What Genital Warts Look Like and Where They Appear
No, genital warts don’t turn into cancer.
Genital Warts
Genital warts are the most common sexually transmitted infection (STI). Certain types of HPV cause genital warts. These types don’t cause cancer. Treatments can get rid of genital warts, but once you have genital warts and HPV, you can always give the STI to someone else. It’s important to use condoms and practice safe sex.
Overview
What are genital warts?
Genital warts are a type of sexually transmitted infection (STI) that causes warts (small bumps or growths) to form in and around your genitals and rectum. Certain strains of human papillomavirus (HPV) cause genital warts. While there’s no cure for HPV itself, you can receive treatment for genital warts. You can give genital warts to other people through vaginal, anal or oral sex.
Where can you get genital warts?
Genital warts can infect your:
- Groin area.
- Anus.
- Rectum.
- Penis and scrotum.
- Vagina (including inside of your vagina), vulva, vaginal lips (labia minora and labia majora) and cervix.
- Lips, mouth, tongue or throat.
Who might get genital warts?
Genital warts affect all genders. It’s most common in teenagers and young adults. People assigned male at birth (AMAB) are slightly more at risk. Your chances of getting genital warts increase if you:
- Don’t use condoms or dental dams while having sex.
- Have multiple sexual partners.
How common are genital warts?
An estimated 400,000 people — most of them in their late teens and 20s — get genital warts every year. The virus that causes these warts, HPV, is the most common STI. Approximately 79 million Americans have HPV. There are many different types of HPV. Not all types of HPV cause genital warts. HPV 6 and HPV 11 are the two strains that cause genital warts.
Are genital warts contagious?
Yes, genital warts and the virus that causes them (HPV) are both contagious. There isn’t a cure for HPV. Once you have the virus, you’re always infectious (you can always spread it to others). Even if you don’t have symptoms like visible genital warts, or you have the warts removed, you can still infect another person with HPV and genital warts.
Symptoms and Causes
What causes genital warts?
Certain types of HPV cause genital warts. Genital warts spread through skin-to-skin contact during sex. A different strain of HPV causes the type of warts you find on other parts of your body. You can’t get genital warts by touching yourself or someone else with a wart on your hands or feet.
Genital warts spread through:
- Intercourse, including anal, vaginal-penile and vaginal-vaginal.
- Genital touching (skin-to-skin contact without ejaculation).
- Giving oral sex to someone who has HPV or genital warts.
- Receiving oral sex from someone who has HPV or who has genital warts on their mouth, lips or tongue.
It’s important to note that you can also have the type of HPV that causes genital warts but never actually develop genital warts. This means you can pass HPV to your partner and they could develop genital warts. This is also why it can be complicated to figure out which partner gave you genital warts.
What are the symptoms of genital warts?
Warts look like rough, skin-colored or whitish-grey growths on your skin. Genital warts often have a bumpy cauliflower look, but some are flat. Genital warts aren’t usually painful. Occasionally, they cause:
- Mild bleeding.
- Burning sensation.
- Discomfort.
- Genital itching or irritation.
Some warts are very small. Still, you can typically feel or see them. Sometimes the warts cluster together in groups or get very large and take on a stalk-like appearance. Most warts begin as tiny, soft growths and may be unnoticeable.
How soon do genital warts appear after infection?
Some people develop genital warts within weeks of sexual contact with someone with HPV. Often, though, it can take months or years for warts to appear. For this reason, it can be difficult to pinpoint when you got genital warts.
It’s also possible to have the virus and not get genital warts. You might not know if you have warts inside your anus or inside your vagina. If you don’t have symptoms, you may unknowingly infect others with the virus.
Diagnosis and Tests
How are genital warts diagnosed?
Your healthcare provider can diagnose external genital warts by looking at them and may request a biopsy to confirm. Internal warts are more challenging to diagnose.
Providers use the following tests to diagnose genital warts:
- Pelvic exam: You may get a Pap test as part of a pelvic exam to check for cervical changes caused by genital warts. Your provider may also perform a colposcopy to examine and biopsy your vagina and cervix.
- Anal exam: Your provider uses a device called an anoscope to look inside your anus for warts.
