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Anal Warts: Risks, Causes, Symptoms, and Prevention

Dr QM Leong
Dr QM Leong

Anal warts are a form of genital warts that appear inside or near the anus. Also known as condyloma cuminata, anal warts result from the Human Papilloma Virus (HPV). HPV is one of the most common sexually-transmitted diseases passed through direct contact. Warts first appear as small growths and may grow larger and occupy the entire anus.

Most cases of anal warts don’t result in any discomfort or painful sensations. Most patients won’t even know if they eventually develop these genital warts. But if the clumps grow much more prominently later on, they may lead to itchiness, bleeding, and a mucus discharge in some cases.

What Are The Causes Of Anal Warts?

Genital warts can look like small, flesh-coloured bumps that cover the part of the skin affected. They usually appear after a sexual encounter with an HPV-infected person. HPV may go away after some time for younger individuals and may not even lead to any visible signs and symptoms. However, the virus may stay longer in the body. It may also lead to the development of cancerous or non-cancerous genital warts.

A carrier transmits HPV through direct contact with the mouth, penis, vagina, or anus. However, sexual intercourse is unnecessary for the infection to spread. Individuals can pass HPV to another through direct skin-to-skin contact. Even if the warts are invisible or not yet formed, HPV contraction is still possible.

Who Are At Risk Of Anal Warts?

In general, men and women who have a sexually active lifestyle may get anal warts. A person increases their chances of spreading or contracting anal warts if:

  • They’re consistently engaged in unprotected sex (not using any condoms or dental dams)
  • They’re promiscuous or have multiple sexual partners all at once
  • They frequently engage in anal/vaginal intercourse
  • They’re sexually active at a young age
  • They’ve had sexual relations with an HPV-carrier
  • They have an immunocompromised immune system due to a chronic illness or medication

What Are The Symptoms Of Anal Warts?

Anal warts often begin as small bumps around the anal area and are no bigger than a pinhead. They’re usually too small to notice but can accumulate into large clumps over time. The clusters may match the colour of the surrounding skin tissue or maybe yellowish or pinkish. 

Painful sensations or discomfort on the anus don’t usually accompany anal warts. Symptoms are rare, but there may be itchiness or a lumpy feeling around the anal region. 

Other forms of genital warts can also appear simultaneously as anal warts. In women, the clusters may develop on the vagina, vulva, or cervix. Meanwhile, men can develop genital warts on the inside of their thighs, groin, scrotum, or penis. 

If someone has engaged in oral sex with someone who has anal warts, this could also lead to a mouth infection. Warts may develop on the insides of the mouth or throat. Although benign, warts may make it difficult for the person to swallow or breathe properly due to partially blocked airways.

How Do Doctors Diagnose Anal Warts?

A doctor or colorectal specialist may diagnose anal warts by examining the anus. The patient will undergo an anoscopy. The doctor places a small tube to observe the lining of the anus and rectum. Through a visual inspection, they can determine the presence of anal warts. 

If the patient isn’t responding to treatment well, the doctor may conduct a biopsy or request tissue samples. The reason is that HPV-infected individuals with anal warts are more prone to anal cancer.

What Is The Treatment For Anal Warts?

Treatment for anal warts can be invasive or non-invasive. A colorectal surgeon can surgically remove warts, or they can prescribe topical medications to the patient. In non-severe cases, warts go away on their own, and the individual may choose not to have them treated further.

Topical Medications

For small, non-cancerous anal warts, a doctor may recommend home treatment in the form of topical medication. Common medications for anal warts include podophyllin, trichloroacetic, and bichloroacetic acid. After applying the cream or gel, the patient may feel burning or discomfort for a few minutes. But they can resume daily activities immediately afterwards.

Some topical creams and gels may irritate the affected anal region. If you experience these, stop using the cream immediately and contact your colorectal physician.

Cryotherapy Or Burning

A doctor applies the liquid nitrogen to warts during cryotherapy to remove them. This procedure causes the tissues to freeze and eventually fall off.

Alternatively, the doctor may cauterise anal warts. Cauterising is done by “burning” the warts. The doctor will apply an acidic solution to destroy the tissue. 


If anal warts have become enlarged, the doctor can recommend a surgical procedure. The doctor will put the patient under general anaesthesia and then cut away the clumps using these instruments:

  • Surgical blade
  • Heated instrument
  • Laser.

After surgery, the patient may need to take time away from work or school to recover. They may also need to return to the doctor for a few more rounds of surgery. This is the case if there are too many anal warts to remove in just one session. 

How To Prevent Anal Warts?

Since the HPV virus stays in the body often without any warning signs, you can protect yourself from it (and anal warts) by taking these precautions:

  • Get tested before and after engaging in sexual intercourse
  • Avoid sexual contact with people who have anal or genital warts
  • Always use protection when having sex
  • Limit sexual contact to only one partner
  • Get HPV vaccination to protect against this STD


Anal warts are a type of genital warts that form in the anus. An HPV-infected individual can pass warts onto others through direct skin contact. 

In this guide, we’ve covered some basics about anal warts, including risk factors, prevention methods, symptoms, and causes. If you or someone you know has anal warts, it’s not a cause for concern as they go away over time. However, if you want to make sure you’re healthy, you can contact a trained colorectal surgeon in Singapore for treatment.

Dr QM Leong is a colorectal surgeon in Singapore specialising in colorectal cancers, haemorrhoids, anal fissures, hernias, and other related medical conditions. Get in touch with us now and tell us how we can help you.

Frequently Asked Questions About Anal Warts

A trained colorectal specialist can tell the difference between anal warts and haemorrhoids. Warts appear in clumps and feel rougher to the touch. Meanwhile, haemorrhoids, which are enlarged blood vessels, tend to be smoother.

If you can’t identify them yourself, it’s best to get in touch with a specialist who can examine and diagnose your colorectal condition.

No, anal warts aren’t usually painful. A person with anal warts can still do their day-to-day activities without being hampered.

Anal warts caused by HPV infections will go away after a few months or years. However, this doesn’t mean that the virus is no longer present in your body. As much as possible, get treatment for anal warts. Treatment prevents them from spreading and growing into larger and potentially painful clumps.

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