Signs and Symptoms of Human Papillomavirus (HPV)

Human papillomavirus (HPV) is currently the most common sexually transmitted infection (STI) in the United States. HPV is a group of viruses with multiple strains. Depending on the strain of HPV you have, you can develop warts and some types of cancer. However, most people with HPV don't experience any symptoms at all.

While there is no cure for HPV, the best way to prevent contracting strains that cause warts or cancer is by getting the HPV vaccination.

No Symptoms

More than 90% of people with HPV never develop symptoms. As a result, you may be "asymptomatic" to HPV—meaning that you show no symptoms at all. This can happen because your immune system can usually fight off the virus over time on its own. Most cases of HPV resolve independently without medical intervention and treatment within two years. 

In fact, up to 90% of people who are sexually active have HPV and don't know they live with the virus because they aren't displaying any symptoms. However, there are several HPV strains, so you can contract a different strain at a later point in life which can cause symptoms.

HPV comes in various strains, causing different symptomatic responses. “Low-risk” strains of HPV can cause warts, while “high-risk” strains can cause certain types of cancer.

Symptoms of Low-Risk HPV Strains

The most common symptoms of low-risk HPV strains are genital and non-genital warts. It's important to note that warts are highly contagious. Genital warts are usually sexually transmitted, while non-genital warts can spread through skin-to-skin contact. This means that you can get low-risk strains of HPV by touching someone else with a wart. 

HPV can also live on surfaces and objects. If someone touches an object with HPV contamination, then touches one of their mucus membranes (such as their mouth, eye, or inside the nose), they can also develop HPV.

Non-Genital Warts

Non-genital warts can appear on any part of the body, including your hands, feet, and face. Keep in mind: it can take six months (or more) after exposure to HPV for a wart to appear on your own body. Some warts go away on their own after a couple of years if the body clears the virus. But, as long as HPV is still in the body, warts can come back even with treatment.

There are several different types of warts you can develop. The color, texture, location, and appearance can differ. The following characteristics describe the types of warts you might develop with HPV: 

Common Warts 

• Small, hard, rough bumps that are typically round or oval
• Typically flesh-colored
• Can mimic the texture or appearance of a cauliflower
• Typically less than one centimeter big, but can grow together and get larger
• Common locations include the hands and knees
• Found in all areas of the body except the soles (bottom) of the feet

Flat Warts

• Small (the size of a pinhead) smooth bumps on the skin
• Often grow together in groups or clusters
• Typically flesh-colored, pink, or brown
• Usually grow on the face and the top of the hands

Plantar Warts

• Flat warts that grow on the soles of the feet
• Can be uncomfortable
• Typically begin as a small, rough, thick patch of skin that grows larger
• Commonly have black dots that look like tiny seeds (which are actually small, clogged blood vessels)
• Have white flakes on them
• May mimic the appearance of a callous

Filiform Warts

• Finger-like shape
• Typically flesh-colored
• Usually grow around the mouth, nose, and eyes

Genital Warts

If you develop HPV through sexual contact (e.g., anal, vaginal, or oral sex), it can cause warts in the genital area, anus (the area outside of where poop exits the body), mouth, or throat.

While about 30 low-risk HPV strains can cause genital warts, HPV types 6 and 11 are the most common.

Genital warts can grow on or near the:

• Vulva (outer female genitalia, including the lips and clitoris)
• Vagina (birth canal)
• Groin or inner thigh
• Anus (even if you have not had anal sex) 
• Penis (shaft or tip)
• Scrotum (sac that holds the testicles)
• Mouth and throat (known as oralpharyngeal HPV)

Genital warts can look like the following characteristics:

• Small flesh-colored, pink, or white bumps
• Can be flat or raised
• May look like a small piece of cauliflower
• Could get larger or grow in groups or clusters 
• Itchy, but not usually painful
• Might bleed during sexual intercourse

Symptoms of High-Risk HPV Strains

High-risk strains of HPV do not typically cause symptoms. However, about 14 high-risk HPV strains, including types 16 and 18, can lead to some types of cancer in the genitals, mouth, throat, and anus.

Symptoms of HPV-related cancers will vary. This is because the symptoms you experience will depend on the exact type of cancer you have and the severity of your condition.

Common symptoms of vaginal, cervical, and vulvar cancers include:

• Abnormal vaginal bleeding (after sex, after menopause, between periods)
• Excessive vaginal discharge
• Pelvic (between the hips) pain
• Painful sex and urination
• A lump in the vagina or vulva 
• Vulvar itching

Anal cancers can cause:

• Bleeding from the anus (where poop exits the body) or rectum (last section of the digestive tract, before the anus) 
• A lump, pain, itching, or pressure near the anus
• Changes in bowel (pooping) habits

With penile cancer, you may experience:

• Redness, irritation, or soreness on the penis
• A lump on the penis
• Painful sex

A Quick Review

HPV is the most common STI in the United States. In fact, nearly 90% of people who are sexually active can develop HPV without even knowing they have the virus. This is because the most common symptom of HPV is no symptoms at all.

However, your symptoms will depend on the strain of HPV you contract. There are low-risk and high-risk HPV strains. Whereas low-risk strains commonly cause genital or non-genital warts, high-risk strains can increase your risk of developing certain cancers.

If you think you may be at risk for developing HPV or another STI, it's a good idea to make STI screenings a routine part of your healthcare. While there is no cure for HPV, the best way to reduce your exposure to the virus is by getting the HPV vaccination.