Genital Warts (HPV): Symptoms, Treatment, and Removal in Singapore
Genital warts are soft, flesh-coloured or grey growths on the genitals or anus, often described as cauliflower-like. They are caused by low-risk human papillomavirus (HPV), specifically types 6 and 11, which together account for about 90% of genital warts.
Medically reviewed by Dr. Qiao Yufei, MD
This guide covers what genital warts look like, how they are treated and removed, the difference between low-risk warts and high-risk HPV linked to cancer, and how the HPV vaccine prevents most new cases. Genital warts are one of several conditions covered in our broader STDs in Singapore overview.
What are genital warts?
Genital warts (medically known as condyloma acuminata) are soft growths on or around the genitals, anus, groin, or thighs caused by infection with the human papillomavirus (HPV). They appear as small flat bumps, single raised lesions, or clusters that resemble a small cauliflower: this cauliflower-like appearance is the classic clinical sign that distinguishes genital warts from other skin conditions.
Genital warts are caused by low-risk HPV types, mainly 6 and 11, which together cause about 90% of genital warts. These are different from the high-risk HPV types (16, 18, and others) linked to cervical, anal, throat, and other cancers. Per the US Centers for Disease Control and Prevention (CDC), HPV is the most common STI worldwide.
No. Genital warts can be effectively treated and removed. About 30% clear on their own within 6 months, though many people prefer faster removal. Even after wart removal, the underlying HPV may persist for 1 to 2 years; most people clear it through their immune response.
How genital warts spread
Genital warts are highly contagious and spread through skin-to-skin sexual contact with someone who has the underlying HPV infection. Importantly, you can transmit HPV (and develop warts) from a partner who has no visible warts.
- Vaginal, anal, or oral sex with an infected partner
- Genital-to-genital skin contact, even without penetration
- Shared sex toys without a fresh condom or thorough cleaning between partners
- Mother-to-baby transmission during childbirth (rare but can cause juvenile-onset respiratory papillomatosis)
Anal warts
Anal warts (also called anogenital warts) appear around or inside the anus. They can develop in anyone who has had receptive anal contact, but are particularly common in men who have sex with men (MSM). Anal warts are clinically the same as warts elsewhere: same HPV types, same treatments, same low cancer risk.
Who is at higher risk?
- Sexually active people who have not been vaccinated against HPV
- People with multiple sexual partners or inconsistent condom use
- People with weakened immunity (HIV, cancer treatment, organ transplant)
- Smokers (smoking impairs HPV clearance)
What genital warts look like and feel like
Genital warts vary in appearance and may be a single small lesion or a large cauliflower-like cluster. They typically develop weeks to months after HPV exposure, and some people only develop warts long after infection.
Visual signs
- Small, flesh-coloured, pink, or grey bumps
- Cauliflower-like clusters of growths
- Flat, slightly raised plaques (less common)
- Sometimes very small and barely visible
Symptoms
- Often painless
- Itching, burning, or soreness
- Bleeding with friction (intercourse, wiping)
- Discomfort during intercourse if warts are large
In women: vulva, vagina, cervix, perineum, anus.
In men: penis (shaft, glans, foreskin), scrotum, groin, anus, thighs.
Both sexes: mouth and throat (less common, from oral contact). Anal warts can occur in anyone who has had receptive anal contact.
How genital warts are diagnosed
Most genital warts are diagnosed by visual examination at the consultation. Their cauliflower-like appearance and location are usually distinctive enough to confirm the diagnosis. Additional tests are sometimes needed:
- Acetic acid (vinegar) test: a dilute white vinegar solution applied to the area turns warts white, helping detect very small or flat warts
- Biopsy: a small sample of an unusual lesion is taken if the appearance is atypical, to rule out other conditions
- Anoscopy or colposcopy: specialist examination of the anus or cervix if warts are suspected internally; usually referred out
- HPV DNA testing: not routinely used to diagnose visible warts, but may be relevant for assessing high-risk HPV types alongside pap smear screening
How genital warts are treated and removed
Genital wart treatment falls into two main categories. The choice depends on wart size, number, location, and patient preference. Multiple sessions are often needed regardless of the method.
Patient-applied creams
- Imiquimod 5% cream: stimulates the immune system to clear warts; applied 3 times weekly for up to 16 weeks
- Podophyllotoxin: applied twice daily for 3 days, then 4 days off, repeated for up to 4 cycles
- Sinecatechins (green tea extract): applied 3 times daily for up to 16 weeks
Doctor-applied removal
- Cryotherapy: liquid nitrogen freezes the warts (most common in primary care)
- Electrocautery: warts burned off with a heated probe
- Laser ablation: laser energy destroys warts
- Surgical excision: cutting away large or treatment-resistant warts
We provide initial assessment, prescription of topical treatments, and counselling. Procedural wart removal (cryotherapy, electrocautery, laser, surgical excision) is referred to a specialist, typically a dermatologist or surgeon experienced in HPV management. We can co-ordinate the referral and follow up after treatment.
How to prevent genital warts
HPV vaccination is the single most effective prevention
The HPV vaccine (Gardasil 9) covers types 6 and 11, the cause of about 90% of genital warts. Given before HPV exposure, the vaccine prevents the great majority of new genital warts. It is recommended for all genders, ideally starting at ages 9 to 14 but available up to age 45. See our HPV vaccination page for details.
