Anal warts are genital warts that appear around or just inside the anus. They're caused by HPV (human papillomavirus), and BASHH, the British Association for Sexual Health and HIV, says anogenital warts are one of the most common sexually transmitted infections. Most go away with treatment, which is free at sexual health clinics. This guide covers what anal warts look like, how you get them, treatment and the HPV vaccine, plus anal herpes and the other infections and conditions that can cause lumps, sores or itching around the bottom, for anyone of any gender.
What are anal warts?
Anal warts are small lumps on the skin around the anus, or sometimes inside it, caused by HPV. There are over 100 types of HPV, but most anogenital warts are caused by just two, types 6 and 11, which are different from the types that cause warts on the hands and feet, BASHH explains.
They're common. An estimated 4% of people in Britain (1 in 25) have had anogenital warts at some time, and in 2023 more than 25,000 people who came to a sexual health clinic in England had them for the first time, according to BASHH.
What do anal warts look like?
Anal warts are usually small, rough lumps on the skin. The NHS says they can appear on their own or in a group (groups of warts can look like a cauliflower), feel soft or firm, and be white, red, skin-coloured or darker than the surrounding skin. BASHH says they're usually skin coloured or slightly darker or pinkish, and they may feel rough to the touch.
They don't usually cause symptoms, but sometimes they may be painful, itchy or bleed, and you may also have pain or discomfort during sex (NHS). Warts inside the anus can be there without you knowing, the Terrence Higgins Trust says.
How do you get anal warts?
You can get genital warts from skin-to-skin contact, including vaginal and anal sex, and from sharing sex toys; oral sex can pass them on, but this is rare, the NHS says. Anal sex isn't the only route: BASHH says it's thought that intimate genital contact without penetrative sex can also pass on the virus.
The virus can be passed on even when there are no visible warts, and many people with it have no symptoms but can still pass it on (NHS). The time it takes for warts to appear varies a lot: on average 3 to 11 months, but sometimes more than a year (BASHH). So it may not be possible to find out who you got them from, or how long you've had the infection, the NHS says.
You can't get genital warts from kissing or from sharing things like towels, cutlery, cups or toilet seats (NHS).
Do anal warts go away?
Sometimes. Treatment for genital warts isn't always needed, and they sometimes disappear on their own within 6 months, the NHS says. Without treatment, warts may also stay the same or increase in size and number, BASHH says, and most people prefer to have treatment so they go more quickly. The body can clear HPV infection without treatment.
How are anal warts treated?
Anal warts treatment is available free at sexual health clinics in the UK (BASHH), and it has to be prescribed by a doctor (NHS). The type you're offered depends on what the warts look like and where they are:
- Cream, liquid or ointment: you can usually apply these yourself, and BASHH says most warts respond to cream treatments. The NHS says they can cause pain, irritation or a burning sensation.
- Freezing (cryotherapy): this may need repeating several times and can be painful.
- Surgery: the warts are cut out under local anaesthetic, or removed using heat or a laser, which can cause pain, irritation or scarring (NHS, Terrence Higgins Trust).
Treatment can take weeks or months to work, and warts can come back (NHS). No treatment is 100% effective in everyone, BASHH says, and warts can be more persistent if you're pregnant, smoke or have a weakened immune system. Many treatments work better if you don't smoke, the NHS adds.
Can you buy a cream for anal warts?
No: don't use wart treatments from a pharmacy, because they're not made for genital warts, the NHS says. The Terrence Higgins Trust adds that a doctor has to treat genital warts and that treatments meant for warts on the hands can't be used. Some creams can weaken condoms and diaphragms, so ask the doctor or nurse about this, and avoid sex if you've just applied a cream or ointment to warts (NHS, BASHH).
The NHS advises not having vaginal, anal or oral sex until the warts have gone, and always using a condom if you do.
Can you prevent anal warts?
Using a condom every time you have vaginal, anal or oral sex lowers the risk, but if the virus is on skin that's not protected by a condom, it can still be passed on (NHS). Don't share sex toys, or wash them or cover them with a new condom before anyone else uses them.
