Anal Warts
Why Do They Occur? How Are They Treated?

What Is an Anal Wart?

The lesions that form as a result of the HPV virus settling in the anal area are called anal warts or perianal warts. These lesions can often be confused with a skin tag or haemorrhoids.

HPV settles in the anal area through micro-cracks on the mucosal or skin surface. The virus multiplies in the tissue it settles in and over time forms visible warts.

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Why Do Anal Warts Appear?

Chronic constipation, anal fissures, removing the hair in the anal area with a razor or hair-removal cream, anal intercourse and irritation in the area can cause micro-cracks. The HPV virus is transmitted by contact through these cracks.

Anal intercourse is not required. Any situation that creates irritation can prepare the ground for transmission. In people with an HPV infection in the genital area, the infection can spread to the anal area.

The Symptoms of Anal Warts

Itching, bleeding, discharge and a feeling of wetness can be seen in the anal area. The lesions can be raised from the skin or flat.

After transmission, symptoms usually appear within 1–6 months. If left untreated, the warts can grow and progress into the anal canal.

Anal Wart Treatment

When a wart is detected in the anal area, it is first important to determine the HPV type. High-risk HPV types can increase the risk of anal cancer.

If the number of warts is small, treatment with a fractional laser under local anaesthesia is possible. In widespread warts that have become a mass, general anaesthesia may be preferred.

The root tissue of the wart needs to be sufficiently destroyed. In this respect, the most effective method is the fractional carbon dioxide laser. Compared to other methods, the recurrence rate is lower.

Are Anal Warts Treated with Medication?

The anal area is not suitable for wart medications. Topical medications can cause serious irritation and ulceration in this area.

Is Cryotherapy Suitable?

In warts that extend into the anal canal, cryotherapy cannot provide destruction at a sufficient depth. For this reason, it is not the preferred method.

Do Anal Warts Cause Cancer?

High-risk HPV types are associated with anal cancer. Especially in lesions that are left untreated for a long time and are associated with high-risk types, there is a risk of malignant transformation.

How Is Recurrence Prevented?

• The warts should be effectively destroyed with the laser.
• The lesions should not be pulled off or made to bleed.
• Razors, waxing and hair-removal creams should be avoided.
• Smoking should be quit.
• The immune system should be kept strong.
• The HPV vaccine provides a protective effect.

Anal Wart Treatment During Pregnancy

Anal wart treatment with laser can be applied during pregnancy. Under appropriate conditions, it is considered safe.