Key points at a glance
🦠 HPV causes genital warts
Certain types of HPV can cause genital warts in the genital and anal areas.
🧫 Easy to pass on
HPV can be passed on during sex or through close physical contact.
💉 Vaccination protects
The HPV vaccine protects against most types of HPV that cause genital warts or cervical cancer.
🩺 Treatment available
Genital warts can be treated, but they may reappear after successful treatment.
What is HPV?
HPV stands for human papillomavirus. There are more than a hundred different HPV subtypes. Some of these can cause genital warts. These small, wart-like growths mainly occur in the genital and anal areas, and less commonly in the mouth.
Not every HPV infection leads to genital warts. In most cases, the body clears the virus on its own and the infection clears up. Other types of HPV can be involved in the development of certain cancers, for example of the cervix or the anus.
What are genital warts?
Genital warts are one of the most common sexually transmitted infections. They are also known as genital warts or condylomas. They typically appear as small, wart-like growths in the genital area or around the anus. In rare cases, they can also occur in the mouth.
Genital warts are caused by human papillomaviruses, or HPV for short. There are many different types of HPV. Some of these can cause genital warts. Others play an important role in the development of cervical and anal cancer. Genital warts can be treated. However, treatment can take a long time.
How HPV and genital warts are transmitted
HPV is usually transmitted through sex. The virus is present in skin flakes and can be easily passed on through close physical contact. Minor breaks in the skin or mucous membranes in particular can make it easier for the virus to enter the body. Shaving the genital area recently can therefore increase the risk.
Transmission is also possible via sex toys if human papillomaviruses are present on them. There are more than a hundred different HPV subtypes. Some can cause genital warts in the genital area, around the anus or, less commonly, in the mouth. Other HPV types are linked to the development of various types of cancer, including cervical and anal cancer. During childbirth, pregnant women can pass HPV on to their baby.
Preventing HPV: How to reduce the risk
Condoms and Femidoms can only reduce the risk of HPV transmission to a limited extent. The reason is that they cover only a small area of skin. HPV can be passed on very easily through close physical contact or via smear infections, for example via the hands or objects in the genital area.
If genital warts are treated early, the risk of passing them on to others is reduced. If you have multiple sexual partners, it may be a good idea to have a screening for sexually transmitted infections at least once a year. This allows genital warts and other infections to be detected and treated at an early stage.
As a general rule, the earlier genital warts and other sexually transmitted infections are treated, the better the chances of a successful outcome.
HPV vaccination: protection against certain types of the virus
A vaccination can protect against certain types of HPV. It is recommended for children and young people aged between 9 and 14. At this age, many have not yet come into contact with HPV. The costs are covered by health insurance.
It is also possible to have the HPV vaccination at a later stage. It protects against most types of HPV that cause genital warts or cervical cancer. However, the vaccination does not provide complete protection.
Genital warts and HPV: Possible symptoms and consequences
In most cases, the body is able to fight off an HPV infection on its own. The viruses then clear up. Furthermore, an infection with HPV types that can cause genital warts does not automatically lead to visible warts. Even long-lasting infections with HPV types that can contribute to the development of cancer rarely progress to cancer.
It can take several weeks or months after infection for genital warts to develop. They typically appear as small, pointed warts. If they spread over a larger area, their surface may become irregular and take on a cauliflower-like appearance. They often develop at the junctions between the skin and mucous membranes, for example on the anus, on the labia, between the labia and the perineum, inside the vagina or on the fold of the foreskin.
Genital warts themselves are not painful. However, in the anal area, they can cause severely itchy eczema. They are usually harmless. Nevertheless, they can be perceived as a nuisance, for example for aesthetic or hygienic reasons. Mechanical discomfort is also possible, such as pain during anal intercourse.
The HPV types that can cause genital warts include, in particular, subtypes 6 and 11. Subtype 6 is responsible for around two-thirds of cases, whilst subtype 11 accounts for around one-third. Other types, such as 42, 43 or 44, are less common.
Other HPV subtypes may be involved in the development of cancerous tumours. It can take between five and ten years from the time of infection to the development of a cancerous tumour. Overall, cancerous tumours actually develop only rarely.
