The human papillomavirus (HPV) is best known as a sexually transmitted infection that can lead to cervical cancer, as well as anal, vaginal, and mouth and throat cancers. While it is often spread through sexual contact, HPV can be transmitted in other settings, too.

HPV can also cause genital warts, which are caused by different types of the virus than those that can lead to cancer.

Still other types of HPV can cause common skin warts or plantar warts, which grow on the bottoms of your feet.

HPV is actually a group of more than 150 related viruses. Each virus in the group has an assigned number, which is known as its HPV type (or serotype).

While both skin warts and genital warts may be distressing or even painful — and can be transmitted from one person to another, or even from one area of the body to another — the most concerning types of HPV are those that can cause precancerous changes in the cells they infect.

These precancerous changes, known as dysplasia, can occur in the cervix, vagina, vulva, anus, penis, or oropharynx (the area at the back of your mouth and throat that includes the base of your tongue and your tonsils).

Virtually all sexually active individuals are infected with one or more types of HPV in their lifetime. But many people never know they have HPV because they never develop any symptoms or experience other consequences of the infection.

While the body often clears an HPV infection within months to years, the infection may persist in some people. There is no treatment available that can rid the body of HPV, but some of the symptoms and consequences of HPV can be treated.

Types of HPV: Skin, Mucosal, High Risk, Low Risk

HPV lives in cells found on the surface of the skin and in the moist mucous membranes that line many areas of the body, such as the mouth and throat, cervix, vagina, and anus. How an HPV infection appears (or doesn’t) depends on the type of HPV and the location of the infection.

Skin Warts

About 75 percent of HPV types cause warts on the skin, such as on the arms, face, chest, hands, and feet.

In healthy people, the immune system can usually fight off the viruses that cause skin warts — limiting the number of warts people typically develop and making them eventually go away.

But this is often not the case in people whose immune systems are compromised, such as by human immunodeficiency virus (HIV), drugs to prevent organ rejection or to treat autoimmune diseases, or simply older age. In these people, HPV infection of the skin may cause more extensive warts that persist.

Genital Warts (Mucosal Warts)

The other HPV types — more than 40 of them — are considered mucosal types, meaning that they infect mucous membranes of the body. These are also known as genital or anogenital HPV types because they typically infect the anal or genital areas.

About 90 percent of anogenital warts are cause by HPV types 6 and 11.

These flat or protruding growths most commonly affect the following areas of the body:

Vulva (outside the vagina)
Shaft or under the foreskin of the penis

Warts from the same HPV types may also occur in the following areas:

Vagina or cervix
Urethra (tube through which urine exits the body)
Scrotum
Perineum (area between the genitals and anus)
Area around the anus
Inside the anus (most common in people who have receptive anal sex)
Inner nose, mouth, and throat
Inner eyelids

Low-Risk Mucosal HPV

Mucosal HPV types are categorized as either low risk or high risk.

Low-risk HPV types can cause genital warts, which may occur around the genitals and anus, as well as in the mouth and throat.

But most low-risk HPV types don’t cause any symptoms and are generally not a reason for anyone to be concerned.

High-Risk Mucosal HPV

High-risk HPV types can cause changes in mucosal cells that lead to cancer.

Scientists have identified about 14 high-risk HPV types, although HPV types 16 and 18 are responsible for most HPV-related cancers.

Signs and Symptoms of HPV

Different types of HPV and different locations of infection in the body can cause different symptoms.

Skin warts — which can vary in size, shape, and appearance — are growths on the skin surface that may range from fairly flat to protruding. It’s not always possible to know if a skin growth is a wart.

Genital warts may also range from flat to protruding, and are typically seen on mucosal or skin surfaces in the anal and genital region. They may be pink, brown, or flesh-colored, and may cause itching or discomfort.

Precancerous cell changes in the cervix cause no symptoms but can be detected with the Pap test, in which a sample of cells is collected and examined under a microscope.

Early vaginal, vulvar, and cervical cancers related to HPV may cause no symptoms, but advanced-stage cancer can lead to abnormal vaginal bleeding or discharge and pain during intercourse.

Signs and symptoms of oropharyngeal cancer may include persistent sore throat, a lump in the neck, and persistent ear pain.