Contact a healthcare provider if you think you have a genital wart. Other sexually transmitted infections (and even things like moles or skin tags) resemble genital warts. An accurate diagnosis is necessary so you get the right treatment.
Management and Treatment
How are genital warts treated?
Genital warts may go away on their own because your immune system can fight off the infection that causes it. However, they may get larger, multiply or become increasingly uncomfortable. Removing genital warts reduces your chances of spreading the infection since an active outbreak spreads more easily. Remember, treatment for genital warts isn’t a cure.
There are different ways to remove genital warts. You may need several treatments to get rid of them. During treatment, you should abstain from sexual contact.
Your healthcare provider may use one of these methods to treat genital warts:
- Electrocautery: An electric current burns away warts.
- Freezing: During cryotherapy, your provider applies liquid nitrogen to freeze and destroy warts.
- Laser treatment: A laser light destroys tiny blood vessels inside warts, cutting off their blood supply.
- Loop electrosurgical excision procedure (LEEP): With LEEP, your provider uses an electrically charged wire loop to remove warts. A provider may use this method to remove warts on your cervix.
- Topical (skin) medicine: Once a week for several weeks, you apply a prescription chemical solution or cream to the warts. The chemical causes blisters to form under the warts, stopping blood flow. In some cases, your provider may apply the chemical solution at their office. There are also prescription creams your provider will prescribe that you can use at home.
- Surgery: Your provider may surgically cut out warts that are large or don’t respond to other treatments.
Treatment to remove genital warts doesn’t cure you from HPV. Even if you don’t have an active outbreak and your warts were removed, you can still spread HPV.
How long do genital warts last?
Genital warts and HPV is lifelong. That means even with treatment to remove them, the warts may come back.
Everyone responds differently to treatment to remove warts. If you have genital warts, talk to your healthcare provider about what removal option works best for you.
Can I get genital warts more than once?
Yes. There’s no cure for HPV, the virus that causes genital warts. As a result, you can get genital warts over and over again.
What are the complications of genital warts?
Genital warts generally don’t cause any serious health complications. The strain of HPV that cause genital warts is low-risk. The HPV strains that cause cancer aren’t the same ones that cause genital warts.
Are genital warts cancer?
No, genital warts don’t turn into cancer.
How do genital warts affect pregnancy?
If you have an active outbreak of genital warts while pregnant, your hormone levels may cause the warts to bleed, get larger or multiply. Rarely, these complications happen:
- A large wart or mass of warts blocks the birth canal. You may need to deliver via C-section.
- HPV passes to the fetus, causing warts to form inside its airway. This condition, called recurrent respiratory papillomatosis, is very rare.
If you’ve had genital warts in the past and don’t have an active outbreak during pregnancy, you shouldn’t have any problems.
Care at Cleveland Clinic
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Prevention
Is there a vaccine for genital warts?
The HPV vaccine can protect against certain types of HPV, including the ones that cause genital warts and certain cancers. There are more than 100 different types of HPV. Even if you already have the type of HPV that causes genital warts, the vaccine could still protect you from other more serious strains.
Recent CDC and FDA guidance recommends that people up to 45 years of age get vaccinated to protect against HPV. HPV is the most common STI and can cause certain cancers and genital warts. More than 14 million new HPV infections occur in the US each year. Check with your healthcare provider to see if you’re eligible for the HPV vaccine.
How can I prevent genital warts?
If you’re sexually active, you can take these steps to protect yourself from getting or spreading HPV, genital warts and other STIs:
- Use condoms or dental dams.
- Get the HPV vaccine.
- Get routine testing and any necessary treatment for STIs.
- Tell your sexual partners if you have HPV or genital warts so they can get tested and treated.
- Be monogamous with one sexual partner or limit your number of partners.
- Don’t douche.
Outlook / Prognosis
What can I expect if I have genital warts?
Genital warts and HPV are common STIs. These types of warts, and the HPV types that cause them, don’t increase your risk for getting cancer. Some people have genital warts just once, while others have recurring outbreaks. Treatment can get rid of the warts, but it can’t cure them or HPV. You’ll always be infectious and need to practice safe sex with your partners.
