What Are Genital Warts and Why Do They Appear?

Genital warts in men are one of the most frequent manifestations of sexually transmitted infections (STIs), caused directly by the human papillomavirus (HPV). They appear as skin growths in the genital, anal, or perianal area that vary in size, shape, and number. While they rarely cause pain, their presence indicates an active infection that requires medical evaluation and treatment.

HPV is the most widespread sexually transmitted virus in the world. It is estimated that most sexually active people contract it at some point in their lives, though not everyone develops visible warts. In men, the virus can remain silent for weeks or months before manifesting, which facilitates transmission without the carrier being aware.

What Do Genital Warts Look Like in Men?

Genital warts can present in different forms, which sometimes makes them difficult to recognize without medical examination:

• Flat warts: small, smooth-surfaced, difficult to detect without a clinical exam
• Exophytic or acuminate warts: cauliflower-shaped, more voluminous and visible
• Papular warts: rounded, rough-surfaced, appearing in clusters
• Macules: flat spots, nearly invisible, detectable only with magnification techniques

The most common areas in men are the glans, foreskin, shaft of the penis, scrotum, perianal area, and the interior of the urethra. Internal warts, especially within the urethra, can go unnoticed for a long time and only manifest through symptoms such as burning during urination or unusual discharge.

Symptoms Associated With Genital Warts

In most men, genital warts are asymptomatic or cause only mild discomfort. However, depending on their location and size, they may produce:

• Itching or burning in the genital area
• Light bleeding during or after sexual intercourse
• Burning or difficulty urinating if warts are present in the urethra
• Discomfort or sensitivity in the affected area
• A feeling of a bump or irregularity on the genital skin

Important: the absence of symptoms does not mean the absence of infection. A man can carry HPV and transmit it to his partner without having developed any visible wart.

Causes and Risk Factors for HPV in Men

HPV is transmitted primarily through skin-to-skin contact during sexual activity, including oral, vaginal, and anal sex. Condom use reduces the risk but does not completely eliminate the possibility of transmission, as the virus can be present in areas not covered by a condom. The factors that increase the risk of developing genital warts include:

• Multiple sexual partners
• Inconsistent use of barrier protection
• Weakened immune system due to illness, chronic stress, or immunosuppressive medications
• Early onset of sexual activity
• History of other sexually transmitted infections
• Smoking, which is associated with a less effective immune response against HPV

It is important to understand that HPV does not distinguish between lifestyles. Any sexually active man is exposed. If you have questions about other conditions that can be confused with warts or share similar risk factors, the article Testicular Pain: 7 Causes You Should Not Ignore offers a useful overview of other common urological conditions in men.

Diagnosis of Genital Warts in Men

Diagnosis is primarily clinical: the specialist identifies warts during the physical examination. In cases where lesions are small, flat, or internally located, supporting techniques may be used:

• Application of 3-5% acetic acid to make subclinical lesions visible
• Urethroscopy when urethral involvement is suspected
• Biopsy in atypical cases or when differential diagnosis is difficult
• HPV typing by PCR to identify high- or low-risk oncogenic strains

There is no blood test that directly detects HPV. Diagnosis always requires a physical examination by a specialist. Consulting a urologist at any change in genital skin, even if it seems minor, is the most prudent decision.

Treatment of Genital Warts: Available Options

The goal of treatment is to eliminate visible lesions, reduce the viral load in the affected area, and minimize the risk of transmission. There is no treatment that definitively eliminates HPV from the body, but its manifestations can be effectively controlled. The article Warts: Effective Medical Treatment Options explains the different available alternatives in detail. Below are the most commonly used in urological practice:

Electrosurgery

This is the preferred method at Endolapv for its precision, effectiveness, and low recurrence rate when lesions are treated correctly. It involves destroying wart tissue using high-frequency electric current. Performed under local anesthesia, it is an outpatient procedure that allows multiple lesions to be treated in a single session. Recovery is quick and scarring is minimal when performed by an experienced specialist.

Cryotherapy

Uses liquid nitrogen to freeze and destroy warts. It is effective for small external lesions, though it may require several sessions. It tends to cause more discomfort during the procedure than electrosurgery.

Topical Treatments

Creams and topical solutions such as imiquimod or trichloroacetic acid can be used for accessible, small lesions. They require regular application over several weeks, and effectiveness varies depending on each patient's individual immune response.

Laser Surgery

Reserved for extensive or difficult-to-reach cases. Offers high precision but requires specialized equipment and carries a higher cost than other methods.

Why Can Genital Warts Come Back?

One of the most frustrating aspects of HPV is its ability to reactivate. Even after successful treatment, the virus can remain dormant in the surrounding skin and cause new lesions weeks or months later. To understand why this happens and how to reduce the risk of recurrence, the article Warts: why do they come back and how to prevent them? offers a thorough explanation based on the virus's behavior and the factors that promote its reactivation.

Maintaining a strong immune system, avoiding tobacco, reducing chronic stress, and scheduling regular follow-up visits with the specialist are the most effective measures for controlling the infection long-term.

When should you see a specialist?

Schedule a consultation with a urologist or specialized surgeon if:

• You notice any change, lump, or irregularity in the skin of the penis, scrotum, or perianal area
• You experience burning, itching, or bleeding in the genital area without apparent cause
• Your partner has been diagnosed with HPV or genital warts
• You had unprotected sex and want a preventive evaluation
• You previously received treatment for warts and notice they have returned

At Endolapv, Dr. Salvador Bricio offers specialized diagnosis and treatment for genital warts in Puerto Vallarta. The consultation includes a full physical examination, assessment of the extent of the lesions, and definition of the most appropriate treatment plan for each patient. The clinic serves both local patients and men traveling from the United States and Canada seeking quality urological care.

Conclusion

Genital warts in men are treatable and manageable when addressed promptly by an experienced specialist. HPV does not define anyone's sexual life, but it does require attention, follow-up, and responsibility. If you notice anything unusual in your genital area, do not delay: a timely consultation can make the difference between a straightforward treatment and a condition that becomes more difficult to control.