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Anal Warts

Anal warts (condyloma acuminata) are caused by the human papilloma virus (HPV), the most common sexually transmitted disease (STD). The warts affect the area around and inside the anus, but may also develop on the skin of the genital area. They first appear as tiny spots or growths, often as small as a pin head. They can grow quite large and cover the entire anal area. 

CAUSES

Sexual intercourse is a common way to get infected with HPV. However, a person can become infected with HPV without having sexual intercourse. Any direct contact to the anal area (e.g. hand contact, fluids from an infected sexual partner) can cause HPV and anal or genital warts. 

PREVENTION

The HPV virus often remains in the body without any signs. There are steps you can take to help prevent anal warts.

  • Do not have sexual contact with people who have anal (or genital) warts
  • Limit sexual contact to a single partner
  • Abstinence: Do not have any sexual contact
  • Always use condoms (this reduces, but does not eliminate the risk)
  • Sexual partners should be checked for HPV and other STDs even when there are no symptoms

SYMPTOMS

Warts are usually painless, so people may not realize they have them. The primary symptom is soft, moist bumps near or in the anus that are light brown or flesh-colored. Additional symptoms may include:

  • Itching
  • Bleeding
  • Mucus discharge
  • Feeling like there is a lump in the anal area

DIAGNOSIS

Your physician will look at the skin around the anus, as well as the entire pelvic area, including the genitals. He or she may perform an exam of the anal canal with a small, lighted scope (anoscopy) to see if there are any warts inside the anal canal (internal anal warts). 

TREATMENT

If warts are not removed, they can grow larger and multiply. Left untreated, warts may lead to an increased risk of anal cancer in the affected area. Internal anal warts may not respond to topical medications, so surgery may be required. Treatment options include:

  • Topical medication: These creams usually work best if the warts are very small and located only on the skin around the anus.
  • Topical medications that will freeze the warts (liquid nitrogen)
  • Topical medications that will burn the warts (Trichlorocetic acid, podophyllin)
  • Surgery: When the warts are either too large for the above mentioned treatments or are internal, surgery is considered. During surgery, the warts are surgically removed. The patient will be anesthetized for the procedure. The type of anesthetic depends on the number and exact location of the warts being removed. When there are many warts, your surgeon may perform the surgery in stages. An internal examination will also be performed so that any lesions on the inside can also be found and treated.

POST-TREATMENT PROGNOSIS

Mild pain and discomfort generally last for a few days. Pain medication may be prescribed. Patients treated in the clinic can return to work immediately. Those that have surgery can usually return to work the next day, while others that have more extensive surgery may stay home for several days to weeks.

Warts may come back repeatedly after successful removal. This happens because the HPV virus stays inactive for a period of time in body tissues. When warts come back, they can usually be treated at your surgeon's office. If a large number of new warts develop quickly, surgery may be needed again.

It is important to discuss with your surgeon how often to schedule follow-up visits. During these visits, an exam will be done to make sure that all the warts are gone and no new ones have formed. 

WHAT IS A COLON AND RECTAL SURGEON?

Colon and rectal surgeons are experts in the surgical and non-surgical treatment of diseases of the colon, rectum and anus. They have completed advanced surgical training in the treatment of these diseases, as well as full general surgical training. Board-certified colon and rectal surgeons complete residencies in general surgery and colon and rectal surgery, and pass intensive examinations conducted by the American Board of Surgery and the American Board of Colon and Rectal Surgery. They are well versed in the treatment of both benign and malignant diseases of the colon, rectum and anus and are able to perform routine screening examinations and surgically treat conditions, if indicated to do so.

DISCLAIMER

The American Society of Colon and Rectal Surgeons is dedicated to ensuring high-quality patient care by advancing the science, prevention and management of disorders and diseases of the colon, rectum and anus. These brochures are inclusive but not prescriptive. Their purpose is to provide information on diseases and processes, rather than dictate a specific form of treatment. They are intended for the use of all practitioners, health care workers and patients who desire information about the management of the conditions addressed. It should be recognized that these brochures should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtain the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all the circumstances presented by the individual patient. 


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