Practise safe sex
- Use condoms consistently and correctly during vaginal, anal, and oral sex (note: condoms reduce but do not eliminate HPV transmission, since HPV can spread from skin not covered by a condom)
- Limit the number of sexual partners
- Avoid sexual contact with someone who has visible warts
Get screened regularly
Routine STI screening detects HPV-related conditions early. For women, regular pap smear and HPV co-testing also screen for the high-risk HPV types associated with cervical cancer. See HPV testing for our full options.
What happens if genital warts are left untreated?
Genital warts caused by low-risk HPV are not directly dangerous, but they can cause:
- Persistent or recurrent warts: warts may grow, multiply, or come back even after treatment
- Psychological distress: warts can affect self-esteem and intimate relationships
- Pregnancy complications: warts may grow rapidly during pregnancy due to immune changes; rarely, the baby can develop respiratory papillomatosis from HPV exposure during birth
- Bleeding or discomfort during intercourse if warts are large or located in sensitive areas
- Continued transmission to sexual partners if untreated
The HPV types that cause genital warts (6 and 11) are low-risk and very rarely cause cancer. Cancer-associated HPV types (16, 18, and others) are different. Having genital warts does not mean you have cancer or are at high risk for it, but co-infection is possible, so regular screening (pap smear, HPV testing) is still recommended.
Frequently asked questions
01 What are genital warts?
Genital warts are soft skin growths on the genitals, anus, or surrounding skin caused by certain types of human papillomavirus (HPV), most often types 6 and 11. They can be small flat bumps, single raised lesions, or clusters with a cauliflower-like surface, and are usually painless but may itch or bleed with friction. HPV can remain inactive in the skin for some time, but many infections are controlled or cleared by the immune system.
02 What causes genital warts?
Genital warts are caused by the human papillomavirus (HPV), specifically low-risk types 6 and 11, which together cause about 90% of genital warts. HPV is transmitted through skin-to-skin sexual contact: vaginal, anal, or oral. The HPV vaccine (Gardasil 9) covers types 6 and 11 and helps prevent most new genital warts in vaccinated people.
03 How can I tell if it is genital warts or something else?
Genital warts are usually small, soft, flesh-coloured or grey growths that may appear singly or in clusters with a cauliflower-like surface. Other conditions can look similar, including skin tags, molluscum contagiosum, pearly penile papules, pimples, or herpes blisters. Herpes usually causes painful blisters or ulcers rather than firm growths. Self-diagnosis is unreliable, so a doctor should confirm the diagnosis by examination and, if needed, further testing.
04 How do you get genital warts?
Genital warts spread through direct skin-to-skin contact, most commonly during vaginal, anal, or oral sex with an infected partner. The virus enters through small breaks in the skin or mucous membranes. Warts may appear weeks to months after exposure, and HPV can remain inactive before visible lesions develop. A person can transmit HPV even when no warts are visible.
05 Are genital warts permanent or can they go away?
No, they are not permanent. Genital warts can be effectively treated and removed. Some clear on their own within months as the immune system suppresses the virus, though many people prefer treatment to remove visible warts faster. Even after wart removal, the underlying HPV may persist and warts can return; most clearance occurs within 1 to 2 years.
06 How are genital warts treated?
Treatment falls into two categories. Topical: prescription creams (such as imiquimod, podophyllotoxin, or sinecatechins) applied over weeks. Procedural: cryotherapy (liquid nitrogen freezing), electrocautery, laser ablation, or surgical excision, performed by a doctor. The choice depends on wart size, number, location, and patient preference. Multiple sessions may be needed, and your doctor will recommend the most suitable option.
07 How can I prevent genital warts?
HPV vaccination can help protect against HPV types that cause most genital warts and several HPV-related cancers. Gardasil 9 is most effective when given before sexual debut but still offers benefit afterwards. Condom use reduces but does not eliminate transmission risk because HPV can spread from skin not covered by a condom. Limiting partners and routine screening also help reduce risk.
08 Can genital warts cause cancer?
The HPV types that cause genital warts (types 6 and 11) are low-risk and do not typically cause cancer. High-risk HPV types such as 16 and 18 are linked to cervical, anal, and other HPV-related cancers; these are different types from the ones that cause warts. Having one HPV type does not exclude having another, so routine screening (Pap smear and HPV testing where applicable) remains important.
09 Do genital warts come back after treatment?
Recurrence is possible. Even after warts are removed, HPV may remain in surrounding skin and trigger new warts in the following weeks or months. The risk of recurrence is highest in the first 3 months after treatment. Maintaining a healthy immune system, completing treatment as directed, and follow-up review with your doctor reduce the chance of new warts.
10 Where can I get tested or treated for genital warts in Singapore?
Mediway Medical Centre offers confidential consultation, examination, and treatment for genital warts at our Clarke Quay clinic. We also offer HPV vaccination (Gardasil 9). For comprehensive STI screening, see our STD test page. Book a consultation through our online booking, WhatsApp, or call 6909 0190.
Related conditions and next steps
References: CDC: HPV fact sheet · CDC: Anogenital wart treatment guidelines · WHO: HPV fact sheet · HealthHub Singapore
This page is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Consult a qualified healthcare professional for diagnosis and treatment of suspected genital warts.