Wart in the Vagina
Why Does It Occur? How Is It Treated?

Is It a Skin Tag or a Wart in the Vagina?

It is possible to see a true skin tag in the vagina, but a significant proportion of the skin-tag-like formations that appear later, grow or multiply in the genital area are warts. Especially if you are a sexually active individual and have noticed new bumps on the vulva/at the vaginal entrance, you should not accept these as a "simple skin tag" and delay. A distinction can often be made easily with an examination.

Why Do Vaginal Warts Multiply?

Vaginal warts can multiply if they are neglected, pulled off, cut with a razor or one tries to treat them at home with ineffective/unlicensed products. This increases the viral load in the genital area; as the warts become widespread, treatment can take longer and the risk of recurrence can increase.

Are Vaginal Warts Dangerous?

The majority of genital warts are associated with "low-risk" HPV types and are not expected to transform directly into cancer. However, "high-risk" HPV types can also be present at the same time in the same person. In the presence of high-risk HPV, the risk of cervical cancer increases. For this reason, in a person with a vaginal/vulvar wart, the truly critical issue is not only the destruction of the wart, but also carrying out an assessment for high-risk HPV.

Can Warts Spread to the Anal Area?

Yes. Genital warts can spread to neighbouring areas through skin contact, and warts can also be seen around the anus. If there is a suspicion of a wart in the anal area, it is important for this area to also be assessed during the examination.

Why Is the HPV Type Important?

Knowing which HPV type caused the vaginal warts determines the follow-up plan. If high-risk HPV is detected, the cervix needs to be assessed with a smear test and, if necessary, colposcopy. If suspicious areas are seen, a definitive diagnosis is made by taking a biopsy and the patient's follow-up is planned. This approach aims to catch and prevent possible risks related to the cervix, vulva and anal area early.

How Is Wart Treatment in the Vagina Done?

Vaginal warts can be treated with different methods according to the location and extent of the wart. The main principle of treatment is the controlled destruction of the wart and, at the same time, carrying out a risk assessment related to HPV.

Vaginal Wart Treatment with Laser

Because laser treatment for vaginal warts is a lesion-focused and controlled method, it better protects the surrounding healthy tissue. For this reason, the risk of scarring and colour change is lower. In suitable cases, the procedure can be done under local anaesthesia; in very widespread lesions or for the patient's comfort, different anaesthesia options can be considered.

Treatment with Cautery (Electrocautery)

Wart treatment with electrocautery is the destruction of the wart by burning it with an electric current. Although it is an effective method, in some areas the risk of scarring and colour change can be higher than with laser treatment. Which method is appropriate should be determined according to the location and extent of the wart and the patient's expectations.

What Do We Assess Together During the Examination?

In a patient who presents with a vaginal wart, not only the treatment of the visible warts but also the following assessments are important:

• The extent and location of the warts (vaginal entrance, labia, vaginal wall, cervix, perianal area)
• HPV type assessment with the HPV DNA test
• A smear test in women and, if necessary, colposcopy
• A biopsy in suspicious areas (when necessary)

How Do We Reduce Recurrences?

Warts can recur for a while. The important thing is to reduce the viral load with the right treatment and to support immunity in suppressing HPV. The general approach to reducing recurrences:

• Effective and controlled destruction of the warts
• Quitting smoking
• Getting the HPV vaccine (planned according to your age and situation)
• Partner assessment and protection methods for the period recommended by the physician
• Not missing follow-up appointments

If the warts recur, intervening at an early stage reduces both the spread and the treatment time. Pulling off, cutting or shaving the warts with a razor is strongly not recommended, as it can increase the spread.

It is a very common situation for a small lesion that starts "like a skin tag" in the vagina to turn out to be a wart. With the right diagnosis, the right treatment and the right follow-up, warts can be brought under control; and in the presence of high-risk HPV, cancer can be prevented with screening and colposcopy.