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Health condition · Clinically reviewed

Genital warts, HPV, treatment options - and how vaccination fits.

A common, treatable sexually transmitted infection. A calm, stepped plan with the right sexual-health support beats guesswork and shame.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against BASHH, NICE and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK GUM practice including HPV vaccination, imiquimod and cryotherapy.

Key facts

Genital warts at a glance.

The essentials, in plain English - what causes them, how they present and how UK sexual-health services treat them today.

  • What it is

    Anogenital warts (condylomata acuminata) caused by human papillomavirus (HPV) - one of the most common sexually transmitted infections in the UK.

  • Cause

    Low-risk HPV types 6 and 11 account for more than 90 per cent of visible warts. High-risk types 16 and 18 rarely cause warts but carry cancer risk.

  • Appearance

    Soft, pink or flesh-coloured papules, plaques or cauliflower-like growths on genital, perianal, urethral, cervical or oral skin.

  • Symptoms

    Usually painless. Some people notice itching, bleeding or interference with intercourse. Many carry HPV with no visible lesions.

  • Diagnosis

    Clinical examination in general practice or a sexual health (GUM) clinic. Biopsy is only needed for atypical or refractory lesions.

  • Prevention

    The NHS HPV vaccination programme (Gardasil 9) protects against types 6, 11, 16 and 18 and has dramatically reduced wart rates.

Why this guide matters

A common infection, a clear plan.

Anogenital warts are one of the most common STIs in the UK - and one of the most treatable. The three points below shape everything else on this page.

  • Most warts are low-risk HPV

    Types 6 and 11 cause more than 90 per cent of visible warts. They rarely cause cancer, but they can be persistent and distressing.

  • Treatment is a menu, not a march

    Watchful waiting, home creams, cryotherapy and specialist procedures all have a place. Choice depends on site, size and pregnancy.

  • HPV vaccination changes everything

    Gardasil 9 protects against types 6, 11, 16 and 18. It has cut wart rates in the UK dramatically - and still helps adults with existing warts.

How the diagnosis is made

From first noticed to a clear plan.

The steps a UK GP or sexual health (GUM) service will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    History and risk assessment

    Sexual history, previous STIs, immune status and pregnancy. HPV is common - the goal is understanding, not judgement.

  2. 02

    Assessing

    Clinical examination

    Inspection of genital, perianal, oral and, in women, cervical skin. Often diagnosis is confident on sight alone.

  3. 03

    Assessing

    Acetowhite test if uncertain

    Selective use of dilute acetic acid can highlight subclinical lesions - not a routine step.

  4. 04

    Confirming

    Full STI screen

    HIV, syphilis, hepatitis B and C, chlamydia, gonorrhoea and herpes - offered to everyone with new anogenital warts.

  5. 05

    Confirming

    Cervical screening and HPV

    Women and people with a cervix should be up to date with NHS cervical screening (see /treatments/cervical-screening/).

  6. 06

    Confirming

    Proctoscopy for anal warts

    Anoscopy or proctoscopy is used when perianal or intra-anal warts are present - typically at a GUM clinic.

  7. 07

    Preparing

    Biopsy only if suspicious

    Reserved for atypical, refractory, pigmented or ulcerated lesions to exclude VIN, PIN or squamous cancer.

Typical timeline: a first visit to a settled plan in a single appointment or two.

Symptoms

What genital warts actually look like.

The typical pattern of soft papules and cauliflower-like plaques - and the features that mean a specialist should have a closer look.

  • Small pink or flesh-coloured papules

    The classic appearance - soft, painless bumps on the vulva, penis, scrotum, perineum or perianal skin.

  • Cauliflower-like clusters

    Larger, exophytic condylomata acuminata - often at the introitus, foreskin or anal margin.

  • Perianal and intra-anal warts

    Common in receptive anal sex and immunocompromise - anoscopy at a GUM clinic can confirm extent.

  • Urethral or cervical warts

    Occasionally cause bleeding, discharge or altered flow - warrant specialist review.

  • Itching or bleeding

    Mild irritation, spotting after intercourse or a snagging sensation during hygiene - all common.

  • Interference with intercourse

    Larger lesions can be sore or bleed with penetration - a reason to seek early treatment.

  • Oral or oropharyngeal lesions

    Uncommon but recognised - see /conditions/head-and-neck-cancer/ for cancer signals worth knowing.

  • Red flag - atypical or pigmented

    Pigmented, ulcerated, indurated or rapidly growing lesions need urgent specialist review and biopsy.

Treatment

How genital warts are treated in the UK.

Watchful waiting, home creams, cryotherapy and specialist procedures - guided by BASHH, tailored to site, size and pregnancy.

  • No treatment

    A valid choice for small, painless warts - many resolve spontaneously within 6 to 12 months as the immune system clears HPV.

  • Podophyllotoxin (Warticon)

    Home-applied solution or cream for external genital warts. Cycled 3 days on, 4 days off. Avoid in pregnancy.

  • Imiquimod (Aldara)

    Immune-modulating cream, 5 per cent, applied three times weekly for up to 16 weeks. Useful in immunocompromise.

