Anal Warts

What are anal warts?

Anal warts (also known as condyloma) are warts that grow in or around your anus (the opening to your rectum). They’re caused by human papillomavirus (HPV), a sexually transmitted infection (STI) that spreads through sexual or skin-to-skin contact with an infected person. Warts caused by HPV can show up on different areas of your body — in this case, the virus shows up as warts in your anal area.

Some people aren’t aware they have anal warts because they aren’t painful and don’t cause noticeable symptoms. Contact a healthcare provider for an evaluation if you think you have anal warts. If left untreated, anal warts caused by certain strains of HPV could lead to cancer. While there is no cure for HPV, anal warts are treatable.

What do anal warts look like?

Anal warts begin as tiny, soft, dome-shaped bumps. They’re light brown, yellow, pink or flesh-colored and may leak fluid. Warts can multiply quickly and form large, cauliflower-like clusters. If anal warts are inside your rectum (where your body stores poop), you may not feel or see them.

Who is at increased risk for anal warts?

You’re at higher risk for anal warts if you:

• Have sexual intercourse or direct contact with a person with HPV.
• Have unprotected sex.
• Have sex with multiple partners.
• Have a weakened immune system.

What are the symptoms of anal warts?

Not everyone has symptoms of anal warts. HPV may stay inactive (dormant) in your body and not cause any symptoms. For those with symptoms of anal warts, some common ones are:

• Soft lumps in or around your anus.
• Light brown, yellow, pink or flesh-colored lumps that may cluster together.
• Bleeding.
• Itching.
• Leaking discharge from your anus (caused by internal anal warts).

How do you get anal warts?

Anal warts are caused by HPV. You can get HPV in two ways:

• Sexual intercourse with an infected person.
• Direct contact with the anal or genital area of an infected person. This could be hand contact or coming in contact with genital or anal fluids from an infected person.

There are several dozen strains of HPV. According to the Centers for Disease Control (CDC), 90% of anal warts are caused by HPV 6 and HPV 11. These strains aren’t usually associated with cancer. However, 10% of anal warts are caused by other strains. Having anal warts (even those strains that are associated with cancer) doesn’t mean you have cancer or that you’ll develop anal cancer.

Are anal warts contagious?

Yes, anal warts are contagious and spread easily. HPV is also contagious, even when it doesn’t cause symptoms.

Do anal warts hurt?

Everyone experiences different symptoms, so some people may never notice anal warts, while others feel itching or like something is stuck in their anus. Anal warts may cause mild discomfort, but don't usually get painful.

How are anal warts diagnosed?

Healthcare providers typically diagnose anal warts with a physical examination. During this exam, your provider will look at the warts and inspect the skin around your anus and genitals. They may need to look inside your anus for warts with a small tool called an anoscope. A pelvic exam may be needed for women or people assigned female at birth (AFAB).

If the warts seem suspicious or don’t respond to treatment, your provider may order a biopsy. A biopsy is when your provider removes a small tissue sample from your skin and examines it under a microscope.

What is the treatment for anal warts?

Treatment varies depending on the symptoms, location and size of your anal warts. It can include topical ointments, surgery or a combination of treatments. In some cases, healthcare providers choose to monitor the warts to see if they heal on their own after several weeks.

Topical treatments for anal warts

Anal warts that are small and located only on the skin around your anus can usually be treated with topical ointments. These treatments include:

• Imiquimod (Zyclara® or Aldara®).
• Podofilox (Condylox®).
• Podophyllin (Podocon-25®)
• Sinecatechins (Veregen®).

It's important not to use over-the-counter wart remover in your anal or genital area. These products aren’t designed for your genitals or anus.

There are also topical treatments that "freeze" or "burn" warts. These treatments cause minor side effects like discomfort or swelling:

• Liquid nitrogen (cryotherapy): When liquid nitrogen is applied, it freezes the skin, causing the warts to fall off.
• Trichloroacetic acid: Acid is applied to the warts, destroying and breaking down the warts.
• Electrocautery: A procedure that uses heat to burn off the warts.

Surgery for anal warts

Surgery may be the best option to remove large anal warts or warts inside your rectum. The surgery to remove anal warts involves cutting off the warts. It can be performed at an outpatient facility, and you can recover at home afterward. Depending on the severity, you may receive local or general anesthesia. Local anesthesia is applied to your anal region, while general anesthesia makes you fall asleep.

Your recovery time varies depending on the extent of the procedure, so check with your surgeon to make sure you know what to expect after surgical removal of anal warts.

Do anal warts need to be removed?

Yes, anal warts need to be removed. Your healthcare provider can recommend the best way to remove your anal warts, whether with surgery or topical medications.

Anal warts may spread or become larger if left untreated. In rare cases, it can cause anal cancer. For this reason, you should contact your healthcare provider if you experience symptoms of anal warts.

Do anal warts go away?

Anal warts may go away without treatment. This is the case if the warts are small and your immune system fights off the virus. But, in most cases, your healthcare provider will recommend treatment.

How can I prevent myself from getting anal warts?

HPV can remain in your body without any noticeable signs. Some people don’t realize they have anal warts because they’re inside their rectum. Like most STIs, practicing safe sex is the best prevention. Some steps you can take to prevent anal warts include:

• Use a condom every time you have sex.
• Not having sex with someone who has anal or genital warts.
• Refraining from sex if you have anal or genital warts.
• Get checked for HPV and STIs regularly (as recommended by your healthcare provider) and encourage your sexual partners to do the same.
• Get the HPV vaccine if you are eligible. Your provider can tell you if you’re a candidate for this vaccine.

HPV vaccine for anal warts

The HPV vaccine protects against certain strains of HPV. Anal warts are associated with HPV 6 and HPV 11. Only HPV 11 is covered by the vaccine.

Anyone that has sexual intercourse can get HPV, even if you’ve only had sex with one person. Getting the vaccine may be your best chance at preventing HPV. The current HPV vaccine recommendations state that children and adults ages 9 through 45 get the HPV vaccine.

Can anal warts come back?

Yes, anal warts can come back. Even if you’ve completed treatment for anal warts, HPV remains in your body. There is no cure for the virus itself (HPV), which means you’re still at risk for anal warts. Your healthcare provider can discuss if follow-up appointments are necessary.

When should I see my healthcare provider?

Call a healthcare provider if you think you have anal warts. Common symptoms include:

• Feeling lumps in your anal region.
• Feeling itching or burning.
• Blood or discharge from your anus.

Most of the time, anal warts are an annoyance but don’t cause pain or lead to cancer. Your provider will recommend treatment for anal warts based on your symptoms and the severity of the infection.

A note from Cleveland Clinic

Anal warts are a result of a very common infection called HPV (human papillomavirus). It’s important to get anal warts checked out by a healthcare provider because certain strains of HPV can lead to cancer. This is rare; however, it’s better to be safe. Most anal warts are treated with topical medication or surgery. You may feel embarrassed to talk to your provider about anal warts or their symptoms, but no one will judge you. What’s important is you get the treatment and care you need.