When this occurs, HPV plays a significant role in cancers of the cervix, anus, labia, penis, and the mouth and throat, amongst others. HPV is almost always involved in cervical cancer. Around 50 per cent of cases are attributed to subtype 16, and around 20 per cent to subtype 18. The remaining cases are distributed across at least twelve other subtypes.
HPV is involved in around 90 per cent of cases of anal cancer. In cases of cancer of the penis or vulva, the proportion is approximately 40 per cent, whilst for cancer of the mouth and throat it is around 30 per cent.
Anal cancer is very rare overall. Around one in 100,000 people are diagnosed with it each year. Anal cancer is more common in people with HIV than in the general population. Cancer of the vulva and penis is similarly rare. Here, too, there is approximately one case per 100,000 people each year.
Recognising genital warts and HPV: How the diagnosis is made
Genital warts can usually be recognised straight away. Specialists in dermatology and venereology or gynaecology generally make the diagnosis by looking at or feeling the affected area. In addition to the genital area, the rectum should also be examined. The rectum is also known as the rectal canal and is situated directly behind the anus. It is approximately 15 to 18 centimetres long.
During the examination, a thin, tube-shaped instrument is inserted into the anus. This instrument is called an anoscope or proctoscope. The examination is not painful.
For those with statutory health insurance – and, as a rule, for those with private health insurance too – there are also screening tests for early detection of cancer. Women aged between 20 and 34 can have a Pap test once a year at a gynaecologist’s surgery. During the test, cells are taken from the cervix and then examined in a laboratory.
From the age of 35, a direct HPV test can be carried out every three years alongside a Pap test. This service is available, for example, to cis women, as well as to trans* men, inter* and non-binary people. Legal gender status is irrelevant in this context. Self-help groups and trans support centres, for example, can help in finding suitable clinics.
People living with HIV should be screened at least once a year for precancerous lesions of the anus and cervix.
Treating genital warts: what options are available?
There is no treatment that acts directly against HPV. Regular check-ups for genital warts or precancerous lesions may therefore be advisable.
Genital warts can be treated in various ways. The most suitable method depends, amongst other things, on the number, size and location of the warts. However, no method can guarantee complete and permanent removal. Even after treatment that appears successful at first, genital warts may reappear.
Creams, ointments or solutions are often used. These can usually be applied to the affected areas by the patient themselves.
In addition, there are surgical procedures. Genital warts can, for example, be removed using a fine spoon – a procedure known as curettage – or with surgical scissors. Other options include ablation using brief heating, laser treatment or freezing with liquid nitrogen.
In the case of a chemical burn, acid is applied to the affected areas. This causes the top layer of skin to be burnt away.
Why HPV plays a particular role in HIV
Following treatment for genital warts, there is an increased risk of HIV infection whilst the wound is healing. You should therefore take particular care to practise safe sex during this time.
People living with HIV are significantly more likely to have genital warts than those who are HIV-negative. Anal HPV infections are also up to six times more common amongst them. This holds true regardless of gender and sexual practices. Cervical cancer is also significantly more common amongst people living with HIV. Anal cancers are also more common. According to estimates, they occur around 80 times more frequently in people with HIV than in the general population. People with HIV should therefore be screened at least once a year for precancerous lesions of the anus and cervix.
HPV and genital warts during pregnancy
In rare cases, HPV can be passed on to the baby during childbirth. For this reason, it is recommended that pregnant women seek treatment for genital warts around the 34th week of pregnancy.
Frequently asked questions
What is HPV?
HPV stands for human papillomavirus. There are more than a hundred different HPV subtypes. Some can cause genital warts, whilst others are involved in the development of certain cancers.
How do genital warts develop?
Genital warts are caused by certain types of HPV. They mainly occur in the genital and anal areas. Less commonly, they can also appear in the mouth.
How is HPV transmitted?
HPV is usually transmitted during sex or through close physical contact. Infection is also possible via sex toys or, less commonly, through contact with contaminated surfaces.
How can I protect myself against HPV?
Condoms and Femidoms only reduce the risk to a limited extent. An HPV vaccination can protect against most types of HPV that cause genital warts or cervical cancer.
How are genital warts treated?
Genital warts can be treated, for example, with creams, ointments or solutions. Surgical procedures, cryotherapy, laser treatment or chemical cauterisation are also options. Despite treatment, genital warts may reappear.
