Finding a genital wart can be unsettling, but genital warts are one of the most common sexually transmitted conditions — and they are very treatable. This guide explains what causes them, the treatment options used in the UK, and what to realistically expect, including why warts can sometimes return.
What genital warts are (HPV) and how they present
Genital warts are caused by certain types of the human papillomavirus (HPV) — most often types 6 and 11, which are considered low-risk in that they do not cause cancer. HPV is passed on through skin-to-skin genital contact, and it is so common that most sexually active people are exposed to some type of HPV at some point.
Because HPV lives in the surface skin, it can be passed on even when there are no visible warts, and even with condom use, since condoms do not cover every area of skin. This is not a sign of poor hygiene, and it is very common — genital warts are one of the most frequently diagnosed conditions at UK sexual health clinics.
Warts can appear as small flesh-coloured or slightly darker bumps, singly or in clusters, and can be flat or have a cauliflower-like surface. They may show up on the vulva, penis, scrotum, around the anus, or inside the vagina or urethra. They are usually painless, though some people notice mild itching or irritation. Many people also worry that warts mean a recent partner has been unfaithful, but HPV can stay dormant for months or longer before warts appear, so their arrival does not reliably date the exposure.
Warts can appear weeks, months or occasionally years after HPV is acquired, and many people who carry these HPV types never develop warts at all. When warts do appear they may come up gradually, sometimes noticed first as a single small bump before others follow. None of this changes how treatable they are — it simply explains why timing is often uncertain.
How genital warts are diagnosed
Most genital warts are diagnosed simply by a clinician looking at them; special tests are rarely needed. There is no routine blood test for HPV, and the types that cause visible warts are not the same as those checked for in cervical screening. A clinician may gently examine the surrounding area, and for internal warts a speculum or proctoscope examination is occasionally needed to see the full extent. Testing for other sexually transmitted infections at the same time is sensible; our guide to STI testing in the UK explains what that involves.
Topical treatment — podophyllotoxin (Warticon)
For external warts, a common first-line home treatment is podophyllotoxin, sold as Warticon. It works by damaging the wart tissue so the body can clear it. A typical regimen is applying it twice daily for three days, then having four days off, and repeating that weekly cycle. This is continued for up to four to sixteen weeks depending on how the warts respond.
Podophyllotoxin suits soft external warts and is applied precisely to the warts themselves to limit irritation of the surrounding skin, which is common. It is not used in pregnancy. As with all of these treatments, a clinician confirms the diagnosis and checks it is appropriate for you before you start.
It is normal for treated warts to become sore, red or to form small ulcers as they respond, and this settles as the skin heals. Washing your hands both before applying it and again afterwards, and being careful to treat only the warts, helps protect the surrounding skin. If irritation becomes severe, a clinician can advise on pausing or adjusting treatment.
Immune-response treatment — imiquimod (Aldara)
A different approach is imiquimod, sold as Aldara. Rather than destroying the wart directly, it prompts the local immune system to attack the HPV-affected tissue. It is usually applied three times a week — for example on alternate days — left on overnight, then washed off, and can be continued for up to sixteen weeks.
Imiquimod is often used as a second-line option, or where podophyllotoxin has not cleared the warts, and it tends to be associated with a lower rate of recurrence, likely because it works through the immune response. It can cause redness and skin irritation where it is applied. Which treatment is most suitable depends on where the warts are, how many there are, and your preferences, and may be considered for some patients over others after assessment.
Cryotherapy and combination approaches
Not all warts respond to creams, and some are better treated physically. Cryotherapy — freezing the warts with liquid nitrogen — is a common clinic-based alternative, usually done over several sessions. Other clinic options include minor procedures to remove stubborn warts.
Cryotherapy can sting, and the skin may be sore or blistered for a short time afterwards before it heals. Because it is applied directly by a trained clinician, it can be useful for warts in awkward places or those that have not responded to creams. Treatments are sometimes combined; for example, cryotherapy may be used alongside a topical treatment to improve clearance. There is no single approach that is right for everyone, and it is common to try one method, review progress, and switch or combine if needed.
What to expect during treatment
Clearing genital warts is often a case of patience rather than a single quick fix. Many people need several weeks of a topical treatment, or a few cryotherapy sessions, before warts disappear, and it is common to switch between methods if the first does not work. Warts in pregnancy are managed differently — topical treatments such as podophyllotoxin and imiquimod are generally avoided, and clinic-based options are used instead — so always mention if you are or might be pregnant. Throughout, a clinician can reassure you about what is normal and step in if anything is not settling as expected.
Recurrence, prevention and when to seek review
An important thing to understand is that treatment removes visible warts but does not remove HPV from the body. The immune system usually clears the virus over time, but until it does, warts can recur — often within the first few months — and may need further treatment. This is normal and does not mean anything has gone wrong. Anything that lowers the immune response — including smoking, or conditions and medicines that suppress immunity — can make warts more persistent, which is one reason clinicians ask about your wider health.
You can lower the chance of passing HPV on by using condoms, though they do not cover all skin that may carry the virus. The HPV vaccine offered in the UK protects against the types that cause most genital warts and is most effective when given before exposure; it is offered to adolescents and to some adults at higher risk. Telling current or recent partners means they can be checked if they wish.
It is common to feel embarrassed or anxious about genital warts, but they are a common infection rather than a reflection on you, and sexual health services are used to helping people manage them discreetly. A clinician can also clear up worries about fertility and cancer risk, and advise on the most suitable option and follow-up for you.
See a clinician if you are unsure whether a lump is a wart, if warts are bleeding, painful or rapidly changing, if you are pregnant, or if warts are not improving with treatment. You can also read our related Sexual Health articles, including how to manage genital herpes flare-ups.