Anal HPV

Anal HPV: What It Is, Why It Matters, and How to Treat It
By Dr. Rodney Kratz, Board-Certified Colon & Rectal Surgeon
Precision Proctology, Seattle–Edmonds

 
 
 
What Is Anal HPV?
Human papillomavirus (HPV) is the most common sexually transmitted infection in the world. When it affects the anal canal or surrounding skin, it’s called anal HPV. Many people with anal HPV have no symptoms at all, yet the virus can still cause important changes in tissue that require expert monitoring.

There are two main types:

Low-risk HPV: causes anal warts (condyloma).
High-risk HPV: causes invisible cellular changes (dysplasia) that can progress to anal cancer if untreated.
Who Gets Anal HPV?
Anyone can get anal HPV—regardless of sexual orientation or gender. It spreads through skin-to-skin contact, including anal intercourse, genital contact, or even without penetration.

Higher-risk groups include:

Men who have sex with men
People with a history of genital warts
Individuals with weakened immune systems
Patients with a history of cervical or vulvar HPV
Anyone with new or multiple sexual partners
But many of my patients are otherwise healthy individuals who simply never noticed symptoms until something changed.

 
Common Symptoms of Anal HPV
Some patients feel nothing. Others experience:

Small bumps or growths (soft, pink, or flesh-colored)
Itching or irritation
Minor bleeding
Moistness or a feeling of “something there”
Changes in bowel habits (rare)
Remember: High-risk HPV doesn’t make warts. It causes silent changes you cannot see. That’s why expert evaluation matters.

 
What Do Anal Warts Look Like?
 
 
 
Anal warts (condyloma) may appear as:

Single small bumps
Clusters resembling cauliflower
Flat, smooth lesions that are easy to miss
They often spread beyond what is visible externally, which is why a colorectal surgeon performing anoscopy is the gold standard for diagnosis.

 
How I Diagnose Anal HPV
My exam is extremely quick—typically under 2 minutes—and performed in a private, comfortable setting. It may include:

Visual inspection
High-resolution anoscopy (HRA) when appropriate
Biopsy for any concerning areas
HPV testing for high-risk strains
You’ll understand your findings immediately and receive a clear plan.

 
Anal HPV Treatment Options
Treatment depends on what type of HPV is present and whether warts, dysplasia, or both are found.

1. Office-Based Wart Removal
Cryotherapy
Chemical treatments
Electrocautery
Infrared coagulation
Excision for larger lesions
Most are fast, minimally painful, and require no downtime.

2. Treatment of High-Risk HPV / Dysplasia
If high-risk HPV has caused precancerous changes, I may recommend:

Ablation during high-resolution anoscopy
Targeted removal of abnormal tissue
Ongoing surveillance every 3–12 months
My goal: eliminate disease early and prevent progression to anal cancer.

3. HPV Vaccination
The HPV vaccine is beneficial even for adults and reduces recurrence and future risk.

 
Can Anal HPV Turn Into Cancer?
High-risk HPV can lead to anal intraepithelial neoplasia (AIN), which can progress to anal cancer if untreated.
Early treatment dramatically reduces the risk.

Most patients do extremely well with early detection and expert care.

 
How Long Does Anal HPV Last?
In many healthy adults, HPV clears within 1–2 years.
However, persistent infection can occur, especially with high-risk strains.
Treatment focuses on controlling the virus, removing visible disease, and preventing recurrence.

 
Prevention: How to Reduce Your Risk
Get the HPV vaccine
Use barrier protection
Avoid smoking (slows immune clearance)
Treat warts or dysplasia early
Schedule annual exams if you’re in a high-risk group
 
When to See a Specialist
You should schedule an evaluation if you notice:

New anal bumps or growths
Itching, bleeding, or discomfort
A history of HPV and no recent follow-up
A partner with HPV
Concerns about anal cancer risk
Early evaluation is simple, quick, and reassuring.

 
Expert Anal HPV Care in Seattle – Edmonds
As a board-certified Colon & Rectal Surgeon with more than 20 years of experience, I specialize in precision evaluation and treatment of anal HPV, anal warts, and dysplasia with an approach designed for privacy, comfort, and results.

Book Your Private Consultation
Precision Proctology
📞 425-410-0569
Seattle | Edmonds
Discreet, expert care for anal health.