You have pain, itching, or bleeding from bumps in the genital or anal region
You are starting a new relationship and want peace of mind about your sexual health
Diagnosis of Genital Warts
The diagnosis of genital warts typically involves a physical examination by a healthcare professional, supported by a review of symptoms and medical history. In some cases, further testing may be required to rule out other conditions or to identify high-risk strains of HPV. Genital warts are usually diagnosed visually, but confirmation and follow-up care are essential for comprehensive sexual health management.
Because the appearance of genital warts can vary widely and overlap with other conditions, a professional evaluation is always recommended before assuming a diagnosis.
Clinical Examination
The first step in diagnosing genital warts is a visual inspection of the affected area. During the consultation, your doctor or sexual health nurse will:
Examine any visible lumps, bumps, or growths
Check for clusters or flat lesions around the genitals, anus, groin, or inner thighs
Possibly use a speculum to inspect the vagina and cervix in women
Conduct an anoscopy (insertion of a small scope) if internal anal warts are suspected
The examination is usually quick and painless, though some discomfort may occur if the area is sore or inflamed.
In most cases, the appearance of warts is distinctive enough that no further testing is needed to confirm the diagnosis.
Vinegar (Acetic Acid) Test
In certain cases — especially if the warts are flat, pale, or hard to see — your clinician may apply a diluted acetic acid solution (vinegar) to the skin. This causes infected areas to turn white, making them more visible. However, this method is not entirely reliable, as other skin conditions can also react similarly.
It is generally used as a supplementary test, not a standalone diagnostic tool.
HPV Testing
While HPV testing is not routinely used to diagnose genital warts, it may be recommended in specific scenarios:
Cervical screening (Pap smear) in women, which can detect abnormal cells linked to high-risk HPV types
HPV DNA testing to determine whether high-risk strains (e.g. HPV 16 or 18) are present
This is especially important in people with a history of abnormal smear results, immunocompromised patients, or persistent/recurrent warts
Routine HPV testing is not usually performed in men, as there is no approved HPV test for males that is widely used in clinical practice.
Differentiating from Other Conditions
Because several skin conditions can mimic genital warts, a proper diagnosis is crucial. Conditions that may resemble genital warts include:
Molluscum contagiosum – small, round bumps with a central dimple
Skin tags – soft, flesh-coloured growths often mistaken for warts
Seborrhoeic keratoses – benign skin growths more common in older adults
Syphilis sores or ulcers – may resemble warts in their early stages
Genital psoriasis or eczema – may cause redness or raised areas
If there is any uncertainty, a small biopsy (removal of a tiny tissue sample) can be taken and examined under a microscope to confirm the diagnosis.
Asymptomatic Carriers and Incidental Findings
In some cases, HPV is detected during routine screenings, even when no visible warts are present. For instance:
During a cervical smear, abnormal cells caused by HPV may be found
In a sexual health screening, HPV may be suspected based on history or exposure
A partner may be diagnosed with genital warts, prompting an examination in someone without symptoms
It’s important to note that even without visible symptoms, individuals can carry and transmit the virus. This highlights the importance of regular check-ups and honest communication between partners.
Psychological Impact of Diagnosis
Receiving a diagnosis of genital warts can trigger a range of emotions:
Shock or disbelief, particularly in monogamous relationships
Guilt or shame, often fuelled by stigma or misinformation
Anxiety about current or future sexual relationships
Fear of long-term health complications, even though warts are usually benign
Understanding that genital warts are extremely common, manageable, and often temporary can help reduce fear and guilt. Most people recover fully with or without treatment, and the condition does not affect fertility or long-term health.
When to Seek Diagnosis of Genital Warts
You should consider seeing a healthcare provider for evaluation if:
You notice unusual growths or changes in your genital area
A partner has been diagnosed with HPV or genital warts
- You have pain, itching, or bleeding from bumps in the genital or anal region
- You are starting a new relationship and want peace of mind about your sexual health
- You are pregnant and suspect warts, to ensure safe monitoring during delivery
Getting a timely diagnosis of genital warts leads to earlier treatment, reduced risk of spread, and better peace of mind — all of which contribute to improved overall sexual wellbeing.
