Genital warts in men

Genital warts (GW) are no cup of tea. They’re highly contagious, incurable, and difficult to completely protect yourself from. Symptom-wise, genital warts in men are the same as in women. But when it comes to risk factors and outbreak locations, the sexes diverge. So let’s dive in to everything you need to know about genital warts in men. 

What causes genital warts?

Like all warts, genital warts in men (also known as condylomata acuminata) are caused by the human papillomavirus, or HPV. There are over 150 different strains of HPV, some of which are known to cause cancer. It’s worth mentioning, however, that the strains that cause genital warts typically aren’t those that cause cancer. Doctors actually call them “low risk” variants, as opposed to the “high risk” strains responsible for cancer.

What do genital warts look like in men and where can they be found?

Genital warts can vary in appearance depending on their host. In some men, they are white or the same colour as skin tone, while in others they show up as darker than skin tone. They can present in clusters, but sometimes appear alone as a single blemish. They aren’t always obvious — sometimes they show up as cauliflower-like growths, but they can also be smooth, raised bumps.

Genital warts on the penis are some of the easiest to spot, so males with genital warts on the penile head or their scrotum are likely to see what’s going on and get help. Genital warts can also infect the mouth, throat, and anus, however, and in those cases they might be easy to miss.

How do you get genital warts and how can you protect yourself from them?

Genital warts spread predominantly through vaginal, anal, and oral sex, but not always. Touching the affected area or sharing of personal objects such as sex toys can also expose you to risk. While condoms and dental dams do lower your risk of contracting genital warts, they don’t eliminate it completely — especially if warts are present in an area not covered by the condom. To further complicate things, you can still contract genital warts even if your partner has no visible warts. Because of these factors, your best line of defence is to use a condom and get the HPV vaccine. The HPV vaccine protects against multiple strains — including those that cause cancer and those responsible for genital warts. 

Treating genital warts

While visible warts usually clear up on their own, in some cases it can take up to two years. If you don’t want to wait that long, there are multiple treatment options to speed up the healing. For at home treatment, your doctor can prescribe a topical cream. For in-office treatment, there are a few different options such as cryotherapy (freezing the warts), laser surgery, or electrodesiccation (burning and scraping the warts off). While these can all shorten the duration of the visible outbreak, there’s no cure for the underlying HPV infection. This means that once infected, you’re at risk of repeated outbreaks of genital warts throughout your life. 

Male HPV rates, genital warts, and cancer

Even though genital warts don’t cause cancer, we can’t talk about one without mentioning the other. The HPV vaccine was first introduced as a way to prevent cervical cancer, so when Canada launched its vaccination campaign in 2006, it was aimed at girls. Since then, the campaign has expanded to include boys aged nine to 26, as the vaccine offers protection against some forms of anal and penile cancers as well. But because boys don’t have the same vaccination rates as girls do, the male population doesn’t have the same herd immunity that the female population does. This is especially true for men who have sex with men (MSM), as they don’t have the same protection against HPV that men who have sex exclusively with women do. Within the MSM population, men who receive anal sex, are also at increased risk of anal warts. This means that they’re more likely to have growths inside their anus as opposed to a visible area such as their scrotum. And since being infected with one strain increases the probability of infection with another, they may also have an increased risk for anal cancers.

I think I might have HPV but not genital warts, how do I get tested?

Most sexually active individuals who haven’t been vaccinated are exposed to HPV at some point in their lives. For many people, their symptoms clear up on their own, however, some people are completely asymptomatic. Because of the link between HPV and cervical cancer, women are directed to get a Pap smear, which screens for HPV-related changes, every three years. What is less well known, is that men have screening options too, and can get an anal Pap smear if they are concerned about HPV infection and anal cancer. An anal Pap smear screens for signs of anal dysplasia, precancerous, or cancerous changes to the cells.

The emotional impacts of genital warts can be profound. Affected individuals can feel intense shame and stigma. But despite the social factors, genital warts in men don’t normally cause physical discomfort, pain, or health effects. Vaccination and using a condom are key to protecting yourself. But even those who take precautions each and every time they have sex can still be infected. If you do end up with a case, speak to a doctor for treatment options.