Living With
When should I call my healthcare provider?
You should call your healthcare provider if you experience:
- Genital irritation or itching.
- Painful intercourse.
- Painful urination (dysuria).
- Unusual or foul-smelling penile or vaginal discharge.
- Vaginal or penile redness, soreness or swelling.
What questions should I ask my healthcare provider?
If you have genital warts, you may want to ask your healthcare provider:
- What is the best treatment for me?
- Will warts come back after treatment?
- What’s the best way to avoid getting another STI?
- How can I protect my partner from getting HPV or genital warts?
- Am I at risk for cervical cancer? If so, what steps can I take to protect my health?
- Should I look out for signs of complications?
Frequently Asked Questions
Are there genital warts that aren’t an STI?
No. All genital warts are a sexually transmitted infection (STI).
How do you stop genital warts from spreading?
There are a few things you can do to help genital warts from spreading to your partner:
- Always use condoms or dental dams during sex.
- Avoid sex when you have a visible wart.
- Tell your partner you have genital warts before engaging in sexual activity.
What’s the difference between genital warts and herpes?
Genital herpes (herpes simplex type 2) is similar to genital warts in that they’re both types of sexually transmitted infections. However, herpes cause sores and fluid-filled blisters to form on your genitals. This is different than warts, which are small bumps that typically don’t cause open sores. Both infections are spread during vaginal and anal sex.
Does having a genital wart mean I have an STI?
Yes. Almost all cases of genital warts are caused by HPV, which is a virus spread through sexual contact.
A note from Cleveland Clinic
Thousands of people get genital warts every year, and thousands more have the virus that causes them. Genital warts may not appear until months — sometimes years — after infection. Once you know you have genital warts and HPV, you should share this information with your sexual partners. Your healthcare provider can offer suggestions for preventing the spread of this sexually transmitted infection (STI). You can also take steps to lower your risk of getting other STIs.
What Genital Warts Look Like and Where They Appear
Mary is a freelance nurse writer specializing in making healthcare and medical content accessible for people at all levels of health literacy. Her MSN in nursing education prepared her to deliver accurate and trustworthy medical information that educates and empowers the public.
Leah Ansell, MD, is a board-certified dermatologist and an assistant professor of dermatology at Columbia University.
Table of Contents
Table of Contents
Genital warts are caused by the human papillomavirus (HPV). This virus is the most common sexually transmitted infection (STI). Nearly everyone who is sexually active will be infected with HPV at some point, but most people will not develop genital warts.
It is important for you to know the symptoms of genital warts. The pictures of genital warts in this article can help you recognize them. Knowing how they spread and what prevention strategies exist is important for reducing your risk and the risk of spreading them to others.
This article discusses genital warts, what they look like, where they typically occur, diagnosis, and treatment.
Types of HPV in Genital Warts
Around 150 types of HPV have been identified, and about 40 of them are known to infect the genital area. Most sexually active people will encounter some form of HPV in their lifetime, but not all types carry the same levels of risk.
Genital warts can occur from HPV types often referred to as low-risk (noncancerous). More than 90% of cases of genital warts are caused by low-risk types, namely HPV types 6 and 11.
Click Play to Learn More About Genital Warts and HPV
This video has been medically reviewed by Anita Sadaty, MD
Pictures of Genital Warts
The appearance of genital warts can vary dramatically. Warts can appear as single bumps or they can occur in groups. They can range in size from less than 1 millimeter to several centimeters in diameter if a cluster of warts merges. They can be smooth or rough and may have fingerlike projections.
The most common appearance of genital warts is as gray growths or growths the color of your skin. They can be raised or flat and can appear on, in, and around the genitals. They can grow in clusters that resemble cauliflower or appear alone. Genital warts can also be white, purple, or brown.
The timing of genital warts can vary widely from person to person. HPV infection can occur with or without the appearance of genital warts. Warts can take up to two or three months to develop on the skin.
Please note that the images below are graphic and show male and female genitalia in detail. Discretion is advised.
