Vaginal warts are soft, skin-colored growths caused by certain strains of the human papillomavirus (HPV). About 90% of cases are caused by two specific low-risk HPV types (6 and 11), which are called “low-risk” because they rarely lead to cancer. These warts can appear on the vulva, inside the vaginal canal, around the anus, or on the cervix, and they’re one of the most common sexually transmitted infections.
What Causes Them
HPV spreads through skin-to-skin contact during vaginal, anal, or oral sex. The virus enters the top layer of skin through tiny breaks or abrasions, then triggers the cells to grow abnormally, forming a visible wart. You won’t see them right away: the incubation period ranges from one to six months after exposure, and some people carry the virus for much longer before warts appear, if they ever do.
Not everyone who contracts HPV 6 or 11 develops visible warts. Your immune system can suppress the virus without you ever knowing you had it. But during the time you carry an active infection, you can still pass it to a partner, even without any visible growths. Occasionally, higher-risk HPV types (16, 18, 31, 33, or 35) show up alongside the wart-causing strains, particularly in people with weakened immune systems. This is one reason a healthcare provider may want to take a closer look if warts appear unusual.
What They Look and Feel Like
Vaginal warts typically appear as small, flesh-colored or slightly darker bumps. They can be flat or raised, smooth or textured with a rough, cauliflower-like surface. Some people develop a single wart, while others get clusters. They range from barely visible to several centimeters across when multiple warts merge together.
Most vaginal warts don’t hurt. The most common complaints are itching, mild irritation, or simply the anxiety of noticing something new. Warts inside the vaginal canal may not cause any symptoms at all and are sometimes discovered during a routine pelvic exam. In rare cases, larger warts can cause discomfort during sex or a feeling of fullness.
How Common Are They
HPV itself is extremely widespread. Before the vaccine was widely available, roughly 14 million new HPV infections occurred each year in the United States, with nearly half in people aged 15 to 24. Among U.S. women aged 18 to 59, about 40% tested positive for at least one HPV type during 2013 to 2014 surveys. The rate of actual visible genital warts is much lower: approximately 1.2 per 1,000 women per year, based on pre-vaccine data. Vaccination has driven that number down significantly in younger age groups.
How They’re Diagnosed
A healthcare provider can usually identify genital warts just by looking at them during a physical exam. No blood test detects wart-causing HPV strains. If a growth looks unusual, doesn’t respond to treatment, or appears in someone with a compromised immune system, a small tissue sample (biopsy) may be taken to rule out precancerous changes. This is uncommon for straightforward cases. Routine HPV screening through Pap tests looks for the high-risk cancer-causing strains, not the strains that cause warts, so a normal Pap result doesn’t mean you’re free of HPV 6 or 11.
Treatment Options
There’s no cure for the underlying HPV infection, but the warts themselves can be removed. Treatment choice depends on the size, number, and location of the warts, as well as your preference. Options fall into two categories: topical treatments you apply at home and procedures done in a clinic.
Topical Treatments
Several prescription creams and gels can be applied directly to external warts over a period of weeks. These work by either destroying wart tissue or stimulating your immune system to fight the virus at the skin’s surface. Treatment courses typically last several weeks, and warts may shrink gradually rather than disappearing all at once. Topical treatments are generally used for smaller, external warts and aren’t appropriate for warts inside the vaginal canal.
In-Office Procedures
For larger warts, internal warts, or cases that don’t respond to topical treatment, a provider can remove them directly. The most common methods are cryotherapy (freezing with liquid nitrogen) and electrocautery (burning with an electric current). In one comparative study, electrocautery cleared warts completely in 76% of patients versus 44% for cryotherapy, though it came with more post-procedure pain, slower healing, and a higher chance of scarring. Cryotherapy tends to be gentler but may require more sessions, typically scheduled weekly for up to eight visits.
Laser therapy is another option, usually reserved for extensive or hard-to-reach warts. All in-office procedures involve some discomfort during and after, and your provider will use a local anesthetic to numb the area.
Recurrence After Treatment
One of the most frustrating aspects of genital warts is that they often come back. Recurrence rates sit around 30 to 35%, with at least 20% of recurrences happening within the first 12 weeks after successful treatment. This happens because treatment removes the visible wart but doesn’t eliminate HPV from surrounding skin cells. Over time, most people’s immune systems suppress the virus enough that warts stop returning, but it can take months to years.
Vaginal Warts During Pregnancy
Warts sometimes grow faster during pregnancy due to hormonal and immune changes. The main concern isn’t transmission to the baby, which is extremely rare. The only serious complication is a condition called recurrent respiratory papillomatosis in the newborn, where HPV causes growths in the infant’s airway. This occurs in roughly 4 out of 100,000 births.
A cesarean delivery is not recommended solely to prevent passing HPV to the baby. It’s only considered if warts have grown large enough to physically block the birth canal, which could cause bleeding or obstruct delivery. Most pregnant people with genital warts deliver vaginally without complications. Some treatment options are avoided during pregnancy, so your provider will adjust the approach based on trimester and wart severity.
Prevention Through Vaccination
The HPV vaccine is the single most effective way to prevent vaginal warts. In clinical trials, the vaccine showed 99% efficacy at preventing genital warts caused by HPV types 6 and 11 in people who hadn’t already been exposed to those strains. The current vaccine also protects against seven cancer-causing HPV types.
The vaccine is recommended starting at age 11 or 12 and can be given through age 26 for most people, or up to age 45 in certain cases after discussion with a healthcare provider. It works best when given before any sexual contact, but it still offers meaningful protection for people who’ve already been sexually active, since most haven’t been exposed to all the strains the vaccine covers. Condoms reduce HPV transmission but don’t eliminate it entirely, because the virus can live on skin that a condom doesn’t cover.