HPV: What You Need to Know About Symptoms, Testing, and Treatment

HPV (human papillomavirus) is the most common sexually transmitted infection — nearly everyone who is sexually active will be exposed at some point. The reassuring news is that the immune system clears about 90% of infections on its own within two years. This guide explains the difference between low-risk and high-risk HPV, how it spreads, what screening and vaccination can do, how genital warts and abnormal results are managed, and when to involve a provider.

What Is HPV

Human papillomavirus is a group of more than 100 related viruses, around 40 of which infect the genital area, mouth, and throat. They fall into two broad categories that matter for your health:

• Low-risk types (such as HPV 6 and 11) can cause genital warts but do not cause cancer.
• High-risk (oncogenic) types (such as HPV 16 and 18) do not cause warts but, if an infection persists for years, can lead to precancerous cell changes and, eventually, cancer of the cervix, anus, penis, vagina, vulva, or the back of the throat (oropharynx).

HPV is extraordinarily common. The Centers for Disease Control and Prevention estimates that nearly all sexually active people will get HPV at some point. For the large majority, it never causes any problem: the immune system clears roughly 90% of infections within one to two years. Cancer develops only in the small fraction of cases where a high-risk infection persists undetected over many years, which is exactly what screening is designed to catch early.

Symptoms and How HPV Spreads

Most HPV infections cause no symptoms at all, which is a large part of why the virus spreads so easily — people transmit it without knowing they have it. When symptoms do appear, the most visible sign is genital warts: soft, flesh-colored or gray growths that can be flat or raised, single or clustered (sometimes described as cauliflower-like), and that may itch but are usually painless. They can appear on the genitals, around the anus, or rarely in the mouth or throat. High-risk types, by contrast, produce no warts and no symptoms — they are detected only through screening or after they have caused cell changes.

HPV spreads through close skin-to-skin contact, most often during vaginal, anal, or oral sex. Because it lives on skin not always covered by a condom, it can pass between partners even without penetrative sex. Importantly, there is no reliable way to know exactly when or from whom an infection was acquired; the virus can stay dormant for years, so a new diagnosis does not point to a recent or specific partner.

Testing and Cervical Screening

There is no general blood test for HPV and no routine HPV screening for people without a cervix — in those cases, the virus is usually identified only if warts appear or an abnormal result turns up. For people with a cervix, however, screening is well established and highly effective at preventing cervical cancer. Current guidance generally recommends:

• Ages 21 to 29: a Pap test every 3 years.
• Ages 30 to 65: primary HPV testing every 5 years (preferred), or co-testing (Pap plus HPV) every 5 years, or a Pap test alone every 3 years.

Newer guidance also supports self-collected HPV samples as an option to expand access, though a Pap (cytology) sample must still be collected in person. If a result comes back abnormal — commonly reported as ASC-US, LSIL, or HSIL — it almost always means HPV-related cell changes, not cancer. Each result has a defined next step under current ASCCP guidelines, which may be repeat testing in 12 months, HPV reflex testing, or referral for colposcopy. Your provider will walk you through what your specific result means and what comes next.

Treatment and Vaccination

There is no medication that cures the HPV virus itself; treatment targets the problems it can cause. Genital warts, when treatment is desired, can be managed with prescription topical medications applied at home, such as imiquimod or podofilox, or with in-office procedures like cryotherapy (freezing), trichloroacetic acid, or surgical removal. When clinically appropriate, a provider can prescribe a home topical and arrange follow-up. Clearing visible warts does not remove the underlying virus, and warts can recur, but most infections are eventually cleared by the immune system. Precancerous cervical changes are treated separately, typically through procedures that remove the affected tissue once colposcopy confirms them.

Prevention is where HPV care has its greatest impact. The Gardasil 9 vaccine protects against the types responsible for most HPV-related cancers and genital warts. It is approved for ages 9 through 45 and is most effective when given before any exposure — routine vaccination is recommended at ages 11 to 12 (and can start at 9), with catch-up vaccination recommended through age 26. For adults ages 27 to 45, vaccination is based on shared decision-making with your provider, since benefit depends on prior exposure. Condoms reduce HPV transmission but, because the virus can infect uncovered skin, do not eliminate the risk — making vaccination plus regular screening the most effective combination.

When to See a Provider

Consider reaching out to a provider if you:

• Notice new genital growths, bumps, or warts, or any unusual lesion you want evaluated.
• Received an abnormal Pap or HPV result and want help understanding it and planning the correct follow-up.
• Are due for cervical cancer screening or unsure when your next test should be.
• Want to discuss whether the HPV vaccine is right for you, particularly if you are between 27 and 45.
• Have questions about transmission, talking with a partner, or protecting your health going forward.
• Develop unusual bleeding, pelvic pain, or a persistent sore throat or neck lump — symptoms that warrant evaluation, though they have many possible causes.

Much of HPV care is well-suited to telehealth. A provider can review prior Pap and HPV results, explain your guideline-based follow-up timeline, prescribe at-home wart treatments, send referrals for colposcopy when needed, and discuss vaccination eligibility. Pap collection itself is done in person, but the counseling and coordination around it do not have to be. STD testing and treatment and women's health telehealth visits through InnoCre are available for patients 12 and older in Pennsylvania, Maryland, Washington, and Delaware.

Frequently Asked Questions