Surgery is performed on an outpatient basis. What this means is that the patient can be discharged in the same day that the surgery takes place.

During the surgery, a special tool will be used to cut the warts off the skin. A special anesthetic is administered for the purpose. Spinal or general anesthesia may be needed if the location and number of the warts is extensive.

Most people may feel some form of discomfort for a few days after cryotherapy, electrocautery or surgery. The discomfort can be eased with pain medications. Your ability to work depends on the extent of your treatment.

Prognosis for anal warts

Anal warts are not life-threatening. In many cases, they do not turn to cancer. However, a recurrence is possible as the causative factor (HPV) may linger for long in your body.

To watch for a recurrence, create follow-up appointments with your physician. This is very important especially in the first three months after treatment.

Preventing anal warts

Testing for HPV is not routinely recommended. However, there is an HPV vaccine. It may be administered to people below the age of 26. According to the CDC, individuals should receive a vaccination at 11 or 12 years of age so that they will be immune to the virus before they get exposed to it through sexual activity.

Other ways through which transmission of anal warts may be prevented include:

  • Abstaining from sexual contact
  • Use of dental dams and condoms
  • Cutting down on your number of sexual partners.

We have stated already that using barriers do not guarantee total protection from HPV. Hence, one must be very careful, and of course, stick to one partner.


Anal warts can cause discomfort; pain only comes in rare cases. If you suspect that you have anal warts, do not hesitate to consult your physician. He or she will carry out a physical examination, and draw up a good treatment plan that may be suitable for you.

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