Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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Anal and peri-anal warts are genital warts in and around the anus, caused by the same low-risk HPV types (mainly 6 and 11) — which means, importantly, that having them does not necessarily mean anal sex, because the virus spreads by skin-to-skin contact across the whole area. They can itch, catch or bleed slightly, but the wart-causing types do not cause cancer. We remove external peri-anal warts discreetly under local anaesthetic; anything inside the anal canal is referred to a colorectal colleague. This guide covers the symptoms, who gets them, when an internal check is needed, and how they’re treated.
What Anal & Peri-Anal Warts Are
Peri-anal warts are soft growths in the skin around the anus; anal warts can also occur just inside the anal opening. Both are caused by the low-risk HPV types (mainly 6 and 11) that cause genital warts generally. They’re common, treatable, and — the reassurance that matters most — the wart-causing types do not cause cancer. Having them is not a reflection of anything other than how common and easily spread the virus is.
Symptoms to Recognise
Anal and peri-anal warts appear as small, soft, flesh-coloured or greyish bumps, singly or in clusters that can look slightly cauliflower-like. They’re usually painless but may itch, feel like a lump, catch on tissue when wiping, or bleed slightly. Some people notice them by chance; others feel them before they see them. Because piles (haemorrhoids), skin tags and other conditions can feel similar, it’s worth having any new lump around the anus checked rather than assuming what it is. Warts here are often noticed while washing or wiping, and it’s common to find several small ones together rather than a single growth — they tend to arrive in a cluster and can slowly increase in number if left, which is one practical reason many people choose to have them dealt with rather than wait.
Causes and Who Gets Them
They’re caused by HPV spreading by skin-to-skin contact across the whole genital and anal area — so peri-anal warts do not necessarily mean anal sex. The virus readily migrates around the region, and warts can appear peri-anally in anyone with genital HPV, regardless of the type of sexual contact they’ve had. HPV is near-universal among sexually active adults, and warts can surface months or years after the virus was acquired, which is why they’re never proof of anything about a current relationship — the same point we make about recurrence and timing.
When an Internal Check Is Needed
Sometimes warts extend just inside the anal opening, and internal warts need treating too for a lasting result — so part of a proper assessment is checking whether they do. Here’s our honest boundary: we treat external peri-anal warts at the clinic, but anything inside the anal canal, or any suspicion of internal disease, is referred to a colorectal colleague who is set up to examine and treat within the canal. That’s not a limitation to work around — it’s the safe, correct pathway, and it means you’re always seen by the right specialist for where the warts actually are.
How They’re Removed
External peri-anal warts are removed discreetly, under local anaesthetic where needed, most often by cautery and curettage; CO2 laser or excision is used for larger or recurrent warts, and cryotherapy for multiple small ones. In most cases this is a same-day see-and-treat appointment in a private consulting room. Aftercare is simple — keep the area clean, expect some soreness for a few days, and avoid the friction of vigorous activity until it settles. As with any genital wart, a proportion recur in the first few months because the virus can persist in nearby skin; that’s normal rather than a sign of failure, and any new warts are simply re-treated. Full methods, aftercare and cost are in the complete genital wart removal guide, and recurrence — common with any genital wart — is covered here.
Your Questions, Answered
- Do anal warts cause cancer?
- The types that cause visible anal and peri-anal warts (mainly HPV 6 and 11) are low-risk and do not cause cancer. The high-risk cancer-linked types are a separate group that usually causes no visible warts. Any lump that bleeds, hardens or changes should still be checked to be safe.
- Does having peri-anal warts mean I’ve had anal sex?
- No. HPV spreads by skin-to-skin contact across the whole genital and anal area, so peri-anal warts can appear in anyone with genital HPV regardless of the type of sexual contact. They’re not evidence of anal sex or of infidelity.
- Do I need an internal examination?
- Sometimes. Warts can extend just inside the anal opening, and internal warts need treating too. We treat external peri-anal warts and refer anything inside the anal canal, or any suspicion of internal disease, to a colorectal colleague.
- How are anal warts removed?
- External peri-anal warts are removed under local anaesthetic, usually by cautery and curettage, with CO2 laser or excision for larger or recurrent ones and cryotherapy for multiple small warts — often as a same-day see-and-treat appointment.
- How do I tell a wart from a pile or skin tag?
- You often can’t for certain on your own — piles, skin tags and warts can feel similar. A wart tends to be firm with a slightly rough or cauliflower-like surface, but any new lump around the anus is worth having checked rather than self-diagnosing.
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