If you’ve noticed soft pink or flesh-colored bumps around your genital area, you may be going through a genital warts outbreak.
Genital warts are cauliflower-like growths caused by certain types of the human papillomavirus (HPV). HPV is the most common viral sexually transmitted disease in the United States.
Although HPV isn’t curable in all cases, genital warts are treatable. You can also go extended periods of time without an outbreak, but it may not be possible to get rid of the warts forever.
That’s because genital warts are only a symptom of HPV, which may become a chronic, lifelong infection for some.
For those who clear the infection, there is a chance of becoming reinfected by the same strain or a different one. You could even be infected with multiple strains at the same time, though this is less common.
So even with treatment, genital warts may come back in the future. This depends on whether you’ve been vaccinated, how well your immune system is functioning, the strain of HPV you have, and the amount of virus you have (viral load).
Some strains are high risk and associated with later formation of squamous cell carcinoma (cancer), and you may not even know if you have a high-risk HPV strain until precancerous or cancerous lesions form.
Some research shows that HPV infections persist latently in 10 to 20 percent of those who contract them, as opposed to the 80 to 90 percent who clear the virus within two years of infection. According to the World Health Organization (WHO), about 90 percent of HPV infections clear within two years.
However, certain factors increase the risk of the infection not going away. These include having sex without protection, contracting other sexually transmitted infections, alcohol use, smoking tobacco, and having a suppressed immune system.
A recent study published in December 2017 noted that over 200 genetically distinct strains of HPV exist. The study looked at HPV infection in unvaccinated men between the ages of 18 and 70. Researchers tracked over 4,100 subjects over five years.
What the study found was that HPV infection strongly increases the risk of future infection by the same strain.
The researchers focused on strain 16, which is responsible for most HPV-related cancers. They noted that an initial infection increases the one year probability of reinfection by a factor of 20, and the probability of reinfection remains 14 times higher two years later.
The researchers found that this increased risk occurs in men regardless of whether they are sexually active. This suggests reinfection arises from the virus spreading to different parts of the body, reactivation of latent virus (that is, virus that’s still inside the body), or both.
There are ways to decrease the risk of contracting HPV, however.
According to the Centers for Disease Control and Prevention (CDC), the most reliable way to prevent HPV infection is to abstain from sexual activity. The CDC also suggests condom use and limiting the number of sexual partners as ways to lower risk of becoming infected. As well, the organization recommends vaccination at a younger age to help protect against the strains that cause the majority of warts and cancer.
HPV symptoms take a while to show, so warts may not appear until weeks or months after infection. In some cases, genital warts can take years to develop.
Outbreaks can happen in or around the vagina or anus, on the cervix, in the groin or thigh area, or on the penis or scrotum. HPV can also cause warts on your throat, tongue, mouth, or lips.
For some people, genital warts may clear up on their own within two years, but treatment helps speed up the process.
Treatment can also prevent possible health complications caused by HPV, as well as:
- ease pain, itching, and irritation
- potentially lower the risk of spreading HPV
- get rid of warts that are hard to keep clean
Genital warts can be treated by a doctor in a number of ways. Topical treatments, prescription medications, and minor procedures can help clear up an outbreak.
Over-the-counter wart removers won’t work on genital warts and may cause more discomfort. Genital warts require a special type of topical treatment that your doctor can. Those creams include:
Podofilox is a plant-based cream used to treat external genital warts and stop wart cells from growing. You should apply podofilox to the wart tissue at least twice daily for three days, then let the area rest for the remainder of the week.
You may need to repeat this treatment cycle four times.
Podofilox is one of the more effective topical creams in clearing warts. According to one study, outbreaks in nearly half of the people using the cream improved by 50 percent or more. Twenty-nine percent of participants saw their warts clear completely.
But like all medication, podofilox does come with side effects, including:
- blistering, crusting, or scabbing
Imiquimod is a prescription cream that’s used to destroy external genital warts, as well as certain skin cancers. You should apply the ointment directly to the warts at least three days a week for about four months.
Although imiquimod may not be effective for everyone, one study did show that warts cleared in 37 to 50 percent of people using the cream. The medicine can also boost your immune system to fight HPV.
Side effects of imiquimod include:
- scabbing and flaking
Sinecatechins is a cream made from green tea extract that’s used to clear up external genital and anal warts. You should apply the ointment three times per day for up to four months.
Sinecatechins may be the most effective topical for getting rid of warts. According to one study, the ointment cleared up warts in 56 to 57 percent of participants.
Side effects of sinecatechins are similar to other topical treatments. They include:
With cryotherapy, your doctor will remove the warts by freezing them with liquid nitrogen. A blister will form around each wart, which will shed once it heals.
Cryotherapy is effective in clearing outbreaks temporarily, but multiple treatments may be necessary to achieve long-term results.
You can go right back to your normal activities after the procedure, but expect a lot of watery discharge for up to three weeks as the area heals.
Side effects of cryotherapy include:
- mild burning
Electrodessication is a treatment that needs to be performed by a specialist. Your surgeon will use an electrical current to burn and destroy external genital warts, and then scrape away the dried tissue.
It’s considered to be a painful procedure, so you may be given a local anesthetic or go under general anesthesia.
Research has found the surgery to be highly effective. One study found that 94 percent of people who had six weekly sessions of electrodessication were clear of genital warts. Healing time takes four to six weeks.
Side effects include:
- skin color changes of treated area
Laser surgery is also a specialist procedure. Your surgeon uses a laser light to burn away wart tissue. You may require local or general anesthesia depending on the size and number of warts.
Laser surgery can be used to destroy large genital warts or hard-to-access warts that can’t be treated by other procedures. Recovery should take a few weeks.
Side effects include:
Most HPV infections that cause genital warts will go away on their own, taking anywhere from a few months to two years. But even if your genital warts disappear without treatment, you may still have the virus.
When left untreated, genital warts can grow very large and in big clusters. They are also more likely to return.
You should wait to have sex at least two weeks after your warts have cleared. You should also talk to your sexual partners about your HPV status before engaging in sexual activity.
Even if you aren’t dealing with an outbreak, you can still spread HPV through skin-to-skin contact. Wearing a condom will reduce your risk of transmitting HPV. This includes dental dams and male or female condoms.
Although genital warts may clear on their own, HPV may still be in your body. Treatment will help get rid of warts and reduce future outbreaks, though you may have to repeat treatments to clear warts completely.
It may take a few months to treat the warts, and you could go years without an outbreak. Make sure to wear a condom every time you have sex, as HPV can spread without warts present.