Human Papilloma Virus

Several types of HPV cause genital warts. Genital warts are the most common viral STI in the United States. They result in over 1 million doctor visits. You are more likely to get HPV if you:

  • had sex at any early age
  • have multiple sex partners
  • don't use birth control, such as condoms, regularly
  • have casual sex often

What Is HPV?
The human papilloma virus (HPV) causes warts on the external genitals and on the cervix (the lower part of the uterus or womb). HPV can also cause warts on the back of the throat, although this is rare.

HPV is now the most common sexually transmitted infection (STI) and chlamydia is the second most common STI.

Viruses are like bacteria in that they cause infection. They are different in that they are smaller and more difficult to treat. Viruses are so small that they can occasionally pass though condoms. However, one should still use condoms when having sex to help prevent the spread of this and other STIs.

The wart viruses are in the environment so a person can have genital warts without being sexually active. And there is no point in accusing partners of having other partners. However, protection against STIs should be discusses with present and future partners.

How Long Does It Take For Warts To Appear?
After being in contact with someone who has warts, you may not get warts for 6 weeks to 8 months or longer. In fact, you may never get warts. The appearance of warts depends upon the strength of your immune system, which protects against all infection. During pregnancy, and in people who have HIV infection, the immune system is not working as well. Warts may appear at these times or get much larger if they are already present.

What Do Warts Look Like?
Warts on the external genitals are easy to see if you are doing genital self-exams every month. When they are small, about 1 millimeter, they look like smooth flesh colored bumps. When they get larger, they look like cauliflower. On the outside, they are seen most often at the lower vaginal opening. The vagina is the opening between the urethra and the anus. Warts in the mouth look the same.

Do Warts Cause Abnormal Pap Smears?
Warts on the cervix are the most common cause of abnormal Pap smears. A Pap smear is scraping cells off the cervix and placing them on a slide. Then the slide is examined under a microscope, which makes the cells appear much larger. When there are warts on the cervix, some of the cells seen on the Pap smear slide will look different.

If I Have HPV On My Pap Smear, What Happens Next?
Your health practitioner will tell you to have a colposcopy. A colposcope is a magnifying instrument that makes the cervix look larger so that warts can be seen more easily. It is used in a doctor's office.

Sometimes a little piece of tissue is taken from the cervix when looking through the colposcope. This is called a biopsy. The tissue is then placed on a slide and the cells are examined for number and appearance of abnormal cells.

There are over 70 types of virus that can cause warts. Of these 70, only about 6 types can increase the risk of cervical cancer. If you have warts on your cervix, the chance that you have one of these 6 types are very small. However, it is very important to have colposcopy and follow-up Pap smears. Colposcopy takes about 15 minutes so it may be helpful to bring a support person with you.

How Often Do I Have Follow Up Pap Smears?
After the tissue cells are checked for cells infected with HPV, you will be told how often to have repeat Pap smears. This is usually every 3 to 6 months for 1 to 3 years and then every year for the rest of your life.

The reason you must have Pap smears every year is that the wart virus will remain in your body the rest of your life.

What Is The Risk Of Giving It To Someone Else?
If there are no warts visible, the risk of passing warts to a partner is very small. If warts are present, there should be no genital contact until the warts are treated and gone, even if you use protection. This is because warts are often places that are not covered by condoms. If there is any doubt, condoms should be used.

What Are The Symptoms Of HPV Infection?
Most women have no symptoms. They just notice the bumps or have an abnormal Pap smear. Symptoms experienced by some women are itching, burning, or stinging and occasionally a vaginal discharge.

What Are The Treatments For HPV?
There are several over-the-counter treatments which may be put on external warts for 3 or 4 weeks. If this is not working see your health practitioner.

Depending on the location and size of the warts the following treatment may be used by your practitioner:

  • Trichloracetic acid
  • Podyphyllin - important to wash off in 4 to 6 hours to avoid painful chemical burn
  • Cryotherapy (freezing)
  • Electrocautery (burning)
  • Laser
  • Surgical Removal

How Can I Protect Myself Against HPV?

  • Use condoms every time the penis is in the vagina, anus or mouth. It won't protect the base of the penis or the woman's external genitals completely, but it will give a lot of protection and should be used. An alternative to the male condoms is the female condom.
  • Use "dental dams" (a piece of latex rubber) or double strength Saran Wrap for oral sex on a female, especially during a menstrual period. You can make a "dental dam" by cutting the tip off a condom and then cutting it along one side.
  • Get Pap smears every year or as advised by your health practitioner.
  • Do external genital self-exams monthly. This can be done along with your breast self-exams.
  • If you have warts on the cervix, consider learning cervical self-exam so you can look at your cervix yourself. However, warts are often so small they can't be seen.
  • Avoid tampon use when warts are known to be present. Warts could be spread.
  • Wash genitals and hands before and after sexual activity.
  • Get plenty of rest and sleep, exercise regularly, and eat well-balanced meals. This helps strengthen your immune system.
  • Consider taking 100 mg of vitamin C and 10 mg of folic acid daily.


The health information provided on is not intended or implied to be a substitute for professional medical advice. Nothing stated by this website or linked pages should be used for medical diagnosis or treatment. If you have an urgent medical problem call 911 immediately or contact your healthcare provider.