HPV and Genital Warts: Screening & What Tests Detect What

Introduction

HPV (human papillomavirus) and genital warts are among the most frequently discussed topics in sexual health, yet there remains a great deal of confusion about how screening and testing work for these conditions. Many people assume that a standard STI test automatically checks for HPV or that genital warts can be detected through blood tests. In practice, the reality is more nuanced.

Understanding what each test can and cannot detect is important for making informed decisions about your sexual health. This guide explains the key differences between HPV, genital warts, and other conditions that may cause similar symptoms. It also clarifies which tests are relevant, when testing may be appropriate, and what to expect from screening.

Our clinic provides private STI testing but does not offer lesion diagnosis, biopsy, or visual examination for warts. If you are concerned about skin changes in the genital area, a GP or sexual health clinic offering clinical examination would be the appropriate first step for visual assessment.

HPV and genital warts are related but distinct. HPV is the virus; genital warts are one possible symptom caused by certain strains. Standard STI tests do not routinely screen for HPV. Understanding which tests detect which conditions can help you make better-informed decisions about your sexual health.

Key points covered in this article:

• How HPV differs from genital warts
• What standard STI tests do and do not detect
• When HPV testing may be appropriate
• How genital warts are typically identified
• Other conditions that can resemble warts
• When further medical assessment may be needed

Appearance alone cannot confirm genital warts. Visual assessment by a trained clinician is generally required for diagnosis.

What Is HPV?

HPV is a group of more than 200 related viruses, of which more than 40 types can infect the genital area. It is the most common sexually transmitted infection globally, and most sexually active adults will contract at least one type of HPV during their lifetime. In the majority of cases, the immune system clears the virus without any symptoms or long-term consequences.

HPV types are broadly categorised into two groups:

• Low-risk types — These can cause genital warts. The most common are types 6 and 11, which are responsible for approximately 90% of genital wart cases.
• High-risk types — These do not cause warts but are associated with an increased risk of certain cancers, including cervical, anal, throat, and penile cancers. Types 16 and 18 are the most well-known high-risk strains.

Most people with HPV will never know they have it. The virus is often cleared by the body naturally, and many individuals carry it without any visible signs.

What Are Genital Warts?

Genital warts are growths or bumps that appear in the genital or anal area, caused by low-risk strains of HPV — most commonly types 6 and 11. They can vary widely in appearance:

• Small, flesh-coloured or slightly darker bumps
• Flat or raised growths
• Single bumps or clusters with a cauliflower-like texture
• Smooth or rough surfaces

Warts can appear on the vulva, penis, scrotum, inner thighs, around the anus, and, less commonly, inside the vagina or on the cervix. They are typically painless, though some individuals report mild itching or irritation.

Genital warts can appear weeks, months, or even years after exposure to HPV. This long and variable incubation period means that the appearance of warts does not necessarily indicate recent sexual contact or a new partner.

HPV Screening: What Does It Involve?

HPV screening in the UK is primarily conducted through the NHS cervical screening programme (smear test). This programme tests for high-risk HPV types that are associated with cervical cancer. It is available to women and people with a cervix aged 25 to 64.

Important points about HPV screening:

• What it tests for: High-risk HPV strains (primarily types 16 and 18, among others)
• What it does not test for: Low-risk HPV types that cause genital warts
• How it works: A small sample of cells is taken from the cervix and tested for the presence of high-risk HPV DNA
• Frequency: Every three years for ages 25 to 49, and every five years for ages 50 to 64

HPV screening through the cervical programme is not a general STI test. It does not detect other infections such as chlamydia, gonorrhoea, or herpes. It is specifically designed to identify individuals who may be at higher risk of cervical cell changes.

For individuals without a cervix, there is currently no routine NHS HPV screening programme. Anal HPV screening is not widely available through the NHS but may be offered in specialist settings for individuals considered to be at higher risk.

What Do Standard STI Tests Detect?

