Genital warts on the penis are small, firm bumps on the shaft, the glans, the foreskin or the surrounding skin. They are skin-coloured to greyish white, usually painless, and often grow in clusters. They come from HPV, almost always type 6 or 11 (Steben, 2014).
Now the part that surprises men most: in the Netherlands there is no HPV test routinely offered to men. Not with us, not at the GGD, nowhere.
That sounds like a shortcoming. Mostly it follows from how the virus works. Below we explain what you can do instead, and why it gets you further than you would think.
What do genital warts on the penis look like?
They are small, firm and dry. A single wart is often no bigger than a few millimetres. The colour sits close to your own skin tone, sometimes redder or greyer. They feel grainy, not moist. Several warts together can form a rough patch resembling a miniature cauliflower.
Pain is usually not part of it. Irritation from friction is.
The full comparison with other bumps sits in what genital warts look like.
Where on the penis do they usually sit?
Genital warts sit where skin meets skin during sex. In circumcised men that is more often the shaft, in uncircumcised men more often the foreskin and the glans. The skin at the base of the penis, the scrotum and the anal rim count too. Location tells you something, but it proves nothing.
| Location | What it could be | Testable in blood or urine? |
|---|---|---|
| Shaft or foreskin, firm bumps in a cluster | Genital warts (HPV 6 or 11) | No, a doctor looks |
| Row of even bumps along the rim of the glans | Pearly penile papules, a normal variant | Not needed, this is not an infection |
| Painful blisters on red skin, tingling beforehand | Genital herpes | Yes, HSV-1 and HSV-2 |
| One firm, painless ulcer | Syphilis, first stage | Yes, syphilis in blood |
| No bump, but burning urination or discharge | Chlamydia or gonorrhoea | Yes, PCR on urine |
That last row is why we wrote this piece. A bump grabs all the attention, while the infections you really want to rule out often show nothing at all.
How do you recognise HPV in men?
In practice you recognise HPV in men only by the warts. There are no other symptoms. No fever, no pain, no discharge. The large majority of men with HPV never notice a thing and clear the virus by themselves, without ever knowing they had it.
That is not meant casually. It is exactly what the research shows.
Picture two men of 28 who both pick up HPV in the same month. One never notices a thing and has cleared the virus after eight months or so, without ever knowing he had it. The other sees three small warts on the shaft after four months. Same virus, same age, different course. That difference sits in the immune system, not in behaviour.
In the HIM study, a cohort of 1,159 men in Brazil, Mexico and the United States, an HPV infection was cleared after a median of roughly 7.5 months (Giuliano, 2011). Some infections lingered longer, HPV-16 for about twelve months on average. Coming and going is the norm, not the exception.
Is there an HPV test for men?
No, not as routine. The Netherlands has no HPV test offered to men, and RIVM does not include men in the national screening programme. That programme targets high-risk HPV on the cervix. In men there is no comparable site to sample and no proven health benefit.
So we do not sell an HPV test, and that is a deliberate choice.
Search online for "hpv test men" and you will find providers selling something. Be critical. Always ask what exactly is sampled, which HPV type is being sought, and what you can do with a result. A positive result with no course of action gives you worry, not an answer.
So what can men have checked?
The infections you cannot see. Chlamydia and gonorrhoea often run without symptoms in men, and those are exactly the ones a urine PCR detects well. Syphilis and HIV sit in the blood. Those are four answers you can have within a few days, while HPV mostly hands you questions.
This is how we approach it when someone asks. Bump: see your GP. The rest: send it to the lab.
- For chlamydia, gonorrhoea and trichomonas: the urine PCR test.
- For HIV, syphilis and hepatitis B: the Viral Infections Package.
- Want to pick what goes in it yourself? Build a custom test.
A broader explainer per symptom sits in STI testing for men. If the warts are around or inside the anus, read warts around the anus.
When should you see a doctor?
See your GP as soon as you find a bump you cannot place, or if it grows, bleeds or hurts. A doctor usually recognises genital warts immediately. Thuisarts.nl describes the possible treatments, from a cream to freezing with liquid nitrogen, and when waiting is also an option.
Treating is not compulsory, by the way. Many warts disappear on their own.
Our advice: get it looked at, and use the same moment to rule out chlamydia and gonorrhoea if you had a new partner in recent months. The complete picture of this virus sits in our hub on genital warts and HPV. A condom lowers your HPV risk considerably, though it does not cover all the skin that makes contact (Winer, 2006).
References
- 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.
- Steben M, Garland SM. Genital warts. Best Pract Res Clin Obstet Gynaecol. 2014;28(7):1063-1073. PMID 25155525.
- 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.
- 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.
- RIVM. Cervical cancer screening programme and HPV. 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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