Anonymous on September 20, 2011

Is it possible to get genital warts in the anus? Also, I have HIV...does that affect genital warts?

I have HIV and HPV. I have skin-colored bumps on my anal area and red bumps on my buttocks. They have been itching and burning for the last 10 weeks. It can be pretty intense. Sometimes they bleed. My dermatologist says the bumps are due to HPV, so I’m starting a treatment with Aldara. She said it was safe to use it perianally and intra-anally...but the manufacturer says to only use it externally. Which one is true? Also, do genital warts usually have these symptoms?

answered by Ruthann M. Cunningham, MD on September 20, 2011

I understand your concern about bumps in your anal area, especially because you’re HIV-positive. 

Yes, genital warts do have the symptoms you describe (skin-colored bumps on the genitals)...and people who have HIV sometimes experience genital warts more intensely than others. In fact, because you have HIV, you’re also more likely to develop genital warts and you might have a harder time treating them. Be sure to keep up with your treatment plan and talk to you doctor if your symptoms don’t clear up soon. 

The good news is, even though you have HIV, you can use the same treatment for genital warts as people who don’t have HIV. Aldara contains a chemical that should help your body minimize the effects of your genital warts. You’re right that the manufacturer recommends Aldara for external use, only...I suggest you apply the treatment only as directed.

And if Aldara doesn’t work for you, your regular doctor or dermatologist can recommend other treatment freezing off your warts, or removing them surgically. You might want to browse our HPV Overview for more details about HPV symptoms and treatment. 

Also, just so you know, there’s a type of skin cancer that is more likely to occur in people who have HIV and genital warts. This type of cancer, called squamous cell carcinoma, can sometimes occur within genital warts...or appear to be genital warts. Because you’ve been dealing with genital warts for a while, I think it’s a good idea to talk to your healthcare provider about your risk for this condition. 

If it turns out that you do have squamous cell carcinoma, it’s very easy to treat by simply removing the bad cells. 

Thanks for your question...and for taking charge of your health by seeking out the right treatments for your conditions, and by continually monitoring your body. 

Related info:

Ruthann M. Cunningham, MD

Dr. Cunningham is a member of the Analyte Physicans Group. She's also a member of the American College of Emergency Physicians, practicing at both Northwestern Lake Forest Hospital in Illinois and at Wheaton Franciscan All Saints Medical Center in Wisconsin. An ER physician since 2000, she regularly treats patients with STDs. Dr. Cunningham was educated at Wayne State University School of Medicine and completed her Emergency Medicine residency at Cook County Hospital in Chicago, IL.

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