Anal Warts

The long-term outlook is generally very good. Treatments can remove visible warts, although the virus that causes them (human papillomavirus, HPV) may remain in the skin for some time.

For most people, the immune system suppresses or clears HPV naturally, often within 18–24 months. During this period, warts may recur, but episodes usually become less frequent and less severe over time.

The HPV types most commonly responsible for anal warts are considered low-risk and are not usually associated with cancer. Once the virus is controlled by the immune system, most people experience no long-term complications.

No. Treating anal warts removes the visible growths but does not always eliminate HPV completely. The virus can remain dormant in the skin and may reactivate, particularly if the immune system is under strain.

There are also many different HPV types, so it is possible to be exposed to a different strain in the future. For these reasons, recurrence can occur even after successful treatment.

Several steps may help reduce the risk of recurrence:

• Having the HPV vaccine, which offers protection against common HPV types
• Avoiding smoking, as it impairs the immune response to HPV
• Maintaining general health, including good sleep and nutrition
• Using condoms, which reduce risk but do not fully prevent transmission

Completing treatment and seeking early assessment if new changes appear can also help prevent warts from becoming more persistent.

Telling a partner is a personal decision, but it is generally recommended. HPV is very common and can be passed on even when warts are no longer visible.

Open discussion allows partners to be aware of their own health, look out for symptoms, and consider vaccination where appropriate. Many people find that honest conversations reduce anxiety and support shared decision-making.

Yes. Anal warts can be treated effectively. Although they are caused by the human papillomavirus (HPV), treatment focuses on removing visible warts, relieving symptoms, and reducing the risk of spread.

At our clinic, we commonly use hyfrecation — a targeted technique that removes warts using controlled electrical energy. The area is numbed with local anaesthetic beforehand, making the procedure well tolerated. Many patients achieve good clearance after one or two treatment sessions.

Other treatment options used in the UK include prescription topical treatments applied over several weeks, or cryotherapy, which removes warts by freezing them. The most appropriate option depends on the size, number, and location of the warts.

A consultation allows the clinician to confirm the diagnosis and discuss the best treatment plan. In some cases, treatment can be arranged on the same day following appropriate pre-appointment assessment.

Treating anal warts can:

• Relieve symptoms such as itching, irritation, or bleeding
• Prevent warts from increasing in size, number, or spreading
• Reduce the risk of transmission to partners
• Improve confidence, comfort, and sexual wellbeing

Not usually. Many anal warts can be managed with non-surgical treatments.

For larger, clustered, or persistent warts, in-clinic removal methods such as hyfrecation may be recommended. These are minor procedures performed under local anaesthetic and do not involve major surgery.

Over-the-counter wart treatments should not be used on the anal area, as they can damage sensitive skin and cause irritation or injury.

In some cases, prescription treatments may be used at home under medical guidance. However, because the anal area is delicate and difficult to treat accurately, many people prefer clinic-based treatment to ensure safe and precise removal.

Certain factors can influence which treatment is most appropriate, including:

• Whether warts are on the external skin or inside the anal canal
• Uncertainty about the diagnosis
• Active skin infection or inflammation in the area
• Medical conditions or medications affecting the immune system
• Pregnancy, which may limit the use of some medicated treatments

These factors rarely prevent treatment altogether but may affect timing or the choice of treatment.

Anal warts are caused by the human papillomavirus (HPV), a very common virus. Most anal warts are linked to HPV types 6 and 11, which are classed as low-risk and are not usually associated with cancer.

HPV is spread through close skin-to-skin contact, most often during sexual activity. It can also be transmitted through hands or shared sex toys. The virus may be present even when there are no visible warts or symptoms, which is why many people are unaware they have been exposed.

Yes. Anal warts are caused by HPV, which is one of the most common sexually transmitted infections.

HPV is passed on through skin-to-skin contact during sexual activity, including anal, vaginal, or oral sex, and through sharing sex toys. Penetrative sex is not required for transmission, and people without symptoms can still pass the virus to others.

Several factors can increase the chance of acquiring HPV and developing anal warts, including:

• Unprotected sexual contact
• Having multiple sexual partners
• Contact with someone who has HPV, even without visible warts
• A weakened immune system or certain long-term health conditions
• Smoking
• Not having received the HPV vaccine

Some factors can influence how large anal warts become or how quickly they spread, including:

• A weakened immune system (for example, HIV or immune-suppressing medication)
• Smoking, which can reduce the body’s ability to clear HPV
• Delayed or no treatment
• Ongoing irritation to the area, such as friction or shaving
• Pregnancy, when hormonal changes may lead to more rapid growth

If you notice increasing size, number, or symptoms, assessment by a Specialist is advised to confirm the diagnosis and discuss treatment.

The most effective way to reduce your risk is the HPV vaccination, which provides strong protection against the HPV types most commonly responsible for anal warts. If you are unsure whether you have been vaccinated, your GP or a sexual health clinic can advise.

You can also reduce your risk by:

• Using condoms or dental dams
• Limiting the number of sexual partners
• Attending regular sexual health check-ups

Barrier protection lowers risk but does not provide complete protection, as HPV can affect skin not covered by condoms.

Anal warts are usually diagnosed during a physical examination. A clinician will carefully inspect the skin around the anus under good lighting to identify characteristic wart-like growths.

If there is a possibility that warts are present inside the anal canal, a gentle internal examination may be recommended. This helps ensure the assessment is complete before treatment is planned.

In most cases, anal warts have a typical appearance and can be diagnosed visually. Blood tests are not required, and biopsies are only rarely needed.