The HPV vaccine protects against genital warts and some cancers, including anal cancer. All children aged 12 to 13 are offered it. Girls who missed it can have it free on the NHS up until their 25th birthday, as can boys born after 1 September 2006. Men who have sex with men can have it at a sexual health or HIV clinic up until their 46th birthday, and it's sometimes recommended for other people at higher risk, such as transgender people who are felt to have the same risk, sex workers and people with HIV (NHS).
BASHH says the vaccine is very good at preventing warts if it's given before you've ever been exposed to the wart virus, and works best before you first have sex. If you already have warts, it isn't yet known whether the vaccine helps them go away or stops them coming back, but you should have it if you're eligible and haven't had it before.
Are anal warts a sign of cancer?
Very rarely. It's extremely rare for warts to become cancer, BASHH says, and the types of HPV that cause cancer are different from the types that cause warts. Most anal cancers are caused by HPV, though, and anal cancer is often similar in its symptoms to piles and anal fissures: bleeding from the bottom, itching and pain around the anus, and small lumps around and inside the bottom (NHS). See a GP if you notice a change around your anus that isn't normal for you.
What is anal herpes?
Anal herpes is genital herpes around the bottom: BASHH counts herpes on the genitals or around the anus as genital herpes. It's caused by the herpes simplex virus and passed on through vaginal, anal and oral sex, including when a cold sore touches the genitals, and by sharing sex toys (NHS).
What are the symptoms of anal herpes?
Most people with herpes don't realise they have it, because they have no symptoms or very mild ones: only 1 person in 3 with herpes knows, according to BASHH. When symptoms appear, the NHS lists small blisters that burst to leave red, open sores around the genitals, anus, thighs or bottom (the sores may look less red on brown or black skin), tingling, burning or itching, pain when you pee, and a discharge that isn't usual for you. Blisters can also appear in the rectum, and can be painful, especially when going to the toilet (Terrence Higgins Trust). The first time, symptoms can start with a flu-like illness (BASHH).
How is anal herpes treated?
There's no cure for genital herpes, but symptoms clear up by themselves and treatment from a sexual health clinic can help (NHS). Go as soon as possible if you have symptoms: the clinic takes a swab from a blister or sore, and antiviral medicine needs to be started within 5 days of the symptoms appearing. Outbreaks that come back are usually milder than the first. Keep the area clean with plain or salt water to stop blisters becoming infected, and don't have vaginal, anal or oral sex until the sores have gone; herpes can still pass on if a condom doesn't cover the infected area.
What else can cause lumps or sores around the anus?
Lumps, sores, itching or discharge around the anus can have several causes, and many STIs cause no symptoms at all. Do not self-diagnose, the NHS says. This is how the NHS, BASHH and the Terrence Higgins Trust describe the common ones:
| What you might notice | Where to get it checked | |
|---|---|---|
| Anal warts (HPV) | Small, rough lumps, on their own or in groups, usually painless | Sexual health clinic |
| Herpes | Small blisters that burst to leave red, open sores; tingling, burning or itching | Sexual health clinic, as soon as possible |
| Syphilis | Small sores, usually painless, around or inside the bottom; later, white or grey warty growths or a rash on the palms and soles | Sexual health clinic or GP |
| Gonorrhoea or chlamydia | Pain and discharge from the bottom, with itching (gonorrhoea) or bleeding (chlamydia); often no symptoms | Sexual health clinic or GP |
| LGV | Most people get painful inflammation in the rectum with bleeding, pus, constipation or ulcers | Sexual health clinic |
| Mpox | A rash that can include the anus, turning into sores or blisters; sometimes anal pain or bleeding | Call NHS 111 or a sexual health clinic before visiting |
| Piles | Lumps inside and around the anus, which can be pink or purple; bright red blood after a poo; an itchy anus | Pharmacist or GP |
| Threadworms | Itching that gets worse at night; worms in poo that look like small pieces of thread | Pharmacist |
| Anal cancer (rare) | Bleeding from the bottom, itching and pain around the anus, small lumps around and inside the bottom | GP |
Sources: NHS, BASHH and the Terrence Higgins Trust. Several of these look alike and many STIs have no symptoms, so get any new lump or sore checked, and an itch that does not stop.
