Genital warts in men: signs, causes, treatment and prevention

Genital warts are small, rough lumps on the skin of the genital and anal area. The NHS describes them as a common sexually transmitted infection (STI). They are caused by certain types of the human papillomavirus, a very common virus, and they are a skin condition rather than a sign that someone has been careless about hygiene.

For men, this usually means the shaft or head of the penis, the area around the anus, and the strip of skin between the genitals and the anus (the perineum). Because warts can sit on skin that is not visible, such as just inside the foreskin or around the anus, a person can have them without realising.

According to the NHS, genital warts may appear on their own or in a group, and groups of warts can look like a cauliflower. They may feel soft or firm and can be white, red, skin-coloured or darker than the surrounding skin. They do not usually cause symptoms, but sometimes they may be painful, itchy or bleed.

Some men notice other changes. The NHS lists pain or discomfort during sex and problems peeing, such as blood in the pee, difficulty peeing or stopping and starting a lot. A change in the normal flow of pee, for example if the stream has begun to go sideways, that does not go away is another reason to be examined, because warts can sit at or just inside the opening of the urethra.

It can take a few weeks or months for genital warts to appear after contact with someone who is infected, so a new wart does not necessarily point to a recent partner.

The NHS says you can get genital warts from skin-to-skin contact, including vaginal and anal sex, from sharing sex toys, and, rarely, from oral sex. The virus can be passed on even when there are no visible warts, and many people with the virus have no symptoms but can still pass it on. That is why it is often impossible to know who the infection came from or how long it has been present.

You cannot get genital warts from kissing or from sharing things like towels, cutlery, cups or toilet seats, according to the NHS. The infection can spread from one part of the body to another if you touch an infected area and then touch another area.

The NHS advises going to a sexual health clinic if you have one or more painless lumps or growths around the penis or anus, itching or bleeding from the genitals or anus, a lasting change in your normal flow of pee, or a sexual partner who has genital warts, even if you do not know whether you have them yourself. A GP will probably refer you to a clinic if they think you might have genital warts, and many clinics offer a walk-in service. There is no prescription charge for medicines prescribed by a sexual health clinic.

At the clinic, a doctor or nurse will usually be able to diagnose genital warts by looking at them. They may ask about your symptoms and sexual partners, examine the lumps around the genitals and anus, sometimes using a magnifying lens, and possibly look inside the urethra, depending on where the warts are. You can ask whether testing for other sexually transmitted infections is appropriate at the same visit.

The NHS says treatment for genital warts is not always needed, as they sometimes disappear on their own within 6 months. If treatment is recommended it needs to be prescribed by a doctor, and the choice depends on what the warts look like and where they are.

• Creams, liquids or ointments, which you can usually apply yourself, although a doctor or nurse needs to apply them if the area is large. These can cause pain, irritation or a burning sensation.

• Freezing (cryotherapy), which may need to be repeated several times and can be painful.

• Surgery, where warts are cut out after the area is numbed with local anaesthetic, or removed using heat or a laser. These treatments can cause pain, irritation or scarring.

The NHS notes it may take weeks or months for treatment to work, the warts may come back and sometimes the treatment does not work. This can be discouraging, and it helps to know that recurrence does not mean the treatment was done wrongly or that you have been reinfected.

While being treated, the NHS advises following the instructions for applying creams carefully, avoiding getting treatment on normal skin or open wounds, and not using wart treatments bought from a pharmacy because they are not made for genital warts. It also says not to smoke because many treatments work better if you do not, and not to have vaginal, anal or oral sex until the warts have gone, although condoms should always be used if you do. Some creams can weaken condoms, so ask the clinician about this.

Partners should consider being checked, because they may have warts and not know it.

The NHS says using a condom every time you have vaginal, anal or oral sex helps, but if the virus is in any skin not protected by a condom it can still be passed on. Not having sex during treatment and not sharing sex toys, or washing them or covering them with a new condom before anyone else uses them, also reduce the chance of passing the infection on.

Vaccination is the main preventive measure. The NHS says the HPV vaccine offered to 12 to 13 year-old girls and boys in England protects against genital warts and some cancers, such as cervical and anal cancer. It is also offered to men up to and including 45 years old who have sex with men, some trans men and trans women, sex workers and people living with HIV.