Genital Warts

Anal Warts Without Anal Sex?

Can a person be diagnosed with anal warts even if they’ve never had anal sex?

Anal warts are sometimes detected in those with no history of anal sex, but the exact route of transmission isn’t well defined. While most cases probably result from receptive anal intercourse, it’s possible that digital insertion poses a risk for HPV transmission. In terms of introducing HPV into the rectum via fingers, the risks may be more likely when warts are actually present at, or very near, the anus. The close proximity of a lesion (which is a reservoir of relatively large quantities of virus) may allow for the rectum to be exposed to infected skin cells by digital insertion, or perhaps through activities related to hygiene (such as wiping or cleaning). Also, perianal warts can develop from genital to anal contact without penetration, such as during sexual foreplay.

Treating Genital Warts

What’s the best treatment option for genital warts?

The goal of any treatment should be to remove visible genital warts to get rid of annoying symptoms. No one treatment is best for all cases. Treating the warts may possibly help reduce the risk of transmission to a partner who may have never been exposed to the wart-types of HPV.

When choosing what treatment to use, the health care provider will consider the size, location and number of warts, changes in the warts, patient preference, cost of treatment, convenience, adverse effects, and their own experience with the treatments. Some treatments are done in a clinic; others are prescription creams that can be used at home for many weeks.

Treatments done in a clinic include:

  • Cryotherapy (freezing off the wart with liquid nitrogen). This can be relatively inexpensive, but must be done by a trained doctor or nurse.
  • Podophyllin (a chemical compound that must be applied by a doctor or nurse). This is an older treatment and is not as widely used today.
  • TCA (trichloracetic acid) is another chemical applied to the surface of the wart by a doctor or a nurse.
  • Cutting off warts. This has the advantage of getting rid of warts in a single office visit
  • Electrocautery (burning off warts with an electrical current)
  • Laser therapy (using an intense light to destroy warts).This is used for larger or extensive warts, especially those that have not responded well to other treatments. Laser can also cost a lot of money. Most doctors do not have lasers in their office and the doctor must be well-trained with this method.
  • Interferon (a substance injected in to the wart). This is rarely used anymore due to extensive side effects and high cost. Less expensive therapies work just as well with fewer side effects.

At-home prescription creams (these are only available by a prescription from a health care provider):

  • Podofilox cream or gel (Condylox®). This is a self-applied treatment for external genital warts. It may be less expensive than treatment done in a health care provider's ofice, is easy to use and is safe, but it must be used for about 4 weeks..
  • Imiquimod cream (Aldara®). This is also a self-applied treatment for external genital warts. It is safe, effective and easy to use. This cream is different than other commonly-used treatments, which work by destroying the wart tissue. Aldara actually boosts the immune system to fight HPV.

IMPORTANT: Over-the-counter wart treatments should not be used in the genital area.

--The NCCC Staff