Anal Warts

Anal warts (also called "condyloma acuminata") create a bothersome condition that affects the area around the anus. They may also affect the skin of the genital area. 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 afflicted individuals. As a result, patients may be unaware that the warts are present.

Anal warts are believed to be caused by the human papilloma virus, which is relatively contagious. The virus can be transmitted from person to person, almost always by direct contact.

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.

If warts are very small and are located only on the skin around the anus, they can be treated with topical 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 by a specialist to prevent injury to the normal skin surrounding the warts. This method usually requires several applications of medications.

Another form of treatment involves more rapid destruction of the warts using electrical cautery, surgical removal, or a combination of the two. These procedures provide immediate results but must be performed using either a local anesthetic or a general or spinal anesthetic, depending on the number and exact location of warts being treated.

Warts inside the anal canal usually are not suitable for treatment by medications and in most cases need to be treated by cauterization or surgical removal.

No. Almost always, the cautery and excision technique can be performed on an outpatient basis, and the patient can go home after the procedure.

Not in most cases, unfortunately. Even with the cautery and surgical treatments that immediately destroy existing warts, many patients develop new warts after treatment. This occurs because the viruses that cause the warts can live under the surface of the skin, allowing the skin to appear normal for up to six months or longer before another wart develops.

As new warts develop, they usually can be treated in the specialist's office, using either a chemical solution or the electrical cautery procedure as new warts become smaller and less numerous.

Sometimes new warts develop so rapidly that office treatment would be quite uncomfortable if all were removed at the same time. In these situations, a second, and occasionally third outpatient surgical visit may be recommended.

Follow-up visits are necessary for some months after the last wart is observed to be certain that no more warts occur from viruses living in the cells of skin.