Genital warts are soft bumps on or around your genitals or anus. They come from the human papillomavirus (HPV), almost always type 6 or 11. Those types do not cause cancer. Here is what strikes us every time: nearly everyone who finds a bump like this books an STI test. And that test does not find HPV.
That is not a detail. An STI panel looks for bacteria and viruses in your blood or urine. Genital warts are visible to the naked eye. A doctor diagnoses them by looking, not by drawing blood.
Below you will read how to recognise them, how you get them, and what you can actually have checked. Because that bump is surprisingly often something else.
What exactly are genital warts?
Genital warts are benign skin growths on the penis, the labia, inside the vagina, around the anus or on the perineum. They are caused by HPV. Almost always it is type 6 or 11, two low-risk types that do not cause cancer (Steben, 2014). The medical name is condylomata acuminata, or condylomas for short.
There are more than two hundred HPV types. It helps to split them into two groups.
- Low-risk HPV (mainly 6 and 11) causes warts. These types are not behind cancer.
- High-risk HPV (mainly 16 and 18) causes no warts, but can lead to cell changes after years. The Dutch cervical cancer screening programme run by RIVM looks for these.
That distinction matters. A wart does not mean you have high-risk HPV, and high-risk HPV does not give you warts. They simply travel in the same company.
Genital warts are not rare. A systematic review found 160 to 289 new cases per 100,000 people per year, with a median of about 195 (Patel, 2013). In women the peak falls before age 24, in men between 25 and 29.
Picture this: you are 23, you step into the shower and you feel three small bumps that were not there last month. Statistically you are in exactly the age group where this happens most. That does not make it less annoying, but it does make you completely ordinary.
What do genital warts look like?
Genital warts are usually small, soft and skin-coloured to greyish white or pinkish red. They often grow in clusters. Sometimes they are flat, sometimes they stick out and resemble a miniature cauliflower. They usually do not hurt. Itching or a burning feeling does happen, especially with friction.
Sizes range from a pinhead to a few millimetres. They can sit separately or merge into a larger patch. We walk through this step by step in what genital warts look like.
The picture differs per location. We cover that separately for genital warts on the penis, for vaginal warts and for warts around the anus.
Here is the core of the problem. Many bumps people take for warts are something else. And some of those other things can be tested.
| What you see | May fit with | Does a blood or urine test find it? |
|---|---|---|
| Soft, skin-coloured bumps in clusters, painless, sometimes cauliflower-like | Genital warts (HPV 6 or 11) | No. A doctor establishes this by looking |
| Cluster of painful blisters on red skin, often with tingling first | Genital herpes (HSV-1 or HSV-2) | Yes, via HSV-1 and HSV-2 in blood, with caveats |
| One firm, painless ulcer that disappears on its own | Syphilis, first stage | Yes, via syphilis in blood |
| Pearly bumps with a dimple in the middle | Molluscum contagiosum (water warts) | No. A doctor establishes this by looking |
| A row of even bumps around the rim of the glans | Pearly penile papules, a normal variant | Not needed. This is not an infection |
See a bump and unsure? Our broader explainer is bumps or blisters on your genitals.
How do you get genital warts?
You get genital warts through skin-to-skin contact during sex. The virus lives in the skin and mucous membranes, not in your blood. Penetration is not required. Contact between the skin of the genital area is enough. In practice you do not get them from a toilet seat or a towel.
A condom lowers your risk, but does not cover all the skin that makes contact. In a prospective study among young women, participants whose partner always used a condom had 37.8 HPV infections per 100 patient-years, against 89.3 among partners who rarely used one (Winer, 2006).
That is more than a halving. It is not zero.
The time between infection and the first wart is erratic. Weeks is possible, months is more common, and sometimes it takes years. Read more on how STIs spread in can you get an STI from oral sex, a toilet seat or a towel.
Can you get HPV with a steady partner?
Yes. HPV can sit quietly in your skin for years before a wart appears. A new wart is therefore no proof that anyone cheated. That sounds reassuring and usually it is, but mostly it is simply how this virus behaves.
This is the question we see most often, and it deserves more room than it usually gets. Two people can be together for seven years. One of them suddenly gets warts. The temptation to build a story around that is enormous.
Yet the biology is boring. HPV can stay latent for a long time and become active again later, for example after stress or illness. In a cohort of 1,159 men, clearing an HPV infection took a median of roughly 7.5 months, though some infections persisted far longer (Giuliano, 2011). In young women a similar pattern of coming and going was seen (Ho, 1998).
Our advice stays the same here: treat a wart as a medical fact, not as evidence. If you do want to have the conversation with your partner, testing together in a new relationship helps.
Does an STI test find genital warts?
No. No blood test and no urine test finds HPV or genital warts. Our panels do not either. That is not a gap in our range, it is how the virus behaves: HPV lives in skin cells, not in your bloodstream. A doctor diagnoses genital warts by looking at them.
We put that bluntly on purpose. Plenty of places online suggest a "complete STI check" also covers HPV. Not one does. Why that is, and what each test actually measures, sits in is HPV an STI.
