Genital warts are small, flesh-colored or slightly darker growths that appear on or around the genitals and anus. They can be flat, raised, or bumpy, and when they cluster together they often take on a distinctive cauliflower-like texture. A single wart may be as small as 2 millimeters (about the size of a pencil tip), while clusters can grow considerably larger if left untreated.
Shape, Color, and Texture
Genital warts don’t all look the same, which is part of what makes them tricky to identify. They come in several forms. Some are smooth, flat, and barely raised above the skin surface. Others are dome-shaped bumps. The most recognizable type is the cauliflower-shaped cluster: multiple small growths packed tightly together with an irregular, rough surface.
Color ranges from flesh-toned to white, pink, or darker brown, depending on your skin tone. They may be the same shade as the surrounding skin, making them easy to miss, or noticeably darker. The surface can feel smooth or slightly rough and grainy to the touch. They’re usually painless, though some people experience mild itching or tenderness, especially if warts are in areas that get friction from clothing or during sex.
Where They Appear
In women, genital warts most commonly show up in or around the vagina, on the cervix, or around the anus. In men, they tend to appear on the tip or shaft of the penis, the scrotum, the groin, the inner thigh, or around the anus. On a circumcised penis, warts often develop along the shaft. On an uncircumcised penis, they frequently appear under the foreskin.
Warts can also develop internally, inside the vaginal canal, inside the anus, or even in the urethra. Internal warts aren’t visible from the outside and are typically discovered during a clinical exam. You might suspect internal warts if you notice bleeding during sex or changes in urinary flow, but many people with internal warts have no symptoms at all.
How Quickly They Show Up
Genital warts are caused by certain strains of human papillomavirus (HPV), with strains 6 and 11 responsible for more than 90% of cases. After exposure, it can take anywhere from a few weeks to many months for visible warts to appear. Some people carry the virus for a long time before any growths develop, and others never develop visible warts at all despite being infected.
Once a wart appears, it may stay small and solitary, or it may multiply. Without treatment, warts can spread to nearby skin and form larger clusters over time. They can also appear at multiple sites simultaneously. Pregnancy and weakened immune systems tend to accelerate growth.
What Genital Warts Are Not
Several harmless skin conditions look similar enough to genital warts to cause alarm. Knowing the differences can save you unnecessary panic, though a healthcare provider is the only one who can confirm a diagnosis.
- Pearly penile papules are tiny, dome-shaped bumps that form in neat, uniform rows around the head of the penis. They’re all the same size and the same color as surrounding skin or slightly white. Genital warts, by contrast, vary in size, appear in irregular clusters rather than tidy rows, and can show up anywhere on the shaft or scrotum rather than just around the head.
- Fordyce spots are small (1 to 3 millimeters), pale yellow or skin-colored bumps caused by visible oil glands. They can appear on the shaft of the penis, the labia, or even the lips. Early-stage genital warts can look similar to Fordyce spots, but Fordyce spots tend to stay very small, remain flat, and don’t grow into rough or cauliflower-like clusters.
- Molluscum contagiosum produces firm, smooth, round bumps that have a distinctive dimple or indentation in the center. Genital warts lack this central dimple and typically have a rougher, more irregular surface.
When Warts Are Hard to See
Not all genital warts are obvious. Flat warts, in particular, can be nearly invisible to the naked eye. They sit flush with the skin and may only become noticeable when the skin is stretched or examined under bright light. On the cervix, warts are virtually impossible to detect without a speculum exam. Around the anus, warts can hide in skin folds.
Because warts can be subtle, many people don’t realize they have them. If you’ve been exposed to HPV or notice any new bumps, even tiny or flat ones, in the genital or anal area, a clinical exam is the most reliable way to know what you’re dealing with. Providers can often diagnose genital warts by visual inspection alone, though in ambiguous cases a small biopsy may be used to confirm.
What Happens With Treatment
Genital warts are treatable, though the underlying HPV infection may persist even after warts are removed. Treatment options generally fall into two categories: topical solutions you apply at home over several weeks, or in-office procedures where a provider freezes, burns, or surgically removes the warts. The choice depends on the size, number, and location of the growths.
Smaller warts often clear with topical treatment within a few weeks to a couple of months. Larger clusters or internal warts typically require in-office removal. Recurrence is common, especially in the first three months after treatment, because the virus can remain in surrounding skin even when visible warts are gone. Over time, your immune system often suppresses the virus enough that warts stop coming back, but this process can take months to a couple of years.
The HPV vaccine, originally designed to prevent cervical cancer, also protects against strains 6 and 11 and has dramatically reduced genital wart rates in countries with high vaccination coverage.