Genital Warts on Men
The picture above displays genital warts on the shaft of the penis. However, genital warts can appear on other parts of the penis, like around the tip of the penis and under the foreskin of an uncircumcised penis. Warts can also appear on the scrotum (as seen below).
Genital Warts on Women
Above is a photo of genital warts on the labia. However, genital warts can also appear on the vulva and cervix.
Genital Warts on the Perineum
The perineum is the area between the genitals and the anus. The picture above shows a case of genital warts around the vagina and the perineum.
Genital Warts on the Thighs
The picture above displays genital warts on the upper inner thigh, but warts may also develop further down the thigh.
Anal Warts
Genital warts can appear around or inside the anus. Anal warts rarely block the anal opening.
Location of Genital Warts
Genital warts can form around or inside the genital region (i.e., the penis, vagina, anus, and perineum) and the thighs.
The location of genital warts does not always match up with areas of sexual contact. Warts usually appear at the site of reported contact. However, they can also be found at sites where people report no history of sexual contact.
Genital warts can be spread even when no warts are visible.
Diagnosis
In most cases, healthcare providers can diagnose genital warts just from visual inspection. However, some lesions can be hard to identify. In those cases, practitioners may do a biopsy (removing a sample of tissue for examination in a lab) to confirm the diagnosis. The biopsy can confirm the presence of HPV and identify the subtype of the virus.
In addition, a special test (called a colposcopy ) using a magnified scope to look at the genitals can help healthcare providers to better see lesions inside the vagina and on the cervix.
Prevention
The Centers for Disease Control and Prevention (CDC), in its 2021 guidance for screening and prevention of STIs, states that vaccination is the primary strategy for preventing HPV. Vaccination with Gardasil 9 is recommended as part of routine care beginning at age 11 or 12.
The HPV vaccine is approved to be administered as early as 9 years old. It can also be given, in some cases, up to age 45.
Treatment
Genital warts may go away on their own without treatment, often within one year. But it is also possible that they will grow and spread. They can also stay and remain the same size.
Treatments include prescription creams or gels you apply yourself, such as Aldara (imiquimod) and Condylox (podofilox). Your healthcare provider can also remove warts using cryotherapy or use a laser or electrosurgery (electric current) to burn them off.
With treatment, visible warts will usually go away. For some people, genital warts come back even if they follow all the steps for treatment. Even after treatment and without visible warts, you may still be able to pass HPV to sexual partners.
Over-the-counter (OTC) wart treatments that contain ingredients like salicylic acid and benzoyl peroxide should not be used for genital warts. These products are not designed for treating warts in the delicate genital areas.
At-Home Remedies
Seeing a healthcare professional is the best way to ensure you receive the appropriate treatment for genital warts. Some home remedies claim to help get rid of warts, but many of these are not supported by evidence and may be unsafe to try on genital warts.
One folk remedy for treating warts is the duct tape method. Some research does show that it may be effective. But this method is more appropriate for common warts on areas like the hands, feet, and arms. It should not be used on genital warts.
Some people also suggest using apple cider vinegar and tea tree oil to treat warts. However, there is a lack of research about their effectiveness in general and specifically on genital warts. In addition, these remedies may cause burning and irritation.
The most natural and evidence-supported at-home remedy for genital warts is the application of a green tea extract known as sinecatechins . Experts believe this green tea extract may have antiviral and anti-inflammatory properties that help eliminate genital warts.
Topical sinecatechins 15% ointment (sold under the brand name Veregen) is the first botanical drug approved by the Food and Drug Administration (FDA) for treating genital warts. It is prescribed by a healthcare professional and typically self-applied.
If you think you have genital warts, see a healthcare provider for diagnosis and treatment. Self-identification and home-based remedies may be unsafe and are unproven. Medical professionals are trained to examine and treat private areas of the body.
Summary
Genital warts are a symptom of infection from certain types of HPV. They typically appear on the genitals but can also be found on the anus and perineum.
Any wart, bump, or growth should be evaluated by a healthcare professional. Typically, a visual examination is all that is required. Your provider can then prescribe treatment for your warts, if appropriate. At-home treatments are typically not effective or safe on the delicate skin of the genitals.