Most anal warts are identified through physical examination alone, as their appearance is usually characteristic of HPV-related warts.

If necessary, a short internal examination, such as proctoscopy, may be performed to assess the anal canal. A biopsy is only considered if the diagnosis is uncertain or if lesions do not respond to treatment as expected.

A full sexual health screen is often offered to check for other infections.

An accurate diagnosis is based on both examination findings and your clinical history. It is helpful to share:

• When you first noticed the changes
• Whether symptoms such as itching, discomfort, or bleeding are present

Because other conditions can look similar, careful assessment of whether lesions are on the external skin, inside the anal canal, or both is important.

Yes. Several conditions can resemble anal warts, including:

• Skin tags
• Haemorrhoids (piles)
• Molluscum contagiosum
• Syphilis-related lesions
• Other benign skin changes

These conditions require different management, which is why professional assessment is recommended.

Most cases are diagnosed through examination alone.

If lesions appear unusual, change rapidly, or fail to respond to treatment, a biopsy may occasionally be taken to confirm the diagnosis and exclude other conditions.

Yes. In many cases, a visual examination is sufficient.

An internal examination may be suggested if warts are suspected within the anal canal, but additional tests are not usually required.

Self-diagnosis is not recommended. Anal warts can be difficult to distinguish from haemorrhoids, skin tags, or other common conditions.

While you may notice changes yourself, a professional assessment is the most reliable way to confirm the cause and ensure appropriate treatment.

Transmission of HPV from parent to baby is possible but uncommon. In rare cases, HPV can be passed to a baby during vaginal delivery through contact with the birth canal.

Very rarely, this may lead to a condition where warts develop in the baby’s airway. However, this is extremely uncommon. Anal warts do not usually affect the baby during pregnancy itself.

Most people with anal warts can safely have a vaginal birth. A caesarean section is only considered if warts are very large, obstruct the birth canal, or pose a risk of significant bleeding.

During pregnancy, anal warts may grow more quickly or become more noticeable due to hormonal changes and natural shifts in the immune system. They may cause itching, discomfort, or occasional bleeding.

They do not usually cause harm to the baby. The risk of transmission during delivery remains very low, and caesarean delivery is rarely required solely because of warts.

Anal warts are relatively common during pregnancy. Some people notice them for the first time while pregnant, while others find that existing warts increase in size.

This is thought to be related to hormonal changes and temporary immune system adjustments. Although they can be uncomfortable, they are usually harmless to the baby.

Managing anal warts during pregnancy is common, and many treatments are considered safe.

Physical treatments such as cryotherapy (freezing) or application of trichloroacetic acid may be used, as they act locally on the skin and are not absorbed in a way that would affect the baby. Certain cream-based treatments commonly used outside pregnancy, such as podophyllotoxin or imiquimod, are usually avoided as a precaution.

In most cases, anal warts do not change birth plans. A physical examination helps determine whether treatment is needed during pregnancy or can safely wait until after delivery.

If you notice new symptoms or changes, inform your midwife or healthcare provider. Monitoring is often sufficient.

Avoid over-the-counter wart treatments, as these are unsuitable for the anal area and not recommended during pregnancy. Keeping the area clean, dry, and avoiding irritation can help reduce discomfort.

The risk of transmission during birth is low, and caesarean delivery is rarely required.

Anal warts do not usually affect postpartum recovery unless they are causing discomfort or irritation near healing tissue.

HPV is not transmitted through breast milk, and it is safe to breastfeed. Some treatments may be delayed until recovery is complete, and certain creams are avoided during breastfeeding. Physical treatments can often be used if treatment is needed.

Many people experience little or no discomfort, meaning anal warts can go unnoticed. When symptoms do occur, they may include:

• Itching or soreness around the anus
• A feeling of fullness or local discomfort
• Mild bleeding, especially during bowel movements
• Increased moisture or discharge
• Because anal warts can develop inside the anal canal as well as on the surrounding skin, they are not always visible. Some people first notice a small lump while washing or during personal hygiene.

If you are unsure about any new lumps, bumps, or skin changes, assessment by a Specialist is advised to confirm the diagnosis and discuss treatment options.

Yes. It is very common to have anal warts without any noticeable symptoms.

HPV can be present on the skin without causing visible changes. When warts do develop, they may be very small, flat, or located inside the anal canal, making them easy to miss. Some people only become aware of anal warts during a clinical examination or after a partner is diagnosed.

Anal warts typically appear as small bumps in or around the anus. They may be flesh-coloured, pink, or light brown, and can be flat or slightly raised. In some cases, they grow in clusters with a rough or “cauliflower-like” surface.

They are often painless, but some people notice itching, mild bleeding, or increased moisture in the area.

Anal warts can affect anyone who is sexually active, regardless of gender, age, or sexual orientation.

They are caused by HPV, which is spread through close skin-to-skin contact during sexual activity, including vaginal, anal, or oral sex, and through sharing sex toys. People with weakened immune systems may be more likely to develop persistent or more extensive warts.

If left untreated, anal warts may increase in size, multiply, or spread to surrounding skin, leading to irritation, itching, discomfort, or bleeding.

Most anal warts are caused by low-risk HPV types. Rarely, long-term infection with certain HPV strains can be associated with precancerous changes. Untreated warts may also affect confidence, sexual wellbeing, and increase the risk of transmitting HPV to partners.

Symptoms can appear weeks to months after exposure to HPV, but the timing varies widely. In some people, warts develop within weeks; in others, they may not appear for months or even years.

HPV can remain dormant without causing visible changes, which is why it is often difficult to determine exactly when infection occurred.