A bum deal

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18 Dec 2014

Adam from Cairns writes: I have some annoying little lumps around my bum that my partner says are warts. They only appeared in the last few months and I haven’t done anything about them because I hoped they would just go away. But they haven’t. What should I do?

Dr Louise replies: It does sound like you have genital warts but it is important you have a doctor check them out to confirm that they are warts and also to make sure there aren’t any other STIs present. (They often hunt in packs!)

Genital warts are caused by a number of strains of the Human Papilloma Virus (HPV). There are lots of different types of HPV. Some strains cause genital warts, others cause the more regular warts you get on your hands and feet, some strains have no symptoms at all and a few are associated with anal and cervical cancer.

Genital warts are spread by close skin-to-skin contact and it can take weeks, months or even years between the time you are infected and the warts appear. They are often painless and can appear as raised or flat bumps, alone or in clusters. Contact with warts from other parts of the body does not seem to cause genital warts.

HPV is good at ‘hiding’ from the body’s immune system and so warts can be tricky to get rid of. Treatment is often difficult and time consuming, usually requiring multiple applications and often this does not eliminate them totally.

Two common treatment options are ‘cryotherapy’ and topical solutions.

Cryotherapy is a technique administered by a doctor or nurse. It involves freezing the warts and the treatment is usually repeated about ten days later. Sometimes the warts blister up immediately and sometimes you don’t notice any change until after a few treatments.

Topical solutions such as podophyllotoxin can be applied to external genital warts but you must be sure the product is specifically designed for sensitive genital skin. I have seen some nasty skin reactions from home-applied wart treatments. Aldara cream can also be self-applied depending on the site of the warts and can be effective in some cases. It is available only by prescription or from a sexual health service.

The bottom line is that you get a full sexual health check-up to confirm the diagnosis and also to get the best treatment option for your situation.