What Are Anal Warts?

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Anal warts are caused by the human papilloma virus, and they’re spread through anal contact. They may change in appearance or disappear on their own, but they can also grow or develop other problems.

Your doctor can usually diagnose anal warts by visual examination. If necessary, he or she can perform a biopsy. Treatment options vary, depending on the number and location of anal warts.

Causes

Anal warts are caused by human papillomavirus (HPV), which is also the cause of most genital warts. The HPV virus is spread through close physical contact such as skin-to-skin contact during anal or vaginal intercourse. The virus may also be spread through the sharing of towels, toothbrushes, and other items that come into contact with the anal area or genitals. The HPV virus can linger in the body for years without causing any symptoms.

Many people have HPV at some point in their lives and do not know it because they do not experience any pain or symptoms. It is important to abstain from sexual activity or limit it to marriage relationships to prevent spreading the contagious HPV virus to sexual partners.

Embarrassment and fear of extreme pain can often prevent a person from seeking treatment for anal warts. However, we are happy to help patients in a private and comfortable environment.

Anal warts that are small and located outside the anus can usually be treated with a topical prescription medication. If warts are larger and located inside the anus or they don’t respond to other treatments, our colorectal surgeon may recommend surgery to remove them. This procedure is performed as an outpatient using local, general or spinal anesthesia depending on the number and location of the warts.

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Symptoms

Anal warts (condyloma acuminata) are tiny spots or growths on the skin of your anus and genital area. They are caused by the human papilloma virus, which is quite contagious. It can spread from person to person through direct contact, including during sexual activity.

Anal warts are small and often not painful, so they may go unnoticed until they grow larger or cause symptoms such as itching or bleeding in the anal canal. If you have these symptoms, you should seek medical attention.

A healthcare provider can usually diagnose anal warts by visual inspection of the anal canal and genital area. They may also use a tool called an anoscope to look inside your anus. If the warts are causing pain, they can also order a biopsy to get a tissue sample for further testing.

Medicated treatment is the most common way to treat anal warts. A doctor can apply solutions such as podophyllin or bichloracetic acid to the anal warts that will cause them to slough off. Depending on the number and exact location of the warts, your doctor will determine how many applications to apply and how long you should wait between each application.

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If the warts are not cured with the topical medication, your doctor will need to remove them surgically. This is done as an outpatient procedure, using a local or general anesthetic, depending on the number and exact location of the warts.

Diagnosis

In most cases, anal warts don’t cause pain or other symptoms. But if they grow larger or spread to other parts of the genital area, they can be uncomfortable and irritated. They may also itch or bleed.

To diagnose anal warts, your healthcare provider will perform a physical examination. They might use a tool called an anoscope to examine the skin around your anus and genitals. They may also check inside your anal canal for warts with a smaller medical instrument called an otoscope. Sometimes doctors need to take a sample of anal wart tissue for testing to confirm the diagnosis.

The most common treatment for anal warts is topical prescription medication. This may include ointments that you apply at home as well as office treatments that remove warts or cause them to slough off. Doctors might also recommend laser therapy, cryotherapy (in which liquid nitrogen is used to freeze the warts), or electrocautery (in which an electric current burns off anal warts). For large anal warts that won’t budge with other methods, surgery is a treatment option.

Anal warts are caused by the human papillomavirus. This virus is contagious, and it’s possible to spread anal warts to sexual partners. If you have anal warts, you should avoid sexual contact until you have them treated. It’s also a good idea to use condoms during sexual contact, because they can protect against HPV.

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Treatment

Some people aren’t aware they have anal warts because the small bumps are hard to see and don’t cause pain. But anal warts should be evaluated by a doctor because certain strains of HPV can lead to cancer.

Treatment options include topical prescription medications, cryotherapy in which liquid nitrogen is used to freeze the warts, and surgery. Surgery is usually performed as an outpatient procedure using a local or general anesthetic. For warts that are inside the anal canal or other types of genital warts, surgical removal is more effective than medication alone.

Before recommending treatment, your physician will perform a visual examination of the area with an eyepiece called an anoscope. They may apply acetic acid to the bumps, which can make them turn white and make them easier to detect. They also might do a pelvic exam to look for other types of genital warts and, in women, a Pap smear.

If your doctor determines that you have anal warts, it’s important to follow up with regular visits and any necessary treatments. It’s also important to avoid sexual contact with anyone who has active anal or genital warts, and use condoms when engaging in sexual activity. This reduces the risk of transmission and helps prevent the HPV virus from lingering in body tissues, which can cause new anal or genital warts to form.