Anal warts are growths that develop on the skin in and around the anus. These growths are a common manifestation of a viral infection. While they can sometimes be unnoticed, understanding their nature and how they develop is important.
What Anal Warts Are
Anal warts, also known as condyloma acuminata, typically appear as small, soft bumps around the anus. They can vary in color, often appearing flesh-colored, light brown, yellow, or pink. These bumps might initially be tiny, but they can grow larger and sometimes merge to form clusters that resemble cauliflower. Warts can be located on the skin surrounding the anus or inside the anal canal. While generally benign, larger warts might cause irritation, itching, or bleeding.
How Anal Warts Develop
Anal warts are caused by the human papillomavirus (HPV), a common infection transmitted through skin-to-skin contact. Specific HPV strains, primarily types 6 and 11, are responsible for approximately 90% of anal wart cases. Transmission often occurs through sexual activity, including anal sex, but direct skin-to-skin contact in the genital or anal area can also spread the virus. The virus can remain dormant in the body for months or even years before warts become visible.
Diagnosis of Anal Warts
A healthcare professional typically diagnoses anal warts through a visual examination of the anal area. If warts are suspected inside the anal canal, an anoscopy may be performed. This procedure involves inserting a small, lighted instrument to view the internal area. Sometimes, acetic acid is applied to make warts more visible by causing them to turn white. A biopsy, where a small tissue sample is taken, can confirm the diagnosis or rule out other conditions, especially if warts do not respond to initial treatments.
Treatment Options for Anal Warts
Treatment for anal warts aims to remove visible growths, though it does not eliminate the underlying HPV infection. The choice of treatment depends on the wart’s size, location, and number. For small, external warts, topical prescription creams like imiquimod, podofilox, podophyllin, or sinecatechins may be applied.
Larger or internal warts often require procedural treatments performed by a healthcare provider. These include:
- Cryotherapy, which freezes the warts with liquid nitrogen.
- Surgical excision, which involves cutting away the warts.
- Electrosurgery, which uses heat from an electric current to burn off the warts.
- Laser removal, which employs a high-energy light beam to destroy the wart tissue.
Multiple treatment sessions may be necessary, and warts can recur because the HPV virus can remain inactive in the body’s tissues. Therefore, ongoing monitoring might be advised after treatment.
Preventing Anal Warts
Preventing anal warts involves reducing exposure to the human papillomavirus. The most effective method is HPV vaccination. Vaccines like Gardasil 9 protect against HPV strains commonly associated with anal warts (types 6 and 11), as well as high-risk strains linked to certain cancers. Routine HPV vaccination is recommended for individuals starting at ages 11 or 12, before potential sexual exposure, and can be given up to age 45.
Practicing safer sexual behaviors also helps reduce transmission risk. Consistent and correct use of condoms can lower HPV spread, though condoms may not cover all areas of skin-to-skin contact. Limiting the number of sexual partners and getting regular check-ups for sexually transmitted infections are additional preventive measures.