A standard STI screen, such as those offered through sexual health clinics or private testing services, typically includes tests for:

• Chlamydia — detected through a urine sample or swab
• Gonorrhoea — detected through a urine sample or swab
• HIV — detected through a blood test
• Syphilis — detected through a blood test
• Hepatitis B and C — detected through blood tests
• Herpes (HSV) — may be included in some panels, typically through a blood test or swab

Standard STI tests do not routinely include HPV testing. This is because:

• HPV is extremely common and most infections resolve on their own
• There is no approved blood test for HPV
• HPV testing in clinical practice is primarily used within cervical screening programmes
• Routine HPV testing in asymptomatic individuals is not currently recommended by UK guidelines

A full STI screen provides valuable information about a range of infections but should not be assumed to cover HPV.

Can a Blood Test Detect HPV or Genital Warts?

No. There is currently no approved blood test for diagnosing HPV infection or genital warts. HPV testing, where it is used, relies on detecting viral DNA from cell samples — typically taken from the cervix during screening.

Genital warts are diagnosed through visual examination by a trained clinician. Laboratory tests are not typically used for wart diagnosis unless the appearance is unusual and a biopsy is needed to rule out other conditions.

This means that even a comprehensive STI blood panel will not tell you whether you have HPV or genital warts. If you have visible skin changes in the genital area, a clinical examination is the appropriate next step.

How Are Genital Warts Diagnosed?

Genital warts are typically diagnosed through visual clinical examination. A healthcare professional experienced in sexual health will assess the appearance, location, and characteristics of any growths. In most cases, no laboratory test is needed.

In certain situations, further investigation may be appropriate:

• If the appearance is unusual or atypical
• If there is uncertainty about whether a growth is a wart or another condition
• If a growth does not respond to treatment as expected

In these cases, a biopsy may be taken for laboratory analysis. However, this is the exception rather than the norm.

Our clinic does not provide visual examination or diagnosis of warts. If you are concerned about possible genital warts, we recommend consulting a GP or attending an NHS sexual health clinic where clinical assessment is available.

Conditions That Can Resemble Genital Warts

Several other conditions can produce bumps, growths, or skin changes in the genital area that may be mistaken for warts. These include:

• Molluscum contagiosum — Small, firm, dome-shaped bumps with a central dimple. These are caused by a different virus (poxvirus) and are spread through skin-to-skin contact.
• Fordyce spots — Small, pale or yellowish bumps on the shaft of the penis, labia, or inner lips. These are normal sebaceous glands and are entirely harmless.
• Pearly penile papules — Small, smooth bumps arranged in rows around the head of the penis. These are a normal anatomical variant and are not caused by infection.
• Skin tags — Soft, small growths that can appear in areas of friction, including the groin and genital region.
• Folliculitis or ingrown hairs — Infected or irritated hair follicles can produce red, raised bumps that may be mistaken for warts.
• Herpes lesions — Herpes blisters can sometimes be confused with warts, though they typically appear as fluid-filled blisters that crust over, whereas warts are usually firm and persistent.
• Seborrheic keratoses — Raised, waxy growths that can appear on various parts of the body, including the genital area, particularly in older adults.

Because of the wide range of conditions that can mimic the appearance of genital warts, self-diagnosis is unreliable. A clinical examination by a trained professional is the most appropriate way to determine the cause of any new or unexplained genital skin changes.

If you are experiencing other symptoms alongside skin changes — such as unusual discharge, discomfort during urination, or irritation — STI testing may help identify or rule out common infections. You can also learn more about how STI transmission actually works.

HPV Vaccination: What It Covers

The HPV vaccine is one of the most effective tools for preventing HPV-related conditions. In the UK, the HPV vaccination programme currently uses Gardasil 9, which protects against nine HPV types:

• Types 6 and 11 — responsible for approximately 90% of genital wart cases
• Types 16, 18, 31, 33, 45, 52, and 58 — high-risk types associated with various cancers

The vaccine is offered through the NHS to children aged 12 to 13 (Year 8 in England). Catch-up programmes are available for older teenagers and young adults who missed their scheduled dose.

Key points about the HPV vaccine:

• It is most effective when given before first sexual contact
• It does not treat existing HPV infections or genital warts
• It does not replace the need for cervical screening
• It is not a test for HPV

Even vaccinated individuals should continue to attend cervical screening appointments, as the vaccine does not cover all high-risk HPV types.

