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    Anal Warts

     Where to Seek Treatment


    Contributed by Singapore General Hospital


    Anal warts are a common condition affecting the area around the anus. They may also affect the skin around the genitals. They may start as tiny spots, as small as a pinhead, and may grow larger than the size of a pea. They usually do not cause pain or discomfort and patients may be unaware that the warts are present. 


    They are caused by the human papilloma virus. It is relatively contagious. The virus can be transmitted from person to person, almost always by direct contact. 
    Must these warts be removed? 

    Yes. If they are not removed, the warts generally grow larger and become more in number. In addition, there is evidence that some of these warts can become cancerous if left untreated for a long time.


    If warts are very small and are located only on the skin around the anus, they can be treated with medications, which are applied directly to the surface of the warts. This must be carried out with great care and precision by a doctor to prevent injury to the normal skin surrounding the warts. This method usually requires several treatments performed over several weeks.

    Another form of treatment involves more rapid destruction of the warts using an electrical knife, surgical removal or a combination of the two. Laser surgery may also be used but has no advantage over other treatments. These procedures provide immediate results but must be performed using a local anesthetic or general or spinal anesthetic, depending on the number and exact location of warts being treated.

    Warts inside the anal canal usually are not suitable for treatment by medications, and in most cases need to be treated by cauterisation or surgical removal.

    Frequently Asked Questions

    Must I be hospitalised for treatment? 

    No. Almost always, the cautery and excision technique can be performed on an outpatient basis, and the patient can go home after the procedure. 
    How soon can I return to work?

    This depends on individual situations and the extent of warts removed. Most people are moderately uncomfortable for a few days after treatment, and pain medication may be prescribed. Depending on the extent of the disease, some people return to work the next day, while others may remain out of work for several days.
    Will a single treatment cure the problem?

    Not in most cases, unfortunately. Even with the cautery and surgical treatment that immediately destroy existing warts, many patients develop new warts after treatment. This occurs because viruses that cause the warts can live concealed in tissues that appear normal for up to six months or longer before another wart develops. New warts will often develop from the virus that was already present in the tissue, but these are not recurrences of warts already treated. 

    How can I avoid getting these warts again?

    In some cases, warts may recur repeatedly after successful removal, since the virus that causes the warts often persists in a dormant state in body tissues. Following are tips to avoid recurrence and reinfection:

    Continue observation for several months after the last wart has been spotted to improve the chances that both the warts and the underlying virus has been eliminated.

    Abstain from sexual contact with individuals who have anal (or genital) warts. Since many individuals may be unaware that they suffer from this condition, sexual abstinence or limiting sexual contact to marriage relationships will reduce your potential exposure to the contagious virus that causes these warts. As a precaution, sexual partners ought to be checked, even if they have no symptoms.

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