Anal Warts

The virus passes through direct skin or sexual contact, including anal sex, and the warts appear where the virus enters small breaks in the skin. Smoking and a weakened immune system make warts more likely to appear and to return. Warts can also appear in people who have never had anal sex, since the virus can spread to the area from nearby skin.

HPV is one of the most common sexually transmitted infections worldwide, and many people carry it without ever knowing. Warts can develop weeks, months or even years after exposure, so it is often impossible to say when or from whom the virus was caught. Risk is higher in people with a weakened immune system.

The doctor can usually recognise warts by looking. Because warts can also be inside the anal canal, an examination with a small scope (anoscopy) is often done. A biopsy is taken if a lump looks unusual, is pigmented, bleeds easily, or does not respond to treatment. Your doctor may also suggest testing for other sexually transmitted infections, which is a matter of general health and is kept confidential.

Do not treat anal warts yourself with wart products bought for the hands or feet; these are not safe for this area.

• See a doctor for diagnosis before starting any treatment

• Do not scratch, pick or cut the warts

• Keep the area clean and dry, and wear loose cotton underwear

• Stop smoking, which helps the immune system clear the virus

• Tell current partners so they can be checked, and use condoms, which reduce but do not remove the risk

There is no diet that removes warts, but good general health supports the immune system.

• Eat a balanced diet with plenty of fruit and vegetables

• Get enough sleep and manage stress

• Do not rely on supplements or herbal remedies for warts, as there is no reliable evidence for them

Treatment depends on the number, size and site of the warts. Your doctor chooses and explains how to use any product.

• Prescription creams or solutions applied by you to warts on the skin, or applied by the doctor

• Some creams boost the local immune response; others destroy the wart tissue

• Treatment is repeated over weeks, and skin irritation is common

• Some creams are not suitable during pregnancy; tell your doctor if you are or might be pregnant

Procedures are used for larger warts, warts inside the anal canal, or those that do not respond to creams.

• Freezing with liquid nitrogen (cryotherapy)

• Burning (electrocautery) or laser removal under local or general anaesthesia

• Surgical removal of larger warts

• Infrared coagulation or other office-based treatments in some centres

• Follow-up visits to check for recurrence

Several treatments are effective, but they remove the visible warts rather than the virus itself, so warts can return even after successful treatment. The immune system often clears the virus over time. HPV vaccination protects against the types that cause most warts and is an important preventive step; ask your doctor whether it is suitable for you.

Anal warts are treatable and usually not dangerous. They can take several weeks or months to clear and may return, which is common and does not mean treatment has failed. Some warts clear by themselves. Regular review is advised, and the risk of cancer is low for the common wart types but rises with certain risk factors, so any unusual change should be checked.

• Are my warts only on the skin, or also inside the anal canal?

• Which treatment suits me and how long will it take?

• Does a biopsy need to be taken?

• Should my partner be examined or should I have any other tests?

• Can HPV vaccination help me?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.