HPV (human papillomavirus) is the most common sexually transmitted infection, a family of more than 200 viruses spread by genital skin contact. Low-risk types cause genital warts; high-risk types can cause cancer. Most infections clear on their own within two years, and the wart types don't cause cancer.
within 2 years
prevents, doesn't treat
| Item | Value |
|---|---|
| Clears on its own | 9 in 10 — within 2 years |
| Wart types | 6 & 11 |
| Cancer types | 16, 18 + |
| Vaccine | Gardasil 9 — prevents, doesn't treat |
What is HPV?
HPV is a group of related viruses that infect skin and the moist linings of the genitals, anus, mouth, and throat. It's the most common STI in the US CDC, so common that nearly every sexually active person encounters at least one type at some point. The virus enters through tiny breaks in the skin or mucosa during contact and sets up shop in the basal cells of that surface.
HPV splits into two camps that behave completely differently. Low-risk types — chiefly 6 and 11 — cause genital warts but never cancer. High-risk types — 16, 18, and a handful of others — can, over years, drive cellular changes that lead to cancer. The types that cause warts don't cause cancer, and the cancer types rarely cause anything you can see or feel. People constantly blur the two together, and keeping them separate keeps the situation in proportion.
In most cases — roughly nine out of ten — your immune system clears HPV within about two years without ever causing a health problem. Cancer comes from a high-risk infection that the body fails to clear and that quietly persists for a long time.
What are the symptoms — and the silent reality?
High-risk HPV produces no symptoms at all. Most HPV infections are asymptomatic and produce no clinical disease, which is what makes high-risk infection dangerous. You can carry it, transmit it, and slowly develop precancer with nothing to warn you. No ache, no discharge, no visible sign. Screening is the only way to catch high-risk HPV.
Genital warts are the visible side of HPV, caused by the low-risk types. A wart usually shows up as a small bump or a cluster of bumps in the genital area; they may be flat, raised, or cauliflower-shaped, and they're typically painless. Because warts can appear months or even years after you acquired the virus, you generally can't pin down when or from whom you got it. The CDC doesn't state a fixed incubation window, and the time of acquisition can't be determined.
How does HPV spread?
HPV passes through intimate skin-to-skin contact, most commonly during vaginal or anal sex. Penetration isn't required; close genital skin contact is enough, part of why condoms only partly protect against it. The virus can also pass through oral sex, infecting the mouth and throat, which is the route behind HPV-related oropharyngeal (throat) cancers, now more common in the US than cervical cancers.
Because warts can surface long after exposure, a new wart doesn't mean a partner was unfaithful. If you're trying to figure out timing after a specific encounter, read how when to test after exposure works for different infections, though for HPV there's no clean post-exposure test.
How is HPV tested?
HPV isn't part of a standard STD panel, and there's no general blood or urine test for it. For people with a cervix, high-risk HPV is detected through cervical screening — either an HPV test on cervical cells or a Pap (cytology) that looks for abnormal cells the virus may have caused. We break down the difference in hpv pap smear vs hpv test.
There's no routine HPV test for men. HPV testing isn't recommended to screen men, adolescents, or women under age 30 CDC Pink Book, because the result wouldn't change anything: there's no treatment for the virus and most infections clear. HPV testing also isn't used to diagnose warts; warts are a visual diagnosis, and an HPV test wouldn't confirm them or guide care.
Current cervical screening follows USPSTF guidance USPSTF 2018. Newer guidance from the American Cancer Society starts screening at age 25 with a primary HPV test every five years as the preferred approach ACS, rather than a yearly Pap. Most HPV clears within two years, and HPV testing catches more real precancer with fewer visits.
| Age group | USPSTF (2018) options |
|---|---|
| Under 21 | No screening recommended |
| 21–29 | Cytology (Pap) every 3 years |
| 30–65 | Cytology every 3 years, OR high-risk HPV test alone every 5 years, OR co-testing every 5 years |
| Over 65 | No screening (with adequate prior screening) |
Anal screening is a gray area. CDC's 2021 guidance found data insufficient to recommend routine anal cytology, even for men who have sex with men or people with HIV. After the 2022 ANCHOR trial showed that treating anal high-grade lesions reduced anal cancer in people with HIV, some specialty groups now suggest periodic anal Pap for high-risk groups where referral for high-resolution anoscopy exists, though that's not a blanket CDC recommendation. If you're due for general testing, you can get tested for other STIs and compare testing providers for cost and convenience.
How is HPV treated?
There's no cure for the virus itself. Treatment targets what HPV causes — warts or precancer — not the infection underneath. Genital warts can be cleared, but treatment doesn't remove the virus, so warts can recur and you may need more than one round.
For warts, you generally choose between a patient-applied prescription cream and an in-office procedure CDC STI Tx Guidelines:
- Patient-applied at home over weeks: imiquimod cream, podofilox solution or gel, or sinecatechins ointment (sinecatechins aren't recommended for immunocompromised or HIV-positive patients).
- Provider-administered in clinic: cryotherapy (freezing with liquid nitrogen or a cryoprobe), trichloroacetic or bichloroacetic acid solution, or surgical removal by excision, curettage, laser, or electrosurgery.
None of these is clearly best. The right choice depends on how many warts there are, where they sit, and your preference. In practice a clinic freezes them or you treat them at home, it can take weeks, and because the virus stays put, recurrence is common. Cancer precursors are a separate matter, managed by a specialist through procedures targeting the abnormal cells, never with wart creams.
What happens if high-risk HPV is left untreated?
Most HPV clears and nothing happens. The risk lies in a high-risk infection that persists. Over years, persistent high-risk HPV can progress through precancerous cellular changes to cancer in several sites NCI:
- Cervical cancer — HPV causes virtually all of it, which is why cervical screening exists.
- Anal cancer — over 90% of cases are HPV-driven.
- Oropharyngeal (throat) cancer — about 70% are caused by HPV, and this has now overtaken cervical as the most common HPV-related cancer in the US.
- Vulvar, vaginal, and penile cancers — less common, but also linked to persistent high-risk HPV.
Types 16 and 18 alone cause about two-thirds of cervical cancers, and five other high-risk types add roughly another sixth. Screening works because the timeline is slow. It catches precancer years before it would become cancer, when it's easily treated.
How do you prevent HPV?
Three tools stack together, and vaccination is the strongest. Given at the recommended ages, the HPV vaccine can prevent more than 90% of HPV-caused cancers, and Gardasil 9 is about 98% effective against the precancers caused by HPV 16 and 18 American Cancer Society.
The shot used in the US today is Gardasil 9, which protects against nine types: 6, 11, 16, 18, 31, 33, 45, 52, and 58 — the cancer-causing high-risk types plus 6 and 11, which cause more than 90% of genital warts. Since 2016 only Gardasil 9 has been distributed in the US, so it covers more cancer-causing types than the older quadrivalent Gardasil or bivalent Cervarix. It won't clear an infection or warts you already have, and vaccinated people still need cervical screening. If you're weighing it, see hpv vaccine - mandatory or not? and the safety record in hpv vaccine side effects.
Condoms give partial protection, since HPV can infect skin a condom doesn't cover, so they lower risk without eliminating it. Cervical screening is the third pillar. It doesn't prevent infection, but it catches the precancer that matters before it turns into cancer.
When should you see a clinician?
See a clinician if you notice a new bump or cluster of bumps in the genital or anal area, if you're due for cervical screening, or if you want the HPV vaccine. Bring up screening early — guidance now favors starting around your mid-twenties, and a single HPV test can cover several years. If you have HIV or another reason for higher risk, ask specifically about anal screening and whether anoscopy referral is available where you live.