Genital Warts
Genital warts are caused by certain strains of HPV and are managed per the CDC Sexually Transmitted Infections Treatment Guidelines, 2021.
Symptoms
Small, flesh-colored or gray bumps in the genital or anal area, sometimes clustered in a cauliflower-like pattern, usually painless.
Causes and risk
Direct skin-to-skin contact with HPV-infected skin during sex; risk rises with more partners and is reduced substantially by vaccination.
How it is evaluated
Diagnosis is by visual exam; atypical, bleeding, ulcerated, or pigmented lesions warrant biopsy since anogenital cancers are more common in immunosuppressed patients and can be mistaken for ordinary warts.
Treatment
Patient-applied options (podofilox, imiquimod, sinecatechins) and provider-administered options (cryotherapy, trichloroacetic acid, surgical removal) are both effective per CDC guidelines -- podofilox and imiquimod should be avoided in pregnancy. HPV vaccination, recommended through the ACIP schedule, prevents most cases and is worth discussing even after a diagnosis, since it protects against other HPV strains.
When to seek care
Warts inside the urethra, vagina, or anus, or any lesion that's bleeding, ulcerated, or rapidly changing, need specialist evaluation rather than home treatment.