Preventing genital warts

Photo of a girl getting an HPV shot

Genital warts are caused by certain types of human papillomavirus (HPV). They are mainly passed on through sex. One way to lower your risk of catching genital warts is by using condoms. But HPV vaccines offer the best protection.

Genital warts (also known as “anogenital warts”) are one of the most common infections that can be spread through vaginal, anal or oral sex. They aren’t cancer, but they can be unpleasant and have a negative impact on your sex life and quality of life.

The warts are usually caused by type 6 and type 11 human papillomaviruses (HPVs) that have entered the skin. There is an effective, safe vaccine that provides protection against the viruses. It is recommended for teenagers, before they have sexual contact for the first time. It also protects the person against HPV types that can cause potentially cancerous changes in the cells. That means it can prevent cervical cancer and other types of cancer too.

How can you protect yourself and others?

A good place to start is by finding out about sexually transmitted infections (STIs) and how they’re passed on. You might want to ask your doctor or your local health department. Then you can assess your own risk and decide whether and how you want to protect yourself – for instance, by getting yourself vaccinated against HPV.

Condoms and femidoms (condoms for women) can also prevent HPV infections. But they don’t provide complete protection against genital warts because they only cover the penis or vagina. The problem is that the viruses can also occur in nearby areas of skin (like the scrotum, perineum or bottom), which means they can be passed on through intimate contact with those areas too.

Germicidal products that women can put in their vagina before sex haven’t been proven to prevent genital warts. No other precautions are known to help either.

If you’ve got genital warts, it’s important to protect others as well as get yourself treated. So you need to tell anyone you might have infected. It is also important that you don’t have sex with anyone who hasn’t had an HPV vaccine until you finish the treatment and your warts have gone. This might not always be necessary, though, so it’s a good idea to ask a doctor what protective measures you need to take.

What do HPV vaccinations do?

Human papillomavirus (HPV) vaccinations protect you against all the different types of health problems HPVs can cause. HPV types 6 and 11 cause non-cancerous genital warts. Other HPV types can cause changes in tissue, particularly around the cervix, which can develop into cancer.

Two HPV vaccines are available in Germany. One of them provides protection against nine HPV types, including HPV 6 and 11. It is a newer version of a previous, 4-in-1 vaccine. As well as giving protection against the two viruses that cause genital warts, the 9-in-1 vaccine protects you against seven HPV types that increase the risk of cancer.

When is the right time for HPV vaccination?

HPV is mainly passed on through sex, so the aim is to make sure people have all their jabs before their first sexual contact. The recommendation in Germany is to vaccinate girls and boys between the ages of 9 and 14. At the latest, they should have had any missed doses by the age of 18. Adults looking to protect themselves against genital warts can get vaccinated too, but not all health insurers will pay then. To be on the safe side, it’s best to ask your insurance company.

The second dose isn’t needed until at least five months after the first one. If you got your second shot earlier, or didn’t have the first one until after your 15th birthday, you’ll need three shots overall.

How well do HPV vaccines prevent genital warts?

HPV has been proven to prevent the development of cancerous changes in the skin. There is also reliable that the 9-in-1 vaccine prevents genital warts. But there is not as much data on this. Research has tended to focus on the (older) 4-in-1 vaccine, which has been compared with a placebo in several studies. This is what was found:

The 4-in-1 vaccine prevents genital warts in girls and also in women who have already had sex. One group of researchers concluded this after analyzing four studies involving more than 20,000 participants overall. Most of the participants were between the ages of 16 and 26. They were given either the vaccine or a placebo and then – in most cases – monitored for the following two to three years. During this time period, genital warts developed in

  • 15 out of 1,000 participants who had been given a placebo and
  • 6 out of 1,000 participants who had been vaccinated.

Less data is available for boys and men. But a study involving over 4,000 male participants between the ages of 16 and 26 also showed that the 4-in-1 vaccine provided protection against genital warts. It found that genital warts developed within three years in

  • 35 out of 1,000 participants who had been given a placebo and
  • 12 out of 1,000 participants who had been vaccinated.

Research suggests that the vaccine is even more effective in people who haven’t yet had sex or contact with human papillomaviruses.

What are the possible side effects and what else should you know?

Most people don’t have any problems with HPV vaccines. Possible side effects include reddening, swelling and soreness around the injection site, but they’re usually harmless. Serious side effects, like an allergic reaction, are very rare.

If you have a feverish illness (such as a bad cold) on the scheduled date, it’s best to postpone the appointment. But you can still have the shot if you only have a minor – like a runny nose or a slight temperature. Pregnant people are better off postponing the HPV until after they’ve given birth. But there’s currently no that it’s dangerous for the unborn baby. It is generally possible to have the vaccine if you’re breastfeeding.

Bergman H, Buckley BS, Villanueva G et al. Comparison of different human papillomavirus (HPV) vaccine types and dose schedules for prevention of HPV-related disease in females and males. Cochrane Database Syst Rev 2019; (11): CD013470.

Gilson R, Nugent D, Werner RN et al. 2019 IUSTI-Europe guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol 2020; 34(8): 1644-1653.

Henderson JT, Henninger M, Bean SI. Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections: A Systematic Evidence Review for the U.S. Preventive Services Task Force. (AHRQ Evidence Syntheses; No. 192). 2020.

Lukács A, Máté Z, Farkas N et al. The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis. BMC Public Health 2020; 20(1): 691.

Obiero J, Ogongo P, Mwethera PG et al. Topical microbicides for preventing sexually transmitted infections. Cochrane Database Syst Rev 2021; (3): CD007961.

Paul-Ehrlich-Gesellschaft für Chemotherapie (PEG). Evidenz- und konsensbasierte Leitlinie Impfprävention HPV-assoziierter Neoplasien (S3-Leitlinie). AWMF-Registernr.: 082-002. 2020.

Robert Koch-Institut (RKI). Empfehlungen der Ständigen Impfkommission beim Robert Koch-Institut 2022. Epidemiologisches Bulletin 2022; 4.

Tejada RA, Vargas KG, Benites-Zapata V et al. Human papillomavirus vaccine efficacy in the prevention of anogenital warts: systematic review and meta-analysis. Salud Publica Mex 2017; 59(1): 84-94.

Villa A, Patton LL, Giuliano AR et al. Summary of the evidence on the safety, efficacy, and effectiveness of human papillomavirus vaccines: Umbrella review of systematic reviews. J Am Dent Assoc 2020; 151(4): 245-254.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on January 2, 2023

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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