Genital Warts Genital warts are caused by the human Papillomavirus (HPV) and are small fleshy bumps, or skin changes that appear on and around the genital or the anal area. The warts are usually painless and do not pose a serious threat to health. Genital warts are the second most common sexually transmitted infection in England, after Chlamydia. Signs and symptoms of genital warts Most people who have an HPV infection will not develop any visible warts. If genital warts do appear, it can be several weeks, months or years after you first came into contact with the virus. If warts do appear, they can either appear on their own, or in clusters of multiple warts that grow together to form a kind of 'cauliflower' appearance. If they are inside the anus or inside the vagina or on the cervix you may not know they are there. Warts in women The commonest places for genital warts to develop in women are: around the vulva (opening of the vagina) on the cervix ( the neck of the womb) inside the vagina around or inside the anus on the upper thighs Warts in men The commonest places for genital warts to develop in men are: anywhere on the penis on the scrotum inside the urethra (tube where urine comes out) around or inside the anus on the upper thighs The causes and how it is passed on The most common way for HPV to be passed on from person to person is through skin-to-skin contact. This is usually through sexual activity such as: Vaginal sex Anal sex Sharing sex toys Non-penetrative genital to genital contact in very rare cases, oral sex. HPV is not passed on through kissing, hugging or sharing towels, clothing and everyday items such as cutlery or toilet seats. A condom can help protect against genital warts but the virus may still be passed on by the surrounding genital areas coming into contact. Testing for genital warts If you think you have warts, or your partner has them, visit your local sexual health or GUM clinic. There is no test for genital warts but its easy for a doctor or nurse to diagnose by examining the affected area. In some cases the doctor or nurse may wish to perform a more detailed examination to see if the warts are present inside the vagina or anus. Treatment for genital warts You will only be offered treatment if you have visible warts. Treatment for warts depends on the type of warts you have and where they are located. There are two main types of treatment: applying a cream, lotion or chemical to the warts destroying the tissue of the warts by freezing, heating or removing them. More detailed information regarding treatment can be found here. You should tell the doctor if you are pregnant or if their is a risk of pregnancy as this may affect the treatment that they offer you. It is recommended that you avoid having sex until your warts have fully healed. This is to prevent you passing on the HPV virus to others but also allows you to recover more quickly. How to avoid infection Using condoms male or female (femidom) every time you have vaginal or anal sex is the most effective way to avoid genital warts. The protection offered by condoms is not 100%. As HPV is spread through skin-to-skin contact, it is possible for the skin around your genital area not covered by a condom to become infected. If you have oral sex, cover the penis with a condom. A dental dam, can be used to cover the anal area or female genitals. If sharing sex toys, wash them or cover them with a condom before anyone else uses them. In the UK, HPV vaccines are offered to all girls in school aged 12-13 years (year 8). There are over 100 strains of the virus but the vaccination protects against two strains which cause the majority of genital warts (type 6 and type 11).