Vocal cord cancers typically cause hoarseness or a change in the voice.

Early penile cancer may cause changes in skin color and thickening of the skin.

Signs and symptoms of anal cancer may include anal bleeding, pain, itching, or discharge; swollen lymph nodes in the anal or genital area; and changes in bowel habits and stool.

You should see your doctor if you have any signs or symptoms of HPV-related cancers.

Learn More About HPV Symptoms and Diagnosis

Causes and Risk Factors of HPV

Skin warts are spread through direct skin-to-skin contact with an infected person. You can also spread warts from one part of your body to another through touch. Children and teens, people who bite their nails or pick at hangnails, and people with a weakened immune system have a higher risk of getting common warts.

Mucosal HPV types are transmitted through intimate skin-to-skin contact — most commonly through vaginal or anal sex but also through oral sex. Anyone who's sexually active is at risk for getting HPV, even if you've had only one sexual partner.

You're at higher risk for genital or oral HPV if you:

Haven't been vaccinated against HPV
Have many sexual partners
Have a sexual partner with HPV
Have a sexual partner who has had many sexual partners or whose sexual history you don’t know
Don’t use a condom every time you have sex
Start having sex at a young age, especially under 18
Have had other STDs, especially chlamydia
Have a weakened immune system, such as from HIV or taking a drug that suppresses your immune response

Symptoms from HPV may develop years after you become infected, so it’s often impossible to know who transmitted the virus to you. Even with no symptoms, you can pass HPV on to other people, and you can get HPV from someone who doesn't show any symptoms.

How Is HPV Diagnosed?

Skin warts and genital warts can usually be diagnosed on sight during a physical examination, but your doctor may also refer you to a dermatologist to be sure your skin condition is a wart. Your dermatologist may take a biopsy, or small tissue sample, to examine under a microscope.

To help diagnose genital warts, your doctor may apply an acetic acid solution to the area to lighten the warts, making them more visible.

If you're a woman with detectable genital warts, your doctor may also perform a colposcopy (a procedure that uses a light and a low-power microscope) to find genital warts on your cervix that are too small to see with the naked eye.

Women can be screened for HPV infection of the cervix with the HPV test, which is done by removing some cervical cells with a swab and testing them for the presence of HPV. The test can detect HPV types 16 and 18, and can provide broad results for other high-risk (cancer-causing) HPV types in cervical tissue.

Women who have a positive HPV test should seek advice from a doctor on how best to follow up to prevent cervical cancer. Depending on a number of individual factors, your doctor may recommend a repeat test in one to three years, a colposcopy or cervical biopsy, or treatment for precancerous changes to the cervix.

Duration and Prognosis of HPV

In many cases, the immune system fights off HPV, so a person never develops symptoms and tests negative on an HPV test, if such a test is available for the body part that came into contact with the virus.

In other cases, the immune system does not prevent the virus from infecting the cells, but the infection doesn’t immediately cause symptoms. In fact, it may never cause symptoms, but the virus can be transmitted to another person through skin-to-skin or sexual contact.

And in still other cases, an HPV infection causes abnormal changes in the infected cells that can eventually develop into cancer. The time between an infection and the development of precancerous changes or cancer may be years or even decades.

The earlier HPV-related symptoms are found, the more likely they can be treated successfully.

Treatment and Medication Options for HPV

How HPV is treated depends on how it is affecting you.

If you have a skin wart, you may choose to leave it until it goes away on its own, treat it with an over-the-counter product, or see your doctor for treatment.

For genital warts, your doctor can prescribe several topical medicines to apply to external warts at home. Genital warts may also be treated in a doctor’s office with topical medication, cryotherapy (freezing the warts), or surgical removal. Topical medication may need to be applied repeatedly for weeks or even months to fully treat genital warts. Cryotherapy may need to be repeated multiple times.

Similar medical and surgical therapies may be used for warts located on the cervix or in the vagina, anus, or urethra. Precancerous lesions in the cervix may be removed using cryotherapy, surgery, or other techniques.

And cancers caused by HPV are treated with standard cancer therapies, including chemotherapy, radiation therapy, and surgery.