For more on lumps that turn out to be piles, see what piles look and feel like and our guide to piles; for itching, see itchy bottom; and for bleeding, see bleeding from your bottom. Our anal sex safety guide covers STIs, testing and vaccines in more detail.
When should you get checked?
Go to a sexual health clinic if you have one or more painless lumps or growths around your anus, itching or bleeding from your genitals or anus, or a sexual partner who has genital warts, even if you don't know whether you have them (NHS). A doctor or nurse will usually diagnose warts just by looking at them, sometimes with a magnifying lens, and may need to look inside the anus. Occasionally, especially if they look unusual, a tiny sample is taken under local anaesthetic to confirm it (BASHH).
You don't usually need a GP referral or an appointment for a sexual health clinic, but contact the clinic first to check. You don't have to give your real name, and you don't pay a prescription charge for medicines prescribed by a sexual health clinic (NHS). Your current sexual partners should consider getting checked too, because they may have warts and not know it. Find a sexual health clinic.
See a GP if you notice a change around your anus that isn't normal for you. Go to A&E or call 999 if you're bleeding non-stop from your bottom, or there's a lot of blood, for example the toilet water turns red or you see large blood clots (NHS).
Common questions
How can you tell anal warts from piles?
Warts are usually small, rough, painless lumps on the skin, while piles are lumps inside and around the anus, and their symptoms include bright red blood after a poo, an itchy anus and pain (NHS). They can look alike, so don't self-diagnose: a doctor or nurse at a sexual health clinic can usually tell warts just by looking.
Can warts around the anus be something other than an STI?
Anogenital warts are caused by sexually transmitted HPV types, which are different from the types that cause warts on the hands and feet (BASHH). Other lumps around the anus can be piles or, rarely, anal cancer, so get any new lump checked.
Should I tell my partner if I have anal warts?
BASHH says it's a good idea to tell your partner if you have warts, or have had them in the past; they don't need treatment unless they also have warts. The NHS says current partners should consider getting checked, because they may have warts and not know it.
When can I have sex again after anal warts?
The NHS advises not having vaginal, anal or oral sex until the warts have gone, and always using a condom if you do. Warts are easiest to pass on when visible warts are present, so waiting until they've cleared after treatment is likely to reduce the risk, BASHH says. Condoms help most if they fully cover the affected skin and go on before any skin-to-skin contact.
Is there a test for anal warts?
Usually no test is needed: in most cases a doctor or nurse can diagnose warts just from looking, and a biopsy is only occasionally used (BASHH). If you have a cervix, cervical screening tests for the HPV types most likely to cause cervical cancer, which are not the same as the types that cause warts.
Can you get anal herpes without having anal sex?
Yes. The NHS says genital herpes passes on through skin-to-skin contact with the infected area, if a cold sore touches the genitals, through infection carried on fingers, and by sharing sex toys, as well as through anal sex.
Sources
- NHS: Genital warts
- BASHH (2024): Anogenital warts, patient information leaflet
- Terrence Higgins Trust: Genital warts and HPV
- NHS: HPV vaccine
- NHS: Genital herpes
- BASHH (2026): Genital herpes, patient information leaflet
- Terrence Higgins Trust: Herpes
- NHS: Causes of anal cancer
- NHS: Symptoms of anal cancer
- NHS: Syphilis
- NHS: Gonorrhoea
- NHS: Chlamydia
- Terrence Higgins Trust: LGV (lymphogranuloma venereum)
- NHS: Mpox
- NHS: Piles (haemorrhoids)
- NHS: Itchy bottom
- NHS: Bleeding from the bottom (rectal bleeding)
- NHS: Anal pain
- NHS: Sexually transmitted infections (STIs)
- NHS: Find a sexual health clinic
How this page was made. We wrote it from the sources listed above, opening and reading every one, and it says no more than they do. It's general information for adults, not medical advice, and it doesn't replace a GP or pharmacist. If you're worried about a symptom, speak to one of them or call NHS 111. In an emergency, call 999.