A Word From Verywell
Seeing a suspicious lump or bump around your genital area can be alarming. Though genital warts are unsightly—and highly contagious—they usually are harmless. However, it is always important to get an accurate diagnosis.
If you suspect that you have genital warts, see a medical professional. If you have been diagnosed with genital warts, you may still be able to transmit HPV to your sexual partners even if the warts are gone.
Frequently Asked Questions
How do you get rid of genital warts?
Genital warts are commonly treated with topical prescription medications, such as Aldara or Zyclara (imiquimod) cream, Condylox (podofilox) solution or gel, and Veregen (sinecatechins) ointment. They can also be removed using cryotherapy (using freezing or near-freezing temperatures) or surgical methods.
Although medications and other treatment methods may help clear genital warts, the virus that causes warts—HPV—may never go away, and warts may reappear.
How long do genital warts last?
When untreated, genital warts may disappear within a year, but the exact time it takes for them to clear can vary. With treatment, warts may go away faster. However, since HPV may reside in the body, warts may reappear over and over again.
What does a genital wart feel like?
Genital warts may feel rough or smooth. They usually are not painful but may cause discomfort, itching, irritation, or a burning sensation.
How long does it take for genital warts to show up?
How long it takes for genital warts to show up can vary. Some people may develop genital warts within weeks after infection. But for others, it may take months or years after infection for warts to appear.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
- Centers for Disease Control and Prevention. Genital HPV infection – fact sheet.
- Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1
- Centers for Disease Control and Prevention. Human papillomavirus.
- University of Rochester Medical Center. Warts.
- Centers for Disease Control and Prevention. Chapter 5: Human papillomavirus (HPV).
- Grennan D. Genital warts. JAMA. 2019;321(5):520. doi:10.1001/jama.2018.20181
- Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines: Anogenital warts.
- Karnes JB, Usatine RP. Management of external genital warts. Am Fam Physician. 2014;90(5):312-318.
- Goldman RD. Duct tape for warts in children: Should nature take its course?Can Fam Physician. 2019;65(5):337-338.
- Balaji G. Sinecatechins: A better prospect for treating anogenital warts. Indian J Sex Transm Dis AIDS. 2014;35(1):75-76. doi:10.4103/0253-7184.132415
- Cleveland Clinic. Genital warts.
How to recognize and treat genital warts and when to contact a doctor
Genital warts are flesh colored bumps that can appear on or around the genitals.
The sexually transmitted infection (STI) human papillomavirus (HPV) is what causes them.
Once a person has genital warts, HPV can transmit to others, even if the person has no symptoms.
This article will cover what genital warts look like, as well as some causes and treatment options. It will also discuss outlook, some similar conditions, and when to contact a doctor.
Genital warts can appear on or around the genitals. Possible locations include the following:
These warts can also appear in the mouth or throat if someone has had oral sex with a person who has them.
Genital warts look similar to the warts that a person might get on their hands or elsewhere on the body. This is because various strains of HPV cause all warts, including genital warts.
Genital warts can appear weeks, months, or even years after an HPV infection.
Some people with HPV have no symptoms at all. For this reason, the fact that a person has not had recent sexual contact does not exclude the possibility of having genital warts.
Genital warts do not cause sores, bleeding, or open wounds unless a person scratches them or they catch on something.
Discolored marks, rashes, or bleeding on or around the genitals usually indicate the presence of something else, such as herpes or a skin infection.
Some symptoms that suggest that the bumps on the genitals might be genital warts include the following:
- The bumps are skin colored or slightly darker.
- The bumps appear as either a single bump or in clusters that may resemble a cauliflower.
- The bumps may be rough, smooth, flat, or raised.
- The bumps may itch, but they do not usually hurt.
HPV causes genital warts. This is the most common STI in the United States.
The strain of HPV that causes genital warts spreads through skin-to-skin contact with someone who has it, often during vaginal, anal, or oral sex. However, genital warts can still spread without penetration and if a person does not have symptoms.
Any anal, vaginal, or penile contact may spread HPV. This can happen even if a person has no HPV symptoms.
Condoms do not fully protect against HPV, since they do not cover all of the areas of the body that may spread the infection. They can, however, reduce the chance of HPV spreading.