Learn More About How HPV Is Treated

Prevention of HPV

The best way to protect yourself against genital warts and cancer caused by HPV is to get the HPV vaccine.

The HPV vaccine currently used in the United States, Gardasil 9, protects against HPV types 6 and 11, which cause most cases of genital warts; 16 and 18, which cause most cases of HPV-related cancer; as well as five other types that can cause cancer (31, 33, 45, 52, and 58).

In the United States, the HPV vaccine is approved for children and adults ages 9 to 45. Routine vaccination is recommended at age 11 or 12, and through age 26 if you didn’t receive the full vaccine schedule before that.

Two doses of the vaccine are recommended for most people who receive it before age 15, while three doses are recommended for anyone who starts the vaccine schedule after that.

An analysis published in June 2019 in the journal The Lancet examined the impact of HPV vaccination, using data from 60 million people in 14 countries that had set up HPV vaccine programs in the previous 10 years. It showed that high-risk HPV infections dropped by 83 percent among girls and women ages 13 to 19, and by 66 percent among women ages 20 to 24. For genital warts, the incidence dropped by 67 percent among girls and women ages 15 to 19, by 54 percent among women ages 20 to 24, and by 31 percent among women ages 25 to 29. Precancerous cervical lesions also dropped, by 51 percent among girls and women ages 15 to 19, and by 31 percent among women ages 20 to 24.

The study further showed that the incidence of genital warts dropped by 48 percent among boys and men ages 15 to 19, and by 32 percent among men ages 20 to 24.

At least two other studies have found that HPV vaccination lowers rates of oropharyngeal HPV infections. One study, published in January 2018 in the Journal of Clinical Oncology, included young adults ages 18 to 33 in the United States from 2011 to 2014. It found that getting at least one dose of an HPV vaccine was linked to an 88.2 percent lower risk for oral HPV.

The second study, published in June 2020 in The Journal of Infectious Diseases, included men who have sex with men and transgender women ages 18 to 26 in three U.S. cities from 2016 to 2018. It found that getting at least one dose of an HPV vaccine by age 18 was linked to a 59 percent lower risk for oral or anal HPV, while getting the vaccine after age 18 was linked to an 18 percent lower risk.

Rates of HPV vaccination are steadily rising in the United States. The proportion of adolescents ages 13 to 17 who had received at least one dose of the HPV vaccine increased from 71.5 percent in 2019 to 75.1 percent in 2020.

The equivalent numbers were 65.5 percent in 2017 and 68.1 percent in 2018.

Learn More About the HPV Vaccine

Complications of HPV

The most serious potential complication of HPV infection is cancer. But most HPV types aren’t known to cause cancer, and most cases of any HPV type are cleared by the body within two years.

HPV is believed to cause over 90 percent of cases of cervical and anal cancer, about 70 percent of cases of vaginal and vulvar cancer, and about 60 percent of cases of penile cancer, according to the Centers for Disease Control and Prevention (CDC).

While oropharyngeal cancer has traditionally been linked to using tobacco and alcohol, more recent studies show that 60 to 70 percent of these cancer cases may be linked to HPV.

Cervical Cancer

Cervical cancer was once a leading cause of cancer deaths for women in the United States, but this death rate has dropped substantially since the development of the Pap test, which looks for precancerous changes to cells in the cervix.

More recently, the HPV test was developed to directly test for HPV infection in the cervix, even before any precancerous changes take place. Both the Pap test and HPV test maybe used for cervical cancer screening.

Even though cervical cancer is now almost entirely preventable, the American Cancer Society estimates that in 2022, about 14,100 new cases of invasive cervical cancer will be diagnosed, and about 4,280 women will die from cervical cancer.

Most cases of invasive cervical cancer are found in women who have not had regular screening tests. While the typical age range for a cervical cancer diagnosis is 35 to 44, more than 20 percent of cases are diagnosed in women over age 65.

Learn More About HPV in Women

Oral Cancer

Oropharyngeal cancer develops on the back and sides of the throat, tonsils, and base of the tongue.

About 12,100 cases of HPV-associated oropharyngeal cancer are diagnosed in men in the United States each year, compared with about 2,300 cases in women.

