Why do I have bumps or warts in the genital area?

Common causes of bumps in the genital area include ingrown hairs, blocked oil glands, pimples, small cysts, and normal skin bumps you were simply born with. Bumps can also be genital warts, which are caused by the human papillomavirus (HPV).

Genital warts usually look like soft, flesh-colored growths that may cluster together in a cauliflower shape. Because so many conditions look alike, the only reliable way to know what your bumps are is to have a healthcare provider look at them.

Harmless skin changes

Many times, bumps in the genital area can be harmless.

• Ingrown hairs and folliculitis. Shaving or waxing can leave red, pimple-like bumps where hair follicles become irritated or infected. These are often itchy or tender.
• Pimples. Ordinary acne can appear anywhere you have oil glands, including the genital area.
• Cysts. Round, yellowish lumps under the skin that feel like a small movable pebble. They are usually caused by a blocked hair follicle and generally stay the same size.
• Angiomas. Small clusters of blood vessels that look bright red or slightly purple. They don't grow or bleed and need no treatment.
• Skin tags. Soft flaps of skin, often where skin rubs against skin.

Infections that cause bumps

Infections that may cause bumps in the genital area include:

• Molluscum contagiosum. A viral skin infection that causes smooth, dome-shaped bumps with a small dimple in the center.
• Genital herpes. Causes painful blisters and open sores rather than firm growths.
• Syphilis. The first stage causes a sore that can appear on the genitals or on the lips and mouth. It is caused by bacteria and clears with antibiotics, but untreated syphilis can cause serious problems later

What genital warts look like

Genital warts usually show up as a single bump or a group of bumps. They may be flat or raised, small or large, and often have a bumpy, cauliflower-like surface. They are typically skin-colored, whitish, or grayish, and most are not painful.

Where they appear depends on your anatomy:

• People with a vulva or vagina: in or around the vagina, on the vulva, on the cervix, or around the anus.
• People with a penis: on the tip or shaft of the penis, under the foreskin, on the scrotum, or on the thigh, groin, or around the anus.

What causes genital warts?

Genital warts are caused by HPV, a family of more than 200 related viruses. More than 90% of genital and anal warts come from just two low-risk types: HPV 6 and HPV 11.

HPV spreads through close skin-to-skin contact, most often during vaginal, anal, or oral sex. Penetration isn't required. Most people who carry HPV have no symptoms and don't know they have it, which is why it spreads so easily.

Symptoms of genital warts

Many times, genital warts do not cause symptoms. Symptoms of genital warts may include:

• Itching, bleeding, or discomfort in the genital area
• Small, flesh-colored or whitish bumps
• Bumps that are either flat or raised and sometimes clustered

Treatment options for genital warts

There is not a cure for the virus that causes genital warts, but some treatments can help manage them. Genital warts may go away within 6 months on their own with the help from your immune system, or they may continue to grow more numerous or in size. Treatments for genital warts include:

• Prescription creams to apply at home
• Cryotherapy (freezing the warts)
• Surgical removal for larger or persistent warts

The CDC lists three patient-applied options for external genital and anal warts:

• Imiquimod 3.75% or 5% cream (Aldara, Zyclara) — works by prompting your immune system to attack the virus
• Podofilox 0.5% solution or gel (Condylox) — destroys wart tissue
• Sinecatechins 15% ointment (Veregen) — a green tea extract

Once the warts go away, they might come back or they may not.

Do not use drugstore wart removers

Over-the-counter products made for hand, foot, or plantar warts are far too harsh for genital skin and can cause burns and scarring. Home remedies like toothpaste, castor oil, or lemon juice are also a bad idea and are not recommended by providers. Only use products prescribed or recommended for genital warts specifically.

How to lower your risk

The HPV vaccine

Gardasil 9 is the only HPV vaccine distributed in the United States. It protects against HPV 6 and 11, the two types behind most genital warts, plus seven cancer-causing types.

Current CDC guidance recommends routine vaccination at age 11 or 12, though the series can begin at age 9. Catch-up shots are recommended for anyone through age 26 who wasn't fully vaccinated earlier. For adults aged 27 to 45, vaccination is a decision to make with your provider, and the vaccine is not licensed above age 45.

One important limit: the vaccine prevents new infections. It will not treat warts or HPV you already have.

Condoms and other steps

Using condoms or dental dams consistently reduces HPV transmission, but it does not eliminate it, because the virus can live on skin the condom doesn't cover. Not smoking also helps, since smoking makes it harder for your body to clear HPV.

When to see a doctor

If you notice any unusual bumps, bleeding, or discomfort in your genital area, it’s important to get checked by a healthcare provider. While genital warts may disappear on their own, treatment can help remove them and reduce the risk of recurrence.

This article is for education only, and not intended for medical advice, diagnosis, or treatment. Always consult with your healthcare provider.

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