Are anal warts always HPV? Can they go away on their own?

Yes, anal warts are caused by HPV (human papillomavirus). Whether they go away on their own in the anus specifically hasn't been directly studied — related research on genital and vulvar warts found many clear without treatment over months to years, but that evidence isn't anal-specific.

Do anal warts go away without treatment?

No study has followed people with untreated anal warts to find out. In similar conditions — vulvar warts and genital warts generally — many cases cleared on their own without treatment, but anal warts themselves haven't been studied this way.

Do anal warts go away naturally?

Possibly, based on how similar warts behave elsewhere on the body, but there's no direct research confirming this for anal warts. Related studies suggest the immune system can clear warts over time in some people, taking anywhere from months to a few years.

What happens if I don't treat anal warts?

Based on indirect evidence, warts can grow, stay the same, or clear up on their own — all three have been described in reviews of genital warts. Nothing in the research tells you which is likely to happen in your case, so it's reasonable to get warts checked rather than guess.

Should I see a doctor instead of waiting?

Since no study has measured how often untreated anal warts clear up, waiting without any confirmation of diagnosis is a gamble. A clinician can confirm it is a wart, rule out other causes, and discuss whether treatment makes sense for you.

Do anal warts go away on their own?

Name: Do anal warts go away on their own?
Published: 2026-10-26
Keywords: do anal warts go away, do anal warts go away on their own, are anal warts always hpv can they go away on their own, do anal warts go away without treatment, do anal warts go away naturally

In patients with untreated anal condylomata acuminata (anal warts), what proportion experience spontaneous clearance, and over what time frame?

How people search for this, in their own words

“do anal warts go away”
“do anal warts go away on their own”
“are anal warts always hpv can they go away on their own”
“do anal warts go away without treatment”
“do anal warts go away naturally”

Evidence review in plain language · compiled 2026-10-26 · checked 2026-10-26 · next 2026-11-26 · automated review, how it works

Bottom line

No study has directly tracked untreated anal warts to see whether, or how often, they clear on their own.

The 20 studies found mostly answer a different question — they looked at genital or vulvar warts in women, HPV infection found by lab testing, or warts in people with HIV. In those related groups, some warts did clear without treatment over months to years, but that does not tell us what happens with anal warts specifically, or in people without HIV.

How well studied

Little evidence

The 10 human studies found measure a related question rather than this one, so they can only be read indirectly.

This question asks how a condition behaves over time, not whether a treatment works, so there is no benefit-or-harm verdict. What can be shown is how well it has been studied.

answer it directly: 0answer it directly
studies found: 20studies found
randomised trials: 0randomised trials
people studied: 17,438people studied
review of trials: 1review of trials
years covered: 2004–2022years covered

What the research shows

Spontaneous clearance rate
No study counted how many untreated anal warts cleared on their own. In the closest related research, a study of vulvar warts (a different body site, mostly in women) found 95% cleared without treatment in women without HIV and 82% in women with HIV. A review of genital warts generally said most cases regressed on their own, without giving a number.[1,2]
Too little evidence
Time to resolution without treatment
Timeframes vary across the indirect studies available: one review of genital warts said spontaneous clearance happened within 2 to 5 years, while the vulvar wart study found most clearance happened within the first year. Neither looked at anal warts, so there is no reliable timeframe for this specific question.[1,2]
Too little evidence
Recurrence after apparent clearance
No study followed people whose anal warts cleared without treatment to see if they came back. The recurrence figures that do exist (30-70% within months) describe warts coming back after active treatment, not after spontaneous clearance.[1]
Not studied
Progression or persistence of lesions
Some reviews mention that untreated warts can also grow or persist rather than clear, and that HPV infection can rarely progress toward abnormal or cancerous cells over time, but none give numbers for how often this happens with anal warts left alone.[1,2,3]
Too little evidence

What the studies found

In a study of vulvar warts (a related but different body site), most cleared without treatment — 95% in women without HIV and 82% in women with HIV, mostly within the first year.[1]
A review of genital warts broadly described spontaneous regression happening in most cases, typically within 2 to 5 years, as the immune system cleared the virus.[1]
Another review notes that untreated warts can grow, stay the same, or go away on their own, rather than always needing treatment to resolve.[1]

Important limitations

None of the 20 studies measured whether anal warts themselves clear up without treatment. Some tracked clearance of HPV infection found by lab testing at the anal site, which is not the same as a visible wart disappearing (for example, 30% of anal HPV infections cleared in one cohort of HIV-positive men). Others studied genital or vulvar warts in women, or genital HPV in men, rather than anal warts specifically.[1,2,3,4]
Several of the relevant studies were done in people living with HIV, whose immune systems clear warts and HPV differently than people without HIV, so the results may not apply to most people asking this question.[1,2,3]
Many of the sources are narrative reviews or a guideline document that summarise opinion or other research rather than reporting original data on how often anal warts clear without treatment.[1,2,3,4,5,6,7]

What kind of studies

Narrative review7 · 35%
Prospective cohort6 · 30%
Retrospective3 · 15%
Laboratory study2 · 10%
Guideline1 · 5%
Systematic review1 · 5%

The key studies

Chikandiwa et al. 2019
Incidence, Persistence, Clearance, and Correlates of Genital Human Papillomavirus Infection and Anogenital Warts in a Cohort of Men Living With Human Immunodeficiency Virus in South Africa
Warts often cleared, especially with higher immunityProspective cohortLow qualityRelated question
304 people1.4 years (0.5-1.7 years)
Incidence of anogenital warts was 1.4 per 100 person-years; men with higher CD4 counts were more likely to clear the warts than those with low CD4 counts (adjusted hazard ratio, 3.69)
Who was studied
Men living with HIV in South Africa
Main outcome
Clearance and persistence of anogenital warts and HPV infection over follow-up
Quality
The study follows HIV-positive men only, with warts assessed alongside HPV testing, so it may not reflect how anal warts behave in people without HIV.
Limitations
Population restricted to HIV-positive men, warts reported as 'anogenital' not specifically anal, and clearance linked mainly to immune status (CD4 count) rather than general natural history.
Taken word for word from the abstract
- population 304 MLHIV 18 years or older were enrolled and attended follow-up visits at 6, 12, and 18 months
- primaryOutcome Time to AGW incidence or clearance was estimated by Kaplan-Meier method.
- result Incