HPV and genital warts – what's the link?

Reviewed by our clinical team

Most of us have heard of both genital warts or human papillomavirus (HPV) – but did you know that HPV is the virus that causes genital warts? 

Genital warts are fleshy growths that develop around the genitals and/or anus, or inside the rectum or vagina. They’re usually painless but sometimes they can be itchy or uncomfortable - they can sometimes bleed if they become very large.

Read on to find out more about the connection, and how to avoid and treat symptoms.

What causes genital warts?

Genital warts are caused by human papillomavirus (HPV). They’re passed on through close contact with someone who has the virus. It’s important to understand that the virus. It’s important to understand that the wart virus can be passed on even if there are no visible warts. This is why it’s important to practise safe sex at all times, and be communicative with any sexual partners if you have, or have recently had, genital warts.

HPV lives just beneath skin, and it can take several weeks, months or even years for warts to appear after you’re first infected. Once you develop warts you can leave them to go away on their own, or you can get treatment to have them removed.

Sometimes genital warts are so small that they’re not visible. They can be flat or smooth small bumps or quite large, cauliflower-like lumps. In rare cases they can multiply and form large clusters – this can happen in people who have a weakened immune system.

For most people, warts go away within a few weeks or months of starting treatment Sometimes the warts can be stubborn, and treatment may have to be repeated a number of times. It can also take a while for the treatment to start working.

If you feel your warts aren’t responding to treatment, speak to your clinician about this. They may recommend a change in treatment.

How are genital warts passed on?

The virus is spread through skin-to-skin contact, which means you can get genital warts from having vaginal or anal sex, by sharing sex toys, or simply through touching and rubbing. It’s also possible to get warts from oral sex, although this is rare.

Does HPV always cause genital warts?

No, not all HPV strains cause genital warts. Over 95% of genital warts are caused by just two strains of HPV: 6 and 11. So, unless you have been infected with a 'wart-producing' strain you won't get genital warts. Sometimes your immune system is so good at clearing the virus that you might never see a wart even though you've been infected with the virus. 

It’s worth noting that certain strains of HPV, so called high-risk HPV, can lead to cell changes that may cause cancer – most commonly, cervical cancer. This is why it’s important for sexually active women to attend their scheduled cervical screenings (i.e. smear tests).

How contagious are HPV and genital warts?

Unfortunately, HPV and genital warts are very contagious. The virus can be transmitted through skin-to-skin contact, which means you don’t have to have penetrative sex to pass it on or catch it.

Genital warts and cancer

High-risk strains of HPV can also cause certain cancers. The strains of HPV that cause the most cases of genital warts are 6 and 11, but these strains aren’t usually associated with cancer. 

Strains 16 and 18 of HPV are the ones most associated with triggering cell changes that might cause cancer. 

If you have genital warts, it doesn’t make you more likely to get HPV-related cancers, as they’re caused by different strains. 

Genital warts and pregnancy

If you’ve had genital warts in the past, it’s important to tell your midwife/maternity care team. You might find that they reappear during pregnancy or get bigger. This is down to the way your immune system and blood flow changes while you’re pregnant. Warts can be treated during pregnancy - this is usually with cryotherapy. 

In some rare cases warts can be passed onto the baby during a vaginal birth, but these can be treated. If you find you have large genital warts one the cervix or in the birth canal, you might be advised to elect a caesarean section instead of a vaginal birth, to avoid complications at birth. 

Will genital warts go away?

Left untreated, genital warts can go away on their own after several months. However, in some cases the warts will come back.

If you do get genital warts and you don't want to wait for your body to get rid of them, you have several options. for treatment

Genital warts treatment

At Online Doctor we can prescribe two topical treatments – Aldara and Warticon – that you can apply at home. Other treatments include surgery and freezing. 

Current treatments are not 100% effective - some treatments just remove the visible aspect of the wart but not the virus  underneath the skin. Other treatments target the virus underneath the skin, but they can't usually clear all of it. This is why warts can come back.

Does the HPV vaccine prevent genital warts? 

The main purpose of the HPV vaccine is to reduce transmission of high-risk HPV strains – in other words, strains that are more likely to cause cell changes that could lead to cancer. A secondary purpose is to prevent genital warts.

The effect of this is already being seen: since the introduction of the HPV vaccine fewer young people are getting genital warts.

There’s more than one type of HPV vaccine but the one used by the NHS and LloydsPharmacy (Gardasil 9) gives protection against the HPV strains 6 and 11 – the two types that cause most cases of genital warts.

HPV vaccinations are generally not available free of charge from the NHS unless you're:

• Offered on in school as part of the national immunisation programmes (girls and boys aged 12 or 13)
• Aged 24 years or younger and missed your vaccination at school when you were invited as part of the UK’s Schools’ based programme
• A man who has sex with other men and are up to 45 years of age

Some trans men and women will also be eligible for a free vaccine if their risk is considered to be high.

If you’re not eligible for a free vaccine on the NHS you can order one through LloydsPharmacy Online Doctor. We offer Gardasil 9, the most advanced version of the vaccine, which offers protection against nine different strains of HPV that are known to cause cancer or genital warts.

Find out more at our online HPV vaccine clinic.

How can I avoid catching HPV and genital warts?

It can be difficult to avoid sexually transmitted HPV if you’re sexually active, as it’s so easily spread. The good news is that most strains aren't harmful and your immune system will get rid of them.

The best way to avoid getting high risk HPV (the strains that are linked to certain cancers) and genital warts is to get vaccinated. Other than that, make sure you always practise safe sex with any new or casual partners whose STI status isn’t clear.

Use condoms

Using condoms and dental dams can help stop the spread of HPV and genital warts.

Use water-based lubricant

Using water-based lubes to prevent condom breakage 

Clean sex toys

Never sharing sex toys without cleaning them between uses or covering them with a fresh condom.

Avoid sex if your partner has STI symptoms

Avoiding sex if you or your partner has any STI symptoms, including growths, bumps, or sores around their genitals will reduce the risk of catching an STI. Make sure you get tested if you have any symptoms, and then you’ll be advised on what it might be and when you can have sex again. 

Avoid sex if your partner is having treatment for an STI

If your partner is having a treatment for an STI, you should avoid sex until they’ve been told they’re clear by the clinicians treating them. 
If you think you might have genital warts, it’s a good idea to visit a sexual health or GUM clinic to get checked. You can also use our genital photo assessment service if you’d prefer not to have a face-to-face appointment.

References

https://www.mayoclinic.org/diseases-conditions/genital-warts/symptoms-causes/syc-20355234
https://www.nhs.uk/conditions/genital-warts/
https://www.nhs.uk/conditions/human-papilloma-virus-hpv/
https://patient.info/doctor/anogenital-warts-pro
https://www.nhs.uk/conditions/vaccinations/who-should-have-hpv-cervical-cancer-cervarix-gardasil-vaccine/
https://www.hpv.org.nz/about-hpv/hpv-strains
https://www.tht.org.uk/hiv-and-sexual-health/sexual-health/stis/genital-warts-and-hpv
https://www.jostrust.org.uk/information/hpv/hpv-and-genital-warts
https://www.bashhguidelines.org/media/1178/wart-pil-printer-v-2018.pdf