Anal wart treatment (Treatment of anogenital warts (perianal/anal))

What is anal wart treatment?

Anal warts are small lumps around, or sometimes inside, the back passage caused by the human papillomavirus (HPV). They are very common and are usually passed on by close skin-to-skin contact, including sex. Most are caused by HPV types that do not cause cancer.

Treatment aims to clear the warts you can see, using creams you apply at home, freezing (cryotherapy) in clinic, or minor surgery to remove or burn them off. The right choice depends on how many warts there are, where they are, and your preference.

It is important to understand that treatment removes the visible warts but does not get rid of the virus itself. Warts commonly come back after any treatment, and many small warts clear on their own over time without treatment at all.

In the UK, anal and genital warts are usually assessed and treated free at sexual health (GUM) clinics, where you can also be checked for other infections if appropriate.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Common options compared

All options can need repeating, and warts can come back whatever is used. Your clinician will help you choose.

Preparing for your surgery

• Consider being seen at a sexual health (GUM) clinic, where assessment and treatment are usually free and confidential.
• Ask for an examination to confirm the diagnosis and check whether warts are also inside the anal canal.
• Tell your clinician if you are, or might be, pregnant, as this changes which treatments are safe.
• Discuss other infection checks if relevant, based on your history.
• If creams are planned, learn exactly how and where to apply them to avoid sore skin.
• If surgery is planned, ask about anaesthetic, transport and time off, and tell them about blood-thinning medicines.
• Ask about HPV vaccination and how to reduce passing the virus to partners.

What happens

What happens depends on the treatment. With creams, you apply the treatment yourself at home in cycles over several weeks, following careful instructions, with reviews to check progress. Freezing is done in clinic: a cold spray or probe is applied to each wart, which stings briefly, and is usually repeated over several visits.

For surgical treatment, the warts are removed or burned off, often under local anaesthetic for small areas or general anaesthetic for larger or internal warts. The clinician may also examine inside the anal canal.

Whichever method is used, treatment often needs to be repeated, and you will usually be reviewed until the visible warts have cleared. Treatment is generally continued for up to about 16 weeks per episode before reassessing.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The most important thing to understand is that treatment clears visible warts but does not remove HPV, so recurrence is common whatever method is used. Creams can irritate the skin, and surgery near the anus can be sore and, if extensive, can rarely cause scarring or narrowing. Ask your clinician which option suits your warts, what to expect, and what to do if they come back.

Published figures to discuss

Wart treatment outcomes vary with the method used, the number and site of warts, and the person's immune system. Reliable, comparable success and recurrence percentages are limited, so cautious, qualitative wording is more honest than precise figures. What is clear is that clearance often takes several treatments and that recurrence is common with every method.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery depends on the treatment: creams and freezing mainly cause skin soreness, while surgical removal needs a short healing period, as the area around the back passage can be tender.

• Sore, red or itchy skin where treatment was applied
• Minor bleeding or spotting after freezing or surgery
• Tenderness opening your bowels after surgical treatment
• Needing repeat treatments over several weeks
• Seeing new warts appear, which is common and not a sign of failure

Aftercare

• Follow instructions carefully on how and where to apply any cream, and stop and seek advice if skin becomes very sore.
• Keep the area clean and dry, and pat rather than rub.
• After surgery, use simple pain relief, stool softeners and warm baths as advised.
• Avoid sex while the area is sore or healing, and discuss reducing spread to partners.
• Attend follow-up so progress can be checked and recurrences treated.
• Ask about HPV vaccination if you have not had it.
• Watch for signs of infection or heavier bleeding and seek advice if they occur.

• Clear written instructions for any cream
• Simple pain relief and stool softeners if having surgery
• Plan for warm baths to soothe the area
• Follow-up appointment booked to check clearance
• A plan for what to do if warts come back
• Information on HPV and protecting partners
• Knowing who to contact about soreness, bleeding or infection

Scars and how they heal

Creams and freezing rarely scar but can cause temporary redness or skin colour change. Surgical removal can leave small marks, and extensive surgery around the anus can occasionally cause scarring or narrowing, which is why removing very large or numerous warts is done carefully by an experienced clinician.

