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Anal Warts

What are Anal Warts?

Viral warts appear as tiny spots on the skin. They are quite commonly seen around the anus and in some people, occur on the lining of the anus. They usually start as tiny spots like pinhead, but may grow to the size of a pea.

They may also occur in clusters or spread from one part of the skin around the anus to another area. In some, they affect the skin around the genitals.

Where do these Warts Come From?

They are caused by the human papilloma virus. It is relatively contagious. The virus can be transmitted from one part of the body to another, or from person to person, almost always by direct contact.

What are Some of the Symptoms?

Some people do not notice that they have warts at all. In others, they notice a small lump on the skin. In some, they may cause itching. When they are larger, they may bleed with minor trauma.

Do these Warts Always Need to be Removed?

Yes. If they are not removed, the warts generally grow larger and become more in number. They may also spread from one area to another by touch. In addition, there is evidence that some of these warts can become cancerous if left untreated for a long time.

As anal warts have to be removed or they will likely worsen, get assessed by a colorectal specialist promptly should you notice symptoms.

What Treatments are Available?

If warts are very small and are located only on the skin around the anus, they can be treated with medications, which are applied, directly to the surface of the warts. This must be carried out with great care and precision to prevent injury to the normal skin surrounding the warts. This method usually requires several treatments performed over several weeks.

Another form of treatment involves more rapid destruction of the warts using electrical knife, surgical removal or a combination of the two. Laser surgery may also be used but has no advantage over other treatments. These procedures provide immediate results but must be performed using a local anaesthetic or general or spinal anaesthetic, depending on the number and exact location of warts being treated.

Warts inside the anal canal usually are not suitable for treatment by medications, and in most cases need to be treated by cauterization or surgical removal.

Must I be Hospitalized for Treatment?

No. Almost always, the cautery and excision technique can be performed on an outpatient basis, and the patient can go home after the procedure.

How much Time do I Lose from Work after a Cautery Treatment?

This depends on each individual situation and the extent of warts removed. Most people are moderately uncomfortable for a few days after treatment, and pain medication may be prescribed. Depending on the extent of the disease, some people return to work the next day, while others may remain out of work for several days.

Will a Single Treatment Cure the Problem?

Not in most cases, unfortunately. Even with the cautery and surgical treatment that immediately destroy existing warts, many patients develop new warts after treatment. This occurs because viruses that cause the warts can live concealed in tissues that appear normal for up to six months or longer before another wart develops. New warts will often develop from the virus that was already present in the tissue, but these are not recurrences of warts already treated.

While recurrence is possible, there are ways to minimise the chances of that happening. Your doctor will best advise you based on your particular situation.

What can be Done to Avoid Getting these Warts Again?

In some cases, warts may recur repeatedly after successful removal, since the virus that causes the warts often persists in a dormant state in body tissues. Following are tips to avoid recurrence and reinfection:
  • Continue observation for several months after the last wart has been spotted to improve the chances that both the warts and the underlying virus that causes them have been eliminated.
  • Abstain from sexual contact with individuals who have anal (or genital) warts. Since many individuals may be unaware that they suffer from this condition, sexual abstinence or limiting sexual contact to marriage relationships will reduce your potential exposure to the contagious virus that causes these warts. As a precaution, sexual partners ought to be checked, even if they have no symptoms. Otherwise, the patient can get reinfected by their partners again. Otherwise, the patient can get reinfected by their partners again.

Our Colorectal Surgeon
Dr Ho Kok Sun
Colorectal & General Surgeon
MBBS (Singapore), M Med (Gen Surg) (Singapore), FRCSEd (Gen Surg), FAMS
Dr Ho Kok Sun has been treating anal warts for over a decade and was the past President of the ASEAN Society of Colorectal Surgeons and the Society of Colorectal Surgeons (Singapore), as well as a founding member of the Eurasian Colorectal Technologies Association. Dr Ho was actively involved in the training of medical students and residents, and has published widely in reputable journals and book chapters. He believes that treatment should always be personalised to the patient’s needs.
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Ho Kok Sun Colorectal Pte Ltd
Colorectal Surgeon
3 Mount Elizabeth,
Mount Elizabeth Medical Centre
#12-09, Singapore 228510

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