Anal Warts or Abnormal Growth

Anal warts (condyloma acuminata) are caused by HPV (human papillomavirus), a virus that is usually transmitted by sexual contact or direct contact with infected body part/fluid. They start as tiny growth the size of a pin head, may be flat or slightly raised, and may be flesh color or darker than surrounding skin color. They may be isolated or may continue to grow and spread-out over an area, with a califlower-like texture. HPV can infect skin and lining around and inside the anus (as anal warts), and also on the genital area (as genital warts). Sometimes anal warts can develop into precancerous growth (anal dysplasia), which may progress to became anal cancer. People at higher risk for such canerous changes include those who are HIV positive, those who take medications that suppress immune system (e.g. after organ transplant, for immune-related disorder, or chemotherapy), and those who had history of cervical cancer (a HPV-related cancer).

Symptoms of anal warts

Small early growth do not usually cause any symptom. You may notice it only when wiping or cleaning the anal or gential area. Warts do not usually go away on their own. When growth continues, you may experience itch or mild irritation, and occasional bleeding or mild moisture/discharge.

Diagnosis and treatment of anal warts and dysplasia

Warts can be diagnosed by its appearance during exam in the office. Dr. Choi will inspect the external skin around the anus and insert a small lighted instrument (anoscope) to examine the lining inside. If the growth appears cancerous or pre-cancerous, a biopsy (removal of some tissue for pathology examination) may be performed, and additional testing and treatment and closer monitoring may be needed. Small warts on external anal skin may be treated with a topical cream which you can apply at home. Warts inside the anal canal or more extensive growth may be better treated with surgical removal, which is done as same-day outpatient procedure under anesthesia. Warts may come back after treatment because the HPV virus remain and cannot be eradicated completely. As such, follow-up exams to check that no warts recur is recommended. You should also make sure your sexual partner is checked and treated for any warts.

Helpful links:


*American Society of Colon and Rectal Surgeons