How to treat anal warts

Anal warts, also called anal condyloma or condyloma acuminata, are a form of anogenital warts caused by HPV virus that occurs inside and around the anus.

Anogenital warts are often small and don’t cause any pain which is why they initially, may go unnoticed. It is when they grow larger and multiply that itching and bleeding occur and this is when a patient usually seeks a doctor for a resolution.

A physician can diagnose anal warts by observation and palpation of the anal region. Sometimes the physician may inspect the area with the aid of an anoscope.

The colorectal surgeon may also decide to perform High-Resolution Anoscopy (HRA) to better identify further lesions and perform a biopsy for tissue analysis.

The colorectal surgeon will then suggest the most suitable treatment option based on the number and the location of warts. If left untreated, anal warts can resolve spontaneously, remain unchanged, or increase in number or size.

Common treatment options for anal warts are:

Anal warts topical treatment

If anal warts are small and limited in number, the colorectal surgeon may prescribe topical medications.

Anal warts outpatient treatments

If anal warts are large and spread in different parts of the anal region, the doctor may recommend specific in-office treatments for their removal, such as:

• cryotheraphy - to freeze warts, making them fall off.
• laser treatment - laser beams are used to burn warts, making them fall off.
• electrocautery - a special tip and electrical current are used to burn warts, making them fall off.
• electrosurgical ablation - electrosurgical blades are used to remove warts.

Today, thanks to innovative new equipment, both electrocautery and electrosurgical ablation of anal warts can be easily performed during High-Resolution Anoscopy (HRA).

High-Resolution Anoscopy (HRA) can also be used to perform a biopsy by removing a sample of tissue with small forceps for further examinations.

Anal warts surgery

In more severe cases with large anal warts that don’t respond to topical medication or outpatient treatments, surgery may be needed.

General or spinal anesthesia may be needed during surgery if the number, size or location of warts may cause excessive pain.

Anal warts: after treatment

After outpatient or surgical treatment, patients may feel discomfort or pain and the colorectal surgeon may prescribe pain killers for a few days.

Many people are unware that HPV virus can linger in the body and cause anal warts to recur even after their removal. Both anal warts outpatient and surgical treatments may require more sessions. So, for the first months after treatment, it’s important to schedule follow-up appointments with your colorectal surgeon.

HPV and anal warts are contagious and are transmissible by skin-to-skin contact. This means you can be infected by HPV without any visible warts. Therefore, removal of warts doesn’t assure the removal of HPV virus.