What Are Venereal Warts?

This page was reviewed or revised on Saturday, October 26, 2002.

Venereal warts (condylomata acuminata) are caused by a papilloma virus, similar to the virus which causes warts elsewhere on the body.

How are they transmitted?

Venereal warts are transmitted sexually and are contagious. About 65% of regular partners of someone with warts will also have warts. The incubation period is long, anywhere from 3 weeks to more than 6 months, and the virus can be transmitted at anytime during this time.

What are the symptoms?

Venereal warts are small, fairly firm lumps, often with an irregular cauliflower-like appearance. The shape and colour vary depending on the location (e.g., those on the vagina are greyer and more fleshy than those on the vulva (vaginal lips).

In women, the warts most frequently appear on the vulva and the perineum (area between the vaginal opening and the anus), but they can also occur in the vagina, cervix, anus and rectum. There can be foul-smelling discharge and/or an intolerable itching accompanying the warts.

In men, warts usually occur near the tip of the penis, sometimes under the foreskin, and less often on the shaft of the penis or scrotum, anus and rectum.

Venereal warts grow quickly. If left untreated, they can grow large enough to block the vaginal, urethral or rectal openings.

How are they diagnosed?

Venereal warts are diagnosed by their appearance. However, a VDRL (blood test) should be done to avoid confusion with the flat warts of syphilis. Screening tests should also be done for possible co-existing infection (e.g., gonorrhea, chlamydia).

What is the treatment?

Treatment can sometimes be lengthy and frustrating. This is due to the long incubation period. As some warts are treated, new ones appear. As well, warts which have been present a long time are sometimes difficult to treat.

The most frequently used treatment is Podophyllin, a dark ointment or liquid which is applied directly to the warts. (after 4-6 hours, the podophyllin must be thoroughly washed off. If left too long, or applied to healthy skin, it can cause painful burns). Treatments usually have to be repeated on a regular basis, once or twice per week.

Podophyllin should not be used during pregnancy as it is absorbed and can cause fetal damage.

If you have warts in your vagina, cervix, rectum or penis, or if external warts are particularly resistant to podophyllin, a referral to a specialist may be necessary for electrocautery or L.A.S.E.R. treatment or cryotherapy (freezing with liquid nitrogen).

Follow-up

It is important to complete treatment until all warts have disappeared. If any remain, they can continue to spread from one infected area to another (e.g., vaginal and sexual secretions can transport the virus from the vagina to the anus).

As treatment is often long, it is unrealistic to abstain from sexual intercourse, but condoms must be used. Partners should be informed, but there is little they can do until warts appear.

N.B.: Pap tests sometimes show signs of papiloma infection before the warts even appear. As well, there may be some connection between the papiloma virus and precancerous changes on the cervix. Cervical cancer takes many years to develop, and early changes do not necessarily progress to cancer. However, women with venereal warts should have regular pap tests.