The rate of oropharyngeal cancer linked to HPV has increased greatly in recent decades. This form of oropharyngeal cancer is more common in younger people with a history of multiple sex (including oral sex) partners but no history of tobacco use or heavy alcohol use.

It’s believed that people get oral HPV from oral sex, although why men develop HPV-associated oropharyngeal cancer so much more than women is not known.

Research and Statistics: Who Has HPV?

It’s difficult to estimate how many people have genital HPV at any given time, since the infection often causes no symptoms and the only widely used screening test is for the cervix.

For most people, the first sign of a mucosal HPV infection is the appearance of genital warts or the signs and symptoms of some form of HPV-related cancer — the most serious consequence of HPV infection.

About 42.5 million people are living with HPV in the United States, while there are 13 million new cases each year.

Each year an estimated 46,143 people in the United States develop HPV-related cancers — cancers that are often caused by HPV. Out of these cancer cases, an estimated 36,500 are actually caused by HPV.

An average of 34,800 cancers reported annually in the United States from 2012 to 2016 were attributable to HPV. Out of these, 92 percent were caused by HPV types targeted by the HPV vaccine. The most common HPV-related cancers were oropharyngeal cancer (with 12,600 cases) and cervical cancer (with 9,700 cases).

The incidence of oropharyngeal cancer increased by about 0.8 percent each year from 2009 to 2018, according to the American Cancer Society. This increase can be explained almost entirely by HPV-related forms of the cancer in non-Hispanic white people.

The incidence of cervical cancer, on the other hand, remained stable between 2009 and 2018 but dropped by more than 50 percent between the mid-1970s and the mid-2000s. Since the mid-1970s, the five-year survival rate for cervical cancer has barely changed, from 69 percent between 1975 and 1977 to 66 percent between 2011 and 2017.

Race, Ethnicity, and HPV Prevalence

HPV can infect anyone, but different populations within the United States have been found to have different rates of infection in various areas of the body, as well as different rates of HPV-related cancers.

Such variability may reflect differences in prevailing community behavior, biology, or unequal access to screening tests and medical care.

The CDC publishes estimates of HPV infections by race and ethnicity, based on data from the National Health and Nutrition Examination Survey, a survey designed to monitor the health and nutritional status of the overall U.S. population.

The most recent estimates were published in April 2017 and are based on data from 2011 to 2014 for genital HPV and from 2013 and 2014 for oral HPV among adults ages 18 to 69. The CDC found the following:

The prevalence of any genital HPV and of high-risk genital HPV was lowest among Asian men and women and highest among non-Hispanic Black men and women, with both non-Hispanic white and Hispanic men and women in between.
The prevalence of any oral HPV and of high-risk oral HPV was lowest among Asian adults, while the rate of any oral HPV was highest among non-Hispanic Black adults.

While rates of HPV vaccination have been on the rise, there are differences in this rate by race and ethnicity, according to CDC data from 2013 to 2018, including adults ages 18 to 26:

Non-Hispanic white men and women were most likely to have received at least one dose of the HPV vaccine (42.1 percent), followed by non-Hispanic Black adults (36.7 percent) and Hispanic adults (36.1 percent).
Among women, the HPV vaccination rate was highest for non-Hispanic white adults (57.9 percent), followed by Hispanic adults (48.8) and non-Hispanic Black adults (44.7).
Among men, the HPV vaccination rate was highest for non-Hispanic Black adults (29.4 percent), followed by non-Hispanic white adults (26.6) and Hispanic adults (24.7).

Using data from cancer registries, the CDC also published estimates of new cases of HPV-associated cancers among Americans of different races and ethnicities based on data from 2014 to 2018:

Among both men and women, white adults had the highest incidence of HPV-associated cancers, while Asian and Pacific Islander adults had the lowest incidence.
For women of all races and ethnicities, cervical cancer was the most common HPV-associated cancer.
For men of all races and ethnicities, oropharyngeal cancer was the most common HPV-associated cancer.

Related Conditions

HPV is one of several common sexually transmitted infections (STIs), also called sexually transmitted diseases. Others include chlamydia, gonorrhea, syphilis, herpes, and HIV/AIDS.

