Anal warts

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What are Anal Warts?

Anal warts (also called ‘condyloma acuminata’), are a relatively common condition that affect the area round the anus (back passage). They may also affect the skin of the genital area (genital warts). They first appear as tiny blemishes, perhaps as small as the head of a pin and may grow larger than the size of a pea. Usually, they do not cause pain or discomfort to affected individuals. As a result, patients may be unaware that the warts are present.

Where do these warts come from?

They are thought to be caused by the human papilloma virus which is quite contagious. This means that the virus is transmitted from person to person by direct contact, including sexual activity.

Do these warts always need to be removed?
Yes. If they are not removed the warts generally grow larger and become more and more numerous. In addition, there is evidence that these warts can become cancerous if left untreated for a long time.

What treatments are available?
If warts are small and 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 method, while relatively simple in
concept, must be carried out with great care and precision to prevent injury to the normal skin surrounding the warts. This method usually requires several applications performed regularly over
several weeks. Another form of treatment involves surgical removal of the warts. This is usually performed under a general anaesthetic. Depending on the number of warts removed, patients can often go home after the procedure on the same day.

The procedure is uncomfortable and painkilling tablets will be required. A dressing will be needed and this will depend on the site and size of the wound/s.

Will a single treatment cure the problem?
Not in most cases. Even with surgical treatments that immediately destroy existing warts, many patients develop new ones after treatment. This occurs because the 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 the warts already treated.

How long is ‘follow up’ continued?
Follow up visits are necessary for some months after the last wart is removed to be certain that no more warts develop.

What can be done to 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 the skin. The following are tips which may help to avoid recurrence and reinfection.

• Attend your follow up outpatient appointments to ensure that the condition has been completely cleared.
• 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 a single partner 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.

Further Information
This leaflet is based on one designed by the Association of Coloproctology of Great Britain and Ireland, but has been modified (with permission) by us to reflect local policies. The Association of
Coloproctology web site ( has further information on all aspects of colon and rectal disease.

People are unique and the alternatives, risks and benefits will of course vary from person t o person. We hope this leaflet will support the information you have already received from your doctor in enabling you to make an informed decision.