When Testing May Be Helpful

While there is no routine test for HPV in the general population, there are situations where related testing or screening may be appropriate:

• Cervical screening (smear test) — All eligible individuals aged 25 to 64 should attend regular cervical screening, which now includes HPV testing as a primary component.
• STI testing for other infections — If you are concerned about symptoms such as discharge, irritation, or discomfort, an STI screen can help identify or rule out common infections that may cause similar symptoms.
• If you notice skin changes — Visible growths, bumps, or lesions in the genital area should be assessed through clinical examination at a GP surgery or sexual health clinic.
• After a change in partner — Routine STI testing when entering a new relationship is sensible, even though HPV is not included. Understanding what other infections may be present is valuable. Read more about how often you should get tested if sexually active.
• If you have symptoms of another STI — Conditions such as herpes, molluscum, and syphilis can sometimes be confused with HPV-related changes. Testing may help clarify the cause. Understanding optimal testing windows for various infections can help ensure accurate results.

What Our Clinic Can and Cannot Help With

What we offer:

• Confidential STI testing for a range of infections including chlamydia, gonorrhoea, syphilis, HIV, hepatitis, herpes, and more
• Guidance on which tests may be appropriate based on your symptoms or concerns
• Private HPV DNA testing where appropriate

What we do not offer:

• Visual examination or diagnosis of genital warts
• Wart treatment or removal
• Cervical screening (smear tests)
• Biopsy or histological analysis
• GP services or prescriptions

If you are concerned about possible genital warts, we recommend attending a GP or NHS sexual health clinic for visual assessment. If you would like to be tested for other STIs that may cause similar symptoms or that may be present alongside HPV, we can help with that.

Frequently Asked Questions

Does a standard STI test check for HPV?

No. Standard STI panels do not include HPV testing. HPV testing is primarily conducted through the cervical screening programme for high-risk types. There is no approved blood test for HPV.

Can genital warts be detected through a urine test or blood test?

No. Genital warts are diagnosed through visual clinical examination. There is no urine or blood test that can detect genital warts.

Should I get tested for HPV if I have no symptoms?

For most people, routine HPV testing is not recommended outside of the cervical screening programme. If you have no symptoms and are attending regular smear tests, additional HPV testing is generally not necessary.

Can HPV be transmitted even with condom use?

Yes. HPV is transmitted through skin-to-skin contact and can infect areas not covered by condoms. While condoms reduce the risk of transmission, they do not eliminate it entirely.

If I have genital warts, does that mean I have a high-risk HPV type?

Not necessarily. Genital warts are most commonly caused by low-risk HPV types 6 and 11, which are not associated with cancer. However, it is possible to be infected with both low-risk and high-risk types simultaneously.

Can HPV go away on its own?

Yes. The majority of HPV infections are cleared by the immune system within one to two years. However, some infections persist, particularly high-risk types, which is why ongoing cervical screening is important.

When to Seek Further Medical Advice

Consider consulting a healthcare professional if:

• You notice new or unexplained growths, bumps, or skin changes in the genital area
• Existing skin changes are growing, spreading, or changing in appearance
• You experience pain, bleeding, or discomfort from genital lumps
• You have not attended cervical screening and are due for an appointment
• You are concerned about a partner's diagnosis of HPV or genital warts
• You are unsure whether symptoms may be related to an STI

Our clinic can provide STI testing for infections that may cause similar symptoms to HPV-related conditions. For visual assessment of warts or skin changes, a GP or sexual health clinic is the appropriate service.

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Disclaimer: This article is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. The information provided is not a substitute for professional clinical judgement. Sexual health concerns should be assessed on an individual basis by a qualified healthcare professional. If you are experiencing persistent, severe, or worsening symptoms, please consult an appropriate healthcare service. Our clinic provides private STI testing services only — we do not prescribe medication, provide ongoing treatment, or offer GP services.

Written: 14 March 2026 | Next Review Due: 14 March 2027