The HPV test that does exist in the Netherlands is the smear or self-sampling kit from the cervical cancer screening programme (RIVM). It looks for high-risk HPV in cells from the cervix, precisely the types that do not cause warts. For men there is no HPV test routinely offered in the Netherlands.
| What you want to know | Does a blood or urine test find it? | What does look at it |
|---|---|---|
| Do I have HPV or genital warts? | No | Your GP, the GGD or a dermatologist, by looking |
| Do I have high-risk HPV on the cervix? | No | Cervical cancer screening (smear or self-sample) |
| Do I have chlamydia, gonorrhoea or trichomonas? | Yes, via PCR on urine | Chlamydia, Gonorrhoea, Trichomonas |
| Do I have HIV, syphilis or hepatitis B? | Yes, via blood | Viral Infections Package |
| Was that blister herpes? | Yes, via blood, with caveats | HSV-1 and HSV-2 |
So what can you have checked?
Two things. One: if you are not sure whether it is a wart, a test can rule out herpes or syphilis. Both look different, but in practice people doubt this all the time. Two: a wart does not rule out another STI. You can have both.
That second point is the most important, and the most often missed.
Chlamydia and gonorrhoea frequently run without symptoms. You do not see them and you do not feel them. If a wart has already got you thinking about the past few months, that is a logical moment to have those two checked. You can do that with the chlamydia, gonorrhoea and trichomonas PCR test, or you can build your own test.
Read more about silent infections in STIs without symptoms. If you first want to know which test answers which question, start with which STI test do you need and when.
Do genital warts go away on their own?
Often they do. Your immune system usually clears HPV by itself, though that can take months to years. In the HIM cohort of 1,159 men, an HPV infection was cleared after a median of about 7.5 months (Giuliano, 2011). Warts that stay or bother you can be treated by a doctor. That choice sits with your GP.
Treatment targets the wart, not the virus. That is a meaningful difference.
A GP may prescribe a cream, such as podophyllotoxin or imiquimod, or freeze the warts with liquid nitrogen. Thuisarts.nl describes the options and the trade-offs. Which option fits depends on the number of warts, the location and your own preference.
Because the virus can remain in the skin, warts sometimes return after a successful treatment. That does not mean the treatment failed, and it certainly does not mean you were reinfected.
Does the HPV vaccine still help if you have had sex?
The HPV vaccine is part of the Dutch national immunisation programme and protects against several HPV types, including 6 and 11. Protection is greatest when you are vaccinated before first sexual contact. If you are already sexually active, the vaccine can still protect against types you have not yet encountered.
After vaccination programmes were introduced, researchers saw substantial drops in HPV infections and genital warts across several countries, including among unvaccinated peers (Drolet, 2019). That last effect is called herd protection.
Whether vaccination makes sense in your situation is a conversation for your GP or the GGD. That is not an evasive answer, it genuinely depends on your age and your history.
When should you see a doctor?
See your GP if you find a bump you cannot place, if it grows, bleeds or hurts, or if it is on your mind. A doctor can usually tell at a glance whether it is a wart. That saves weeks of worrying, and it is the only way to know for sure.
If your real question is whether something else is going on, that is a different question. That one a test can answer.
Here is how we would do it: have the bump looked at by your GP, and have chlamydia and gonorrhoea checked at the same time if you had a new partner in recent months. A doctor answers the first question with their eyes. A lab answers the second. They do not replace each other.
If you want to handle that second question anonymously, how an anonymous STI test works explains exactly what happens to your data.
References
- Steben M, Garland SM. Genital warts. Best Pract Res Clin Obstet Gynaecol. 2014;28(7):1063-1073. PMID 25155525.
- Patel H, Wagner M, Singhal P, Kothari S. Systematic review of the incidence and prevalence of genital warts. BMC Infect Dis. 2013;13:39. PMID 23347441.
- Winer RL, Hughes JP, Feng Q, et al. Condom use and the risk of genital human papillomavirus infection in young women. N Engl J Med. 2006;354(25):2645-2654. PMID 16790697.
- Giuliano AR, Lee JH, Fulp W, et al. Incidence and clearance of genital human papillomavirus infection in men (HIM): a cohort study. Lancet. 2011;377(9769):932-940. PMID 21367446.
- Ho GY, Bierman R, Beardsley L, Chang CJ, Burk RD. Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med. 1998;338(7):423-428. PMID 9459645.
- Drolet M, Bénard É, Pérez N, et al. Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis. Lancet. 2019;394(10197):497-509. PMID 31255301.
- RIVM. Genital warts and the cervical cancer screening programme. Available via rivm.nl.
- Thuisarts.nl (NHG). I have genital warts. Available via thuisarts.nl.
This information is general and does not replace personal medical advice. Every STI test result at Discreet Test is reviewed by a BIG-registered doctor. Always discuss symptoms or treatment decisions with your GP, the GGD or a Centre for Sexual Health.
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