Genital warts are not dangerous, though a person might not like how they look.
A different strain of HPV from the one that causes genital warts may increase the risk of cancer. That strain of HPV correlates with a higher risk of certain cancers, including:
- throat cancer
- vulvar and vaginal cancers
- penile cancer
- anal cancer
- cervical cancer
According to the World Health Organization (WHO) , “nearly all cases of cervical cancer can be attributable to HPV infection.”
The strain of HPV that causes genital warts is a low risk strain for cervical cancer, but other HPV strains are higher risk.
People who have genital warts may also have a strain of HPV that increases their risk of cancer.
Some people with genital warts say that they feel similar to tiny, bumpy cauliflowers.
The outer surface of the warts may feel smooth or rough. The warts may grow or change texture a little before they clear up.
These warts do not usually hurt, but the skin under the wart may feel itchy. If the warts catch on something, such as underwear, they may hurt.
Genital warts will not bleed if a person does not disturb them. However, friction from walking or sex can irritate or tear the warts. Warts may open, bleed, or become infected from friction or if they snag on something.
The presence of bumps on or around the genitals does not necessarily mean that a person has HPV.
Some other potential causes of genital bumps include:
- cysts or other growths under the skin
- razor burn and other forms of skin irritation, such as heat rash
- skin infections from bacteria, yeast, or other microbes
- tumors, including both benign tumors and cancerous growths
- other STIs, such as herpes or syphilis
No test can reliably detect HPV for both sexes . However, in females, doctors can test for HPV during cervical cancer screenings with a Pap smear.
For many people, doctors will diagnose the condition based on symptoms, after ruling out other potential conditions.
A person should contact a doctor if they:
- have genital warts or other genital bumps
- have genital pain
- want a doctor to test for other STIs
Certain tests can look for cancer related to HPV. A doctor may recommend undergoing regular Pap smears or other tests based on a person’s history of genital warts.
Because it is impossible to self-diagnose HPV, it is important to contact a doctor about any unusual or new growths on the genitals, even if the person thinks that they have had no HPV exposure.
It is possible to vaccinate both females and males against some types of HPV, including those that cause most cervical cancers.
Experts usually recommend that people receive the vaccine before they become sexually active and have exposure to any strains of HPV. However, some younger adults may still benefit from vaccination.
Anyone who is interested in having themselves or their child vaccinated should consult a doctor.
HPV is a chronic virus with no cure. This means that a person may periodically develop genital warts for the rest of their life.
Not all people with HPV develop genital warts, however, and even those with a history of wart outbreaks may never again have another outbreak.
There are treatments available for genital warts. For example, a doctor may recommend prescription creams to clear up the infection. If the warts become infected or cause a skin infection, they may also recommend an antibiotic.
The cancers that HPV increases the risk of are also treatable. So, a person should contact a doctor early about any symptoms of cancer or unusual growths.
Females with HPV may need more frequent cervical cancer screenings.
HPV is a common infection, and many people who contract the virus never know that they have it.
People with genital warts should assume that they are contagious and discuss risk and risk mitigation strategies with their partners.
A doctor can help with assessing risk and recommending treatment options.
Last medically reviewed on February 2, 2021
- Dermatology
- Men’s Health
- Sexual Health / STDs
- Women’s Health / Gynecology
How we reviewed this article:
Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
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https://www.cdc.gov/condomeffectiveness/latex.html - Genital HPV infection – Fact sheet. (2021).
https://www.cdc.gov/std/hpv/stdfact-hpv.htm - Genital warts. (n.d.).
https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/genital-warts - Genital warts: Overview. (n.d.).
https://www.aad.org/public/diseases/a-z/genital-warts-overview - HPV vaccine information for young women. (2016).
https://www.cdc.gov/std/hpv/stdfact-hpv-vaccine-young-women.htm - Human papillomavirus (HPV) and cervical cancer. (2020).
https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer - Human papillomavirus (HPV) treatment and care. (2016).
https://www.cdc.gov/std/hpv/treatment.htm - What are the symptoms of genital warts? (n.d.).
https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/genital-warts/what-are-symptoms-genital-warts