Definition

Anal warts, also known as condyloma, are growths found on the skin around the anus (rectal opening) and in the anal canal.  

Causes

Anal warts are caused by the human papilloma virus, which is usually transmitted through sexual contact but not necessarily through anal intercourse. The same type of warts may occur on the penis, scrotum, vagina or labia. The time from exposure to the virus to the growth of the warts is commonly from one to six months, but can be longer. During that time, the virus remains in the tissues but is inactive. There are many types of human papilloma virus— some cause warts on the hands and feet and others cause genital and anal warts.

Symptom

Many patients with anal warts have no symptoms. Some patients may notice small growths in the anal area. Others have minor complaints of itching, occasional bleeding, or moisture in the anal area.

Diagnosis & Treatment

Diagnosis is made by the doctor, who inspects the skin around the anus and checks the anal canal with an anoscope (a short instrument inserted into the anus).

There are several ways anal warts can be treated, depending on the location, number, and size of the warts. If the warts are small and only on the outer skin, they can be treated with podophyllin or bichloracetic acid, which are solutions applied directly to the warts and exfoliate the warts. This is an office procedure and takes just a few minutes. Another form of treatment is cauterization: the area is numbed with local anesthesia before the warts are burned off. The doctor may also recommend a course of treatment with imiquimod, a medication which enhances the immune response to the virus. If there are numerous warts or if they are located inside the anal canal, the doctor may choose to remove them surgically; this is done as a same-day procedure in our Ambulatory Surgery Center.

In most cases, a single treatment will not cure anal warts. Close follow-up is critical because the virus may continue to be present and cause new anal warts to form. Even after there are no visible warts, the virus may remain in the tissue. Small warts that reappear are easily treated in the office. However, if multiple warts are found on further examinations, it is not uncommon to need an additional surgical excision of the warts. Follow-up visits are necessary even after there are no visible warts. Visits are recommended for at least six months after all the warts have resolved. There is a possibility of serious problems if the warts are left untreated. On rare occasions, these warts can become cancerous if allowed to go untreated for years. It is important to keep your follow-up appointments.

Prevention

There are several ways to prevent this virus from spreading:

  • Sexual partners should be examined.
  • Refrain from sexual activity until treatment is completed.
  • Use condoms. They offer some, but not complete, protection.
  • Because anal warts are highly contagious, you will lessen your chance of recurrence if these suggestions are followed.

Visit the American Society of Colon & Rectal Surgeons website for more information