Anal Warts (HPV)

If you believe you have anal warts, contact our clinic.

Detecting, diagnosing and treating anal warts early may help reduce your risk of anal cancer.

Are You Concerned About Anal Warts?

Human papillomavirus (also called HPV) is the most common sexually transmitted infection (STI) in America.  This is the virus that causes anal warts. It is very contagious and can, in some cases, increase the risk for anal cancer.  Most sexually active people in the United States will have HPV at some time in their lives. There are more than 40 types of HPV that are passed on through sexual contact. Some types of HPV can infect a man’s genital area, including the skin on and around the penis or anus. They can also infect the mouth and throat.

Most men who get HPV never develop any symptoms or health problems. But some types of HPV can cause genital warts. Other types can cause penile or anal cancers. The types of HPV that cause genital warts are not always the same types that cause cancer, although genital warts may increase the risk of cancer if left untreated.

Anal cancer is not the same as colorectal cancer. Colorectal cancer is more common than anal cancer, but it is not caused by HPV.

How common are HPV-related health problems in men?

About 1% of sexually active men in the U.S. have genital warts at any one time.

Each year in the U.S. there are about:

  • 800 men who get HPV-related penile cancer

  • 1100 men who get HPV-related anal cancer

  • 5700 men who get HPV-related head and neck cancers. (Although HPV is associated with some head and neck cancers, most of these cancers are related to smoking and heavy drinking).

Some men are more likely to develop HPV-related diseases than others:

  • Men who have sex with men are about 17 times more likely to develop anal cancer than men who only have sex with women.

  • Men with weakened immune systems, including those who have HIV, are more likely than other men to develop anal cancer. Men with HIV are also more likely to get severe cases of genital warts that are harder to treat.

What are the signs and symptoms?

Most men who get HPV never develop any symptoms or health problems. But for those who do develop health problems, these are some of the signs and symptoms to look for:

Signs of genital warts

  • One or more growths on the penis, testicles, groin, thighs, or anus.

  • Warts may be raised, flat, or cauliflower-shaped. They usually do not hurt.

  • Warts may appear within weeks or months after sexual contact with an infected person.

Signs and symptoms of anal cancer:

  • Sometimes there are no signs or symptoms.

  • Anal bleeding, pain, itching, or discharge.

  • Swollen lymph nodes in the anal or groin area.

  • Changes in bowel habits or the shape of your stool.

How do Men get HPV?

HPV is passed on through genital contact—most often during vaginal and anal sex. HPV may also be passed on during oral sex. Since HPV usually causes no symptoms, men and women can get HPV—and pass it on—without realizing it. People can have HPV even if years have passed since they had sex. Even men with only one lifetime sex partner can get HPV.

Is there a test for HPV in men?

Currently, there is no test to find HPV in men. The only approved HPV tests on the market are not useful for screening for HPV-related cancers or genital warts in men.

  • Some doctors use anal Pap tests to screen for anal cancer in men, however, there is no routine screening recommended for anal cancer. More research is needed on how best to screen for anal cancer, and to determine if screening can reduce the risk of anal cancer.

  • There is no approved test to find genital warts for men or women. However, most of the time, you can see genital warts. Some doctors may use a vinegar solution to help find flat warts—but this test can sometimes wrongly identify normal skin as a wart. If you think you may have genital warts, you should see a health care provider.

  • There is no test for men to check one’s overall “HPV status.” But HPV usually goes away on its own, without causing health problems. So an HPV infection that is found today will most likely not be there a year or two from now.  REMEMBER: HPV is very common. Most men with HPV will never develop health problems from it. Finding out if you have HPV is not as important as finding out if you have the diseases that it can cause.

  • Screening tests are not available for penile cancer.

  • You can check for any abnormalities on your penis, scrotum, or around the anus. See your doctor if you find warts, blisters, sores, ulcers, white patches, or other abnormal areas on your penis—even if they do not hurt.

Are there ways to lower my chances of getting HPV?

A safe and effective HPV vaccine (Gardasil) is available to protect males against the HPV types that cause most (90%) genital warts. The vaccine is available for boys and men, ages 9 through 45 years. It is given in three shots over 6 months.

Condoms (if used with every sex act, from start to finish) may lower your chances of passing HPV to a partner or developing HPV-related diseases. But HPV can infect areas that are not covered by a condom—so condoms may not fully protect against HPV.

Because HPV is so common and usually invisible, the only sure way to prevent it is not to have sexual contact. Even people with only one lifetime sex partner can get HPV, if their partner has  HPV.

I heard about a new HPV vaccine – can it help me?

The HPV vaccine (Gardasil) works by preventing nine common HPV types, including some that cause genital warts and some that cause cancers. It protects against new HPV infections, but it does not cure existing HPV infections or disease (like genital warts). It is most effective when given before first sexual contact (i.e., before you are  exposed to HPV).

Some men may benefit more from this vaccine than others.

  • Males who have not yet had sex will benefit most from the vaccine, since they are unlikely to have been exposed to  HPV. Sexually active men may also benefit from the vaccine, but they will get less benefit from it if they have already been infected with HPV.

  • Young men who have sex with men might benefit more from this vaccine, especially if they have had few or no partners prior to vaccination, since they are more likely to develop HPV-related diseases than other men.

The HPV vaccine is very safe and effective, with no serious side effects. The most common side effect is soreness in the arm.

Available data show that the vaccine can protect men against genital warts.  It is possible that this vaccine also protects men from HPV-related cancers, like anal and penile cancers. Studies are being completed to evaluate this.

How Can I Tell If I Have Anal Warts?

Anal warts usually appear as white, raised, irregular lesions at the anal area, often with a "cauliflower-like" appearance. They are visible to the patient on the outside of the anus but are frequently present inside the anus as well, making treatment of the internal warts mandatory if treatment is to be effective.

How Do You Get Them?

Anal warts are obtained through anal sexual activity. The incubation period for warts to become visible is about three months but can range from 3 weeks to eight months.


HPV can cause anal cancer. Over 20 million people in this country have HPV and most do not know it.  Many of these infections progress to anal cancer if left undiagnosed or untreated.

 Dale Prokupek, MD is an award-winning, board-certified internist. He has over 14 years of experience treating HPV, including the most complex cases. He understands the need for thorough evaluation, aggressive treatment, and close follow-up. Dr. Prokupek uses the most current, state-of-the-art medical equipment to accurately diagnose and treat anogenital warts.

Dale Prokupek, MD receives outstanding reviews from patients, and has been awarded the Patient’s Choice Award. He is also an associate clinical professor of medicine at the Geffen School of Medicine at UCLA. Dr. Prokupek sees patients at his private practice in Beverly Hills, and at Cedars-Sinai Medical Center.