⚠ Get urgent help if…

• Heavy or persistent bleeding from the area
• Increasing pain, swelling, redness, heat or pus (signs of infection)
• Fever or feeling generally unwell
• Difficulty or severe pain when opening your bowels after surgery
• Difficulty passing urine
• Severe skin reaction, blistering or ulceration from a cream
• A lump that looks unusual, is hard, or bleeds easily and does not heal

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is clearance of the visible warts and comfort in the area. Many people get there, though it can take weeks and more than one treatment. The result is about the visible warts, not the virus.

Because HPV stays in the skin, warts can come back after any treatment, and new ones can appear. This is common and does not mean treatment has failed; it may simply need repeating.

Clearance is often not permanent. The virus can persist in the skin, so warts may recur weeks or months later, and treatment may need repeating. Over time many people's immune systems control the virus and warts stop returning, but this varies from person to person.

Combining with other procedures

Anal wart treatment is often combined with a check for other sexually transmitted infections and a conversation about HPV vaccination, which can help protect against some HPV types. If warts are inside the anal canal, an examination and sometimes specialist treatment are combined with treating the external warts.

Follow-up & long-term care

You will usually be reviewed until the visible warts have cleared, with treatment continued for up to about 16 weeks per episode before reassessing. You can return if warts come back. Tell your clinician about a wart that looks unusual, bleeds or does not heal, as it may need a closer look or a biopsy.

• Returning for treatment if warts recur, which is common
• Considering HPV vaccination if not already vaccinated
• Using condoms, which reduce but do not remove the risk of passing HPV on
• Telling a clinician about any wart that looks unusual or does not heal

Revision and secondary surgery reality

• Treatment often has to be repeated, and switching methods is common if one does not work.
• New warts can appear during or after treatment without it being a failure.
• Stubborn or internal warts may need specialist or surgical treatment.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear instructions on how to use treatments and what soreness to expect.
• A named contact and easy route back if warts recur.
• Follow-up until the visible warts are clear, with a plan for recurrences.
• Advice on HPV, vaccination, partner notification and reducing spread, plus a low threshold to biopsy an unusual lump.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether treatment is with creams, freezing or surgery
• The number of treatment sessions or weeks of cream needed
• The clinician's fee and, for surgery, any anaesthetist's fee
• Clinic or theatre facility costs for in-person treatments
• Whether warts inside the anal canal need specialist treatment
• Any tests for other infections or a biopsy if a wart looks unusual
• Follow-up appointments to check clearance and treat recurrences

• The cost of the chosen treatment and any likely repeat sessions
• The clinician's fee and any anaesthetist's fee for surgery
• Facility or theatre costs where relevant
• Whether tests for other infections are included or extra
• Follow-up appointments and treatment of recurrences
• Any laboratory (biopsy) fee if a wart needs examining
• What happens, and what it costs, if warts come back or need a different treatment

On the NHS? Anal and genital warts are commonly assessed and treated free at NHS sexual health (GUM) clinics; private care may be used for convenience or speed, but the same warts can usually be treated on the NHS.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• Are my warts only external, or are some inside the anal canal?
• Which treatment do you recommend for me, and why?
• How likely are the warts to come back, and what do I do if they do?
• Is this treatment safe if I am, or might become, pregnant?
• Should I be checked for other infections, and should I consider HPV vaccination?
• How can I reduce the chance of passing HPV to my partner?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for anal wart treatment

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: BASHH — National guideline for the management of anogenital warts (2024) NHS — Genital warts Right Decisions (NHS Scotland) — Warts and other anogenital lumps Milton Keynes University Hospital NHS — Anal warts (patient leaflet) Genital wart recurrence after laser treatment — cohort study (PMC) CDC — Anogenital warts treatment guidelines

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.