Some people will be infected with a strain that does not produce warts, or they will remain asymptomatic (i.e. no warts will appear), even though the virus is present in the skin or mucous membranes around the genital area, or on the cervix in women. Those who do go on to develop genital warts will usually notice them 1 to 3 months after initial infection.

If symptoms do appear then the infected person may notice pinkish/white small lumps or larger cauliflower-shaped lumps on the genital area. Genital warts can appear on or around the penis, the scrotum, the thighs or the anus. In women genital warts can develop around the vulva or inside the vagina and on the cervix. If a woman has warts on her cervix, this may cause slight bleeding or, very rarely, an unusual coloured vaginal discharge. Warts may occur singly or in groups. The warts may itch, but they are usually painless. Sometimes genital warts can be difficult to spot. In severe cases, it is possible for genital warts to spread from the genitals to the area around the anus, even if anal intercourse has not occurred.

Occasionally, people can confuse skin problems caused by other STDs (such as genital herpes, syphilis or molluscum) with genital warts. Other people may become very worried because they mistake perfectly normal and non-infectious lumps and bumps for genital warts. Conditions that may be confused with genital warts include:

Pearly penile papules – small white or skin-coloured bumps that, when numerous, appear in a ring around the edge of the head of the penis. More rarely, similar papules may be found on the vulva.
Angiokeratomas – bright red or purple spots that look a little like blood blisters.
Sebaceous glands (also known as ‘Fordyce spots’) – hard white, yellowish or skin-coloured little bumps that may be found all over the skin of the penis and scrotum in men, and the vulva in women. Sebaceous glands produce a substance called sebum, which keeps the skin healthy.
Pimples or spots – caused by blocked sebaceous glands. Pimples and spots can form just as easily around the genital area as they do on the face, and may become sore and inflamed in a similar way.

All of the above are common, non-infectious skin manifestations that are not sexually transmitted. Any doubt about lumps and bumps on the genitals can usually be resolved by a visit to a doctor.