Anal Warts (Condyloma)

What Are Anal Warts?

Doctors define anal warts as raised skin-colored growths around the anus or inside the lower rectum. The rectum is the last part of the large intestine.

You may hear your health care provider call anal warts by their medical name — condyloma or condyloma acuminatum.

Anal warts often appear as small bumps that sometimes clump together. They can be raised, flat, or cauliflower-shaped. They usually don’t hurt but may be itchy.

Because they are often painless and don’t always cause symptoms, you may not even know you have anal warts. But while they aren’t life-threatening or dangerous, anal and rectal warts can grow large and eventually cause pain and bleeding. They may multiply and restrict bowel movements.

Health care providers can remove anal warts with medicines or surgery. But because the virus that causes them remains in your body, anal warts can come back.

Is there a difference between anal warts and genital warts?

Anal warts are often classified along with genital warts and referred to as anogenital warts.

Genital warts and anal warts are the same type of growth. The difference is their location.

Genital warts grow on the penis, vagina, scrotum, or labia. Anal warts grow on the anus and inside the rectum.

HPV can also cause warts on the lips and tongue, and in the mouth and throat. Different strains of HPV can also lead to warts on the hands and feet.

What’s the difference between anal warts and hemorrhoids?

Sometimes it can be hard to tell the difference between anal warts and hemorrhoids. They both occur in the rectum and anus; both are protrusions from smooth skin. But anal warts and hemorrhoids are two different conditions.

Hemorrhoids are swollen veins in the anus and lower rectum. They can cause bleeding, pain, and itching.

Anal warts typically don’t cause much pain or bleeding. They are flesh-colored, while hemorrhoids are usually dark red or purple.

How common are anal warts?

Doctors don’t know exactly how many people have anal warts. They fall under the umbrella of anogenital warts — genital and anal warts. About one in 100 sexually active adults in the U.S. has anogenital warts.

Anal warts are a result of HPV — the most common sexually transmitted infection worldwide. Doctors estimate 9% to 13% of the world's population is infected with HPV.

What causes anal warts?

The sexually transmitted infection HPV causes anal warts. HPV can spread by skin-to-skin contact, usually during oral, anal, or vaginal sex with an infected partner. HPV can be present in the body's tissues but remain inactive.

Anal warts are very contagious. HPV strains 6 and 11 are the most common cause of anal warts.

Anal warts typically appear within weeks or months after sexual contact with someone who has HPV. However, most people with HPV have no symptoms. Because they are unaware of their infection, they can pass it on unknowingly.

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What Are the Signs and Symptoms of Anal Warts?

Anal warts are visible, soft bumps shaped like little domes. They may eventually form clusters that look like cauliflower. They can be pink, brown, or flesh colored. If the warts are in your rectum, you can’t see or feel them.

But if the warts get bigger or multiply, you may have:

• Bleeding
• Itching
• Mucus discharge

When should I see a doctor about my anal wart symptoms?

If you think you have anal warts, you should make an appointment with your primary care provider (PCP). They can treat anal warts, although they may come back.

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How Do You Diagnose Anal Warts?

Your doctor will be able to diagnose anal warts through a visual examination. They may run some additional tests to confirm the diagnosis.

Tests to diagnose anal warts

Tests include:

• Acetic acid test — Involves applying a 5% acetic acid to the wart to monitor the reaction. Areas that turn white may raise concern for dysplasia — abnormal cell growth that can lead to cancer.
• Colposcopy — A small camera magnifies the affected region to get a closer look at the spread of anal warts.
• Polymerase chain reaction — A gene typing and DNA detection test to confirm the presence of HPV.

Anal wart outlook

Doctors can remove anal warts, but they may come back. That’s because the virus that causes them is still in your body. It may be dormant for years and then return.

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How Do You Treat Anal Warts?

The goal of treating anal warts is to remove them and reduce any discomfort they cause.

There are several methods of treating anal warts. Treatment options depend on the location, number, and size of the warts, as well as your personal preference.

If you have a strong immune system, anal warts may go away on their own. But because the virus that causes them is still in your body, they can come back.

You should never use over-the-counter (OTC) wart remover on anal warts. These products aren’t meant for use on the genitals or anus.

Medicine to treat anal warts

Your doctor may recommend a medicine that can be applied directly to the skin. Some of these are for at-home use, while others need a health care provider to apply them.

• Imiquimod — Boosts the immune system’s ability to fight warts. You can apply this medication yourself at home.
• Podophyllin — A plant-based formula that destroys wart tissue. A health care provider needs to apply it. There’s also an at-home version called podofilox.
• Sinecatechins — A prescription formula made from green tea leaf extract. It works as an antioxidant and immune system booster. You can apply it yourself at home.
• Trichloroacetic acid — A chemical treatment that burns off anal warts. A health care provider needs to apply it.

Surgery for anal warts

If you have numerous warts, your doctor may choose to remove them in a same-day procedure at a surgery center or hospital. You will have anesthesia to keep you from feeling pain during the procedure.

Other therapies for anal warts

• Cryotherapy — In this method, the warts are briefly exposed to liquid nitrogen to freeze the growths.
• Electrocautery — Uses an electric current to burn off the warts.
• Laser treatments — For use on hard-to-treat or large anal warts. This method uses a high-intensity light beam to break down warts.

How effective is treatment?

Anal warts are curable. Surgery can get rid of anal warts completely, and other treatments can reduce or eliminate anal warts.

However, no matter what treatment you use, anal warts can come back. That’s because the virus that causes them (HPV) still lives in your body.

There’s no treatment that will get rid of HPV.

How long does it take to recover after surgery for anal warts?

You can resume most normal activities within a few days after surgery for anal warts. You’ll need to avoid strenuous activity and sex for at least a week or two. Full recovery might take two to four weeks.

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