Depending on their size and location, anal warts can be treated in a number of different ways.
If they are small, they can be treated with a cream, lotion or chemical applied directly to the warts. This will destroy the tissue of the warts and, over a period of time, the warts will disappear. You’ll be advised if this is a suitable treatment for your warts and we’ll give you instructions on how to carefully apply the cream. Sometimes, the cream will need to be applied by a nurse or consultant during an appointment at the hospital.
If the warts need to be physically removed (ablation), there are a number of treatment options which will need to be carried out during a visit to hospital. These treatments include cryotherapy, excision, electrosurgery and laser surgery. Laser surgery may be recommended to treat large warts that can’t be treated using other physical ablation methods. This may be because they are difficult to access, such as warts deep inside your anus or urethra (the tube which urine passes through between the bladder to the penis or vulva).
Physical removal of anal warts can be carried out using a number of different methods.
Cryotherapy, which is a freezing treatment, is usually used to treat multiple smaller warts. During the procedure you may experience a moderate burning sensation.
Excision involves cutting warts away using a surgical scalpel. This will be carried out under local anaesthetic which numbs the area, so any pain will be minimised. Stitches will be used to seal the incision.
Electrosurgery is often combined with excision to treat large warts that haven’t responded to topical treatments. After removing the bulk of the wart by excision, the remaining part of the wart is burned away using an electric current. This can be quite painful, particularly if there are a number of warts, so we may need to give you a regional anaesthetic (which numbs everything below your spine) or even a general anaesthetic.
During laser surgery, a laser is used to burn away the warts. Depending on the size of the warts and how many there are, we may perform laser surgery under either a local or general anaesthetic to minimise discomfort.
After cryotherapy and laser surgery, in the two to four weeks your skin takes to heal, you may experience some skin irritation, blistering and pain where the warts were removed.
Excision and electrosurgery can cause scarring and the area of skin where the wart was removed will be sore and tender for two to four weeks.
In most cases just a single treatment may not be enough to cure all anal warts and, whichever treatment is used, there is a chance that the warts may recur. Additionally, even after the warts can no longer be seen, the virus that causes them may still remain in the tissue.
This means that follow-up visits may be suggested even after there are no visible warts, perhaps for several months. It’s important to keep these appointments because, if anal warts are left untreated they can on very rare occasions become cancerous.
The virus that causes anal warts is highly contagious, so there is a risk of passing the virus to other people. To help prevent the virus from spreading and to reduce the chance of recurrence we would recommend checking any sexual partners, refraining from sexual activity until treatment is completed and using condoms (which offer some protection).