  • Cryotherapy

    Liquid nitrogen applied at a GUM clinic - repeated every 1 to 2 weeks. Effective and safe in pregnancy.

  • Trichloroacetic acid

    Specialist-applied caustic solution for small mucosal warts, including in pregnancy where podophyllotoxin is contraindicated.

  • Electrocautery or curettage

    Specialist ablation under local anaesthetic for larger, keratinised or refractory lesions.

  • Laser or surgical excision

    CO2 laser or scalpel excision for extensive, refractory or intra-anal disease - a specialist option.

  • HPV vaccination

    Gardasil 9 is offered on the NHS to all children aged 12 to 13, catch-up cohorts, MSM up to 45 and immunocompromised patients.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or sexual health clinician knows your history and can tell you which parts apply to you. If in doubt, get seen.

  • BASHH. UK national guideline on the management of anogenital warts.

  • NICE CKS. Warts - anogenital.

  • UKHSA / NHS. HPV vaccination programme.

  • Royal College of Obstetricians and Gynaecologists. HPV and cervical screening guidance.

Red flags

When warts need urgent attention.

Most anogenital warts are managed comfortably in GUM and primary care. These are the situations that aren’t.

  • Atypical or pigmented lesion

    Pigmented, indurated, ulcerated or bleeding warts can mimic VIN, PIN or squamous cancer - biopsy is essential.

  • Rapid growth or refractory disease

    Lesions that grow quickly or fail to respond to first-line therapy warrant specialist GUM and sometimes MDT review.

  • Immunocompromise

    HIV, transplant recipients or long-term steroid use predispose to florid, atypical or high-grade HPV disease.

  • Suspected syphilis

    Condylomata lata (flat, moist plaques) can be mistaken for warts - see /conditions/syphilis/ and screen with treponemal serology.

  • Pregnancy

    Warts can proliferate in pregnancy. Avoid podophyllotoxin and imiquimod - use cryotherapy or trichloroacetic acid.

  • Child with anogenital warts

    Always needs safeguarding review - vertical transmission, autoinoculation and abuse must all be considered.

  • Urethral, cervical or intra-anal

    Deeper lesions need specialist assessment - urology, colposcopy or proctoscopy at a GUM service.

  • High-risk HPV positive

    A positive HPV 16 or 18 result on cervical screening carries cancer risk - follow the colposcopy pathway.

  • Oropharyngeal lesion

    HPV-related oropharyngeal cancer is rising - persistent oral lesions need ENT review (see /conditions/head-and-neck-cancer/).

Living with it

A common condition, with a clear plan.

Four things that make the biggest difference - reassurance, partner conversations, vaccination and staying on top of screening.

A quiet reminder

Genital warts do not define you.

HPV is common, treatable and something the NHS sees every day. Ask the questions you need to ask - clinicians will not be surprised.

  1. 01 Reassurance

    HPV is very common

    Most sexually active adults meet HPV at some point. Warts are a visible but usually harmless expression of a common virus.

  2. 02 Partners

    Talking to partners

    Current and recent partners should be offered a sexual health check. Condoms reduce but do not eliminate transmission.

  3. 03 Prevention

    HPV vaccination still helps

    Vaccination benefits adults even after exposure by protecting against types not yet acquired.

  4. 04 Follow-up

    Screening stays important

    Keep up with NHS cervical screening. Anal screening is offered to some higher-risk groups through specialist services.

Frequently asked

Everything we get asked about genital warts.

Quick answers on HPV, treatment options, sex and pregnancy, and vaccination.

  • What are genital warts?

    Anogenital warts are soft, pink or flesh-coloured lumps caused by low-risk types of human papillomavirus, most often HPV 6 and 11. They can appear on the vulva, penis, scrotum, perineum, perianal skin, urethra, cervix or, rarely, in the mouth.

  • Are genital warts serious?

    The warts themselves are not dangerous and often clear on their own. The concern is that HPV is a family of viruses - some high-risk types (16, 18) can cause cervical, vulval, anal and oropharyngeal cancer. That is why cervical screening and HPV vaccination matter even if you only have low-risk warts.

  • How are they treated?

    Options include watchful waiting, home-applied creams (podophyllotoxin or imiquimod) and clinic-based cryotherapy, trichloroacetic acid, electrocautery or laser. Choice depends on the site, number, size and whether you are pregnant. A sexual health clinic can guide you through the ladder.

  • Can I still have sex?

    Yes, though warts can transmit HPV to partners. Condoms reduce but do not eliminate risk because the virus lives in skin the condom does not cover. Be open with partners and encourage them to have their own sexual health check.

  • Do I need the HPV vaccine if I already have warts?

    Often yes. Gardasil 9 protects against nine HPV types - you may not have met all of them. NHS eligibility now includes adolescents, catch-up cohorts, men who have sex with men up to 45 and immunocompromised patients. Ask your GP or sexual health clinic.

  • What about pregnancy?

    Warts can flare in pregnancy because immunity shifts. Podophyllotoxin and imiquimod are avoided - cryotherapy or trichloroacetic acid are safer choices. Most babies are born unaffected, but talk to your midwife or obstetrician if lesions are large or bleeding.

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