Unlike HPV, which is a viral infection, chlamydia, gonorrhea, and syphilis are caused by bacteria. All three bacterial STIs can be cured by antibiotics, although some strains of the bacteria that cause gonorrhea have become resistant to most antibiotics.

Like HPV, genital herpes and HIV/AIDS are caused by viruses and cannot be cured, although they can be treated — both to reduce symptoms in the person who is infected and to reduce the likelihood of spreading the virus to others.

Resources We Love

If you want to learn more about HPV, the websites of these organizations can help.

American Academy of Dermatology

Get the lowdown on skin warts — their symptoms, treatment, and prevention — from experts on skin and skin care.

American Sexual Health Association

Learn the basics on sexually transmitted forms of HPV, including common myths and facts, and information on the connection between HPV and cervical cancer.

Centers for Disease Control and Prevention

The CDC offers information for parents on having their children vaccinated against HPV, as well as HPV fact sheets written specifically for men and for young women.

Cleveland Clinic

Check out Cleveland Clinic’s Health Library for information on oropharyngeal cancer caused by HPV.

Mayo Clinic

Plantar warts — those that occur on the bottom of the feet — can make walking painful. The Mayo Clinic explains how to identify them and how they can be treated.

MedlinePlus

This government website provides links to numerous resources on warts, including how to identify and treat them.

National Cancer Institute

The National Cancer Institute provides an in-depth discussion of the HPV vaccine, which protects against seven types of HPV that can cause cancer, as well as two that cause most genital warts.

National Cervical Cancer Coalition

This program of the American Sexual Health Association focuses on cervical cancer information and prevention, and offers an online support platform for people dealing with this form of cancer.

Office of Women’s Health

Get the information you need on genital warts, including what they are, how you get them, and what effect, if any, they could have on a pregnancy.

Planned Parenthood

For information on sexually transmitted types of HPV or for help getting tested, Planned Parenthood is the place to turn. Call 800-230-PLAN (7526).

Sex, Etc.

This is a website for teens, by teens. Sex, Etc. offers frank talk on sexually transmitted infections including HPV, as well as on relationships and communicating about sex with parents and peers.

Learn More About Sexual Health Resources

Additional reporting by Quinn Phillips.

Editorial Sources and Fact-Checking

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HPV and Cancer. National Cancer Institute. October 25, 2021.
Bayan S, Faquin WC, Zeitels SM. Glottic Carcinoma in Young Patients. Annals of Otology, Rhinology, and Laryngology. January 2019.
HPV Infection. Mayo Clinic. October 12, 2021.
What Are the Symptoms of HPV? Planned Parenthood.
Common Warts. Mayo Clinic. April 30, 2022.
Risk Factors for Cervical Cancer. American Cancer Society. January 3, 2020.
Next Steps After an Abnormal Cervical Cancer Screening Test: Understanding HPV and Pap Test Results. National Cancer Institute. March 22, 2022.
HPV Vaccination Recommendations. Centers for Disease Control and Prevention. November 16, 2021.
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Pingali C, Yankey D, Elam-Evans LD, et al. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2020. Morbidity and Mortality Weekly Report. September 2021.
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Cancers Associated With Human Papillomavirus (HPV). Centers for Disease Control and Prevention. December 13, 2021.
Key Statistics for Cervical Cancer. American Cancer Society. January 12, 2022.
How Many Cancers Are Linked With HPV Each Year? Centers for Disease Control and Prevention. December 13, 2021.
Risk Factors for Oral Cavity and Oropharyngeal Cancers. American Cancer Society. March 23, 2021.
Sexually Transmitted Infections Prevalence, Incidence, and Cost Estimates in the United States. Centers for Disease Control and Prevention. January 25, 2021.
Senkomago V, Henley SJ, Thomas CC, et al. Human Papillomavirus–Attributable Cancers — United States, 2012–2016. Morbidity and Mortality Weekly Report. August 2019.
Cancer Facts and Figures 2022. American Cancer Society.
McQuillan G, Kruszon-Moran D, Markowitz LE, et al. Prevalence of HPV in Adults Aged 18–69: United States, 2011–2014. Centers for Disease Control and Prevention. April 2017.
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What Is HPV? Symptoms, Causes, Diagnosis, Treatment, and Prevention