Human papillomavirus (HPV) is the most common sexually transmitted infection with most sexually active men and women being exposed to the virus at some point during their lifetime

The virus is common in the United States, there are approximately 14 million newly diagnosed cases of HPV annually.2 HPV is comprised of approximately 100-150 viral strands, with more than 40 affecting the genitals.1,

What is human papillomavirus?

While most HPV infections are benign causing warts on areas of the body including the hands, feet and genitals, there are certain strains that put a person at a higher risk of developing certain types of cancers.1-3

HPV is a common and highly contagious infection that can affect your skin, cervix, anus, mouth and throat.
The strains of HPV, which cause a person to develop warts, is not the same group of HPV strains that cause cancer.1

The strains of HPV known to cause genital warts are low-risk HPV 6 and 11, while the strains of HPV associated with cancer include high-risk HPV 16, 18, 31, 33, 45, 52 and 58.2

HPV is a virus which is passed skin-to-skin through sexual intercourse or other forms of skin-to-skin contact of the genitals.

HPV can infect anyone who is or has ever been sexually active, and sometimes the most infected individuals are asymptomatic, meaning they display no symptoms of the virus.1-3

Most HPV infections self-resolve on their own, however, at times they can remain dormant and later infect a new or existing sexual partner.2

At times, HPV can be transmitted during birth to an infant causing the infant to experience a genital or respiratory system infection.3

HPV generally self-resolves however when it persists, it can cause warts, such as genital warts, or certain cancers.1 When genital warts become present, they may appear as a small bump, cluster of bumps or stem-like protrusions. They can range in size and appearance and be large, small, flat or cauliflower shaped and may be white or flesh tone.1-3

The most common area affected in women includes the vulva. However, they can also be present near the anus, on the cervix or within the vagina.2,3 Warts in men may appear on the penis, scrotum or around the anus.2,3 In both men and women, the groin may also be another area where genital warts are found.2

Other warts associated with HPV include common warts, plantar and flat warts.3 Common warts are rough, raised bumps most commonly found on the hands, fingers and elbows. Plantar warts are described as hard, grainy growths on the feet, most commonly appearing on the heels or balls of the feet.

Flat warts, which generally affect children, adolescents and young adults, appear as flat-topped slightly raised lesions which are darker than normal skin color and are most commonly found on the face, neck or areas having been scratched.

If HPV has contributed to the development of cancer, a person may become symptomatic of the cancer itself in the later stages of the disease.1 These cancers include cancer of the cervix, vulva, vagina, penis, anus and oropharynx.

Who is at risk for contracting a human papillomavirus infection?

There are certain risk factors that place a person at a higher risk of contracting an HPV virus including:3

Age: common warts occur most commonly in children, genital warts occur most commonly in adolescents and young adults, and plantar warts occur most commonly in adults but initially occur in adolescents and young adults
A higher number of intimate partners
Having sexual intercourse with a partner who has had a higher number of intimate partners
Those who are immunocompromised
Having areas of damaged skin
Personal contact with warts or surfaces where HPV exposure has occurred.

Diagnosis of human papillomavirus

If warts or lesions are visible, a health care provider can generally make a diagnosis of HPV during a visual inspection. However, additional tests may need to be completed to evaluate further for the presence of HPV.3

3d image of human papillomavirus
Tests that often need to be completed to evaluate for HPV may include a Pap smear, a DNA test and the use of acetic acid.
Tests to evaluate for HPV or HPV-related cervical cellular changes include a Pap smear, a DNA test and the use of acetic acid (vinegar).

A Pap smear is a test that collects cells from the surface of the cervix or the vagina and will reveal any cellular abnormalities that may lead to cancer.2,3

The use of a DNA test will evaluate for the high-risk types of HPV and is recommended for women 30 and older in conjunction with a Pap smear.2,3

Currently, there is also a DNA test for HPV, which can be used alone without the need for concurrent Pap testing starting at age 25.2

The use of an acetic acid solution test will identify lesions that are not easily seen as any abnormal areas affected by HPV will turn white.3 At times, a biopsy of any abnormal areas may be necessary.2

At this time, there is no test available for men to directly test for HPV and diagnosis is made primarily on visual inspection. In certain situations, if men or women have a history of receptive anal sex, it may be advisable to speak with a health care provider regarding the possibility of undergoing an anal Pap smear

Treatments for human papillomavirus

At times, warts will often self-resolve without treatment. However, there are topically applied medications to remove the wart itself and include over-the-counter salicylic acid for common warts, and prescription medications including:2,3

HPV vaccine

HPV vaccines are given as a series of three shots over 6 months to protect against HPV infection and the health problems that HPV infection can cause.
Podophyllin (chemical applied by a health care provider)
Imiquimod (Aldara, Zyclara)
Podofilox (Condylox)
Trichloroacetic acid (chemical applied by a health care provider).
In certain situations, surgical interventions may be necessary and include:2,3

Cryotherapy: a method that uses liquid nitrogen to freeze the abnormal areas
Electrocautery: a method that uses an electrical current to burn the abnormal areas
Laser therapy: method using a light beam to remove abnormal areas
Interferon injection: rarely used due to a high side effect profile and cost
Surgical removal.
It is important to speak with your health care provider about which treatment is best for you depending on the type and location of the wart being treated. It is also important to note that although warts and cellular changes may be removed or resolve, the virus can remain in the body and can be passed to others, as there is no treatment to remove the virus from the body

Prevention of HPV

Although HPV is a very commonly contracted virus, there are certain things that can be done to try to prevent contracting the virus and include abstinence, monogamous sexual relationships, not having sex with visible genital warts and the use of HPV vaccines.2,3

Currently, there are three HPV vaccines on the market and include Gardasil, Cervarix and Gardasil 9.2 Speak with your health care provider to see if vaccination is appropriate for you.

Prevention of common warts is difficult. However, not picking a wart or biting the nails when a wart is present is recommended.


For plantar warts, it is recommended that shoes/sandals be worn in public areas such as pools and locker rooms.