Anal warts, also known as condyloma, are growths found on the skin around the anus or in the lower rectum. They first appear as tiny spots but can grow quite large and cover the entire anal area.
Anal warts are caused by HPV (Human Papilloma Virus) which is transmitted through sexual contact but not necessarily through anal intercourse. Any direct contact to the anal area (e.g., touch/fluids from infected partner) can transmit HPV.
There is an HPV vaccine available. Currently the CDC recommends 2 doses of HPV vaccine for adolescents. The first dose should be given between their 11th and 15th birthday and the second dose should be given 6–12 months later. Those older than 15 years are given 3 doses.
HPV also can cause AIN (Anal Intraepithelial Neoplasia). AIN is a pre-cancerous change in the skin in the perianal area. Those at risk of developing AIN are women with abnormal PAP tests, those who have had genital warts, men having sex with men, people with immune suppression related to HIV, post-organ transplant patients, and people with inflammatory bowel disease (IBD). AIN is important to diagnose because over time it can develop into anal cancer.
Warts are usually painless so people may not realize they have them. Some may notice small growths or moist bumps that are light brown in the anal area, minor complaints of itching, occasional bleeding, or mucus discharge in the anal canal. Warts can become cancerous if left untreated.
Since anal warts are so contagious, it is important to check sexual partners, refrain from sexual activity until treatment is completed, and use condoms to lessen the chance of reoccurrence.
Our doctors inspect the skin around the anus and view the anal canal with an anoscope (short lighted instrument inserted into the anus).
Treatment varies depending on the location, number, and size of warts. If small, they can be treated topically. Options include:
- Topical cream medications
- Topical medications that freeze the warts (e.g., liquid nitrogen)
- Topical medications that burned the warts (e.g., Trichloroacetic acid, podophyllin)
- Surgery when warts are large or above treatments are ineffective
A single treatment will usually not permanently remove warts. Follow-up is essential because the virus may continue to be present and cause new anal warts. Small warts that reappear are easily treated in office.
If diagnosed with AIN, our doctors will monitor and treat it to ensure it does not progress to anal cancer. Treatments include topical medications, electrocauterization, or laser therapy to remove the harmful tissue.