saudigastro.com/patients/anal-warts
Category
Common
Red flags
5
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
Anal warts (also called condylomata acuminata, or genital warts when they affect the genital area) are soft, flesh-coloured or pink growths that can be flat or look like tiny cauliflowers. They may appear on the skin around the anus or inside the anal canal. They are caused by certain types of human papillomavirus (HPV), usually the low-risk types that rarely cause cancer. They are common, and having them does not mean you are unclean.
How common is it?
HPV is one of the most common sexually transmitted infections worldwide, and many people carry it without ever knowing. Warts can develop weeks, months or even years after exposure, so it is often impossible to say when or from whom the virus was caught. Risk is higher in people with a weakened immune system.
Why does it happen?
The virus passes through direct skin or sexual contact, including anal sex, and the warts appear where the virus enters small breaks in the skin. Smoking and a weakened immune system make warts more likely to appear and to return. Warts can also appear in people who have never had anal sex, since the virus can spread to the area from nearby skin.
Symptoms
- Small, soft lumps or bumps around the anus
- Itching, irritation or a feeling of a lump at the anus
- Bleeding, especially after wiping or a bowel movement
- Discharge or moisture around the anus
- Pain or discomfort, which is not usual unless the warts are large or infected
- Many people have no symptoms and notice only a small lump
Red flags — seek urgent medical care
A growth that is hard, fixed, ulcerated, bleeds easily or grows quickly
Rarely, what looks like a wart is a pre-cancer or cancer. See a doctor soon so it can be examined and biopsied.
Warts that do not respond to treatment, or keep coming back
Need review, as the diagnosis or treatment may need to change.
Persistent anal bleeding or pain, or a change in bowel habit
May have another cause that needs examination. Do not self-treat.
Heavy bleeding, or redness, swelling, pus and fever around treated warts
Could be infection or a complication. Seek urgent care.
Pregnancy or a weakened immune system with new warts
Treatment choices differ, so tell your doctor early.
How is it diagnosed?
The doctor can usually recognise warts by looking. Because warts can also be inside the anal canal, an examination with a small scope (anoscopy) is often done. A biopsy is taken if a lump looks unusual, is pigmented, bleeds easily, or does not respond to treatment. Your doctor may also suggest testing for other sexually transmitted infections, which is a matter of general health and is kept confidential.
What the latest science says
Several treatments are effective, but they remove the visible warts rather than the virus itself, so warts can return even after successful treatment. The immune system often clears the virus over time. HPV vaccination protects against the types that cause most warts and is an important preventive step; ask your doctor whether it is suitable for you.
Outlook — what to expect
Anal warts are treatable and usually not dangerous. They can take several weeks or months to clear and may return, which is common and does not mean treatment has failed. Some warts clear by themselves. Regular review is advised, and the risk of cancer is low for the common wart types but rises with certain risk factors, so any unusual change should be checked.
Treatment
Habits & Lifestyle
Do not treat anal warts yourself with wart products bought for the hands or feet; these are not safe for this area.
- See a doctor for diagnosis before starting any treatment
- Do not scratch, pick or cut the warts
- Keep the area clean and dry, and wear loose cotton underwear
- Stop smoking, which helps the immune system clear the virus
- Tell current partners so they can be checked, and use condoms, which reduce but do not remove the risk
Diet
There is no diet that removes warts, but good general health supports the immune system.
- Eat a balanced diet with plenty of fruit and vegetables
- Get enough sleep and manage stress
- Do not rely on supplements or herbal remedies for warts, as there is no reliable evidence for them
Medications
Treatment depends on the number, size and site of the warts. Your doctor chooses and explains how to use any product.
- Prescription creams or solutions applied by you to warts on the skin, or applied by the doctor
- Some creams boost the local immune response; others destroy the wart tissue
- Treatment is repeated over weeks, and skin irritation is common
- Some creams are not suitable during pregnancy; tell your doctor if you are or might be pregnant
Procedures & Surgery
Procedures are used for larger warts, warts inside the anal canal, or those that do not respond to creams.
- Freezing with liquid nitrogen (cryotherapy)
- Burning (electrocautery) or laser removal under local or general anaesthesia
- Surgical removal of larger warts
- Infrared coagulation or other office-based treatments in some centres
- Follow-up visits to check for recurrence
Living with the condition
- Feeling embarrassed, anxious or worried about relationships is understandable; your doctor can support you
- Recurrence is common and treatable
- Ask about HPV vaccination, and about screening if you are in a higher-risk group
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- Are my warts only on the skin, or also inside the anal canal?
- Which treatment suits me and how long will it take?
- Does a biopsy need to be taken?
- Should my partner be examined or should I have any other tests?
- Can HPV vaccination help me?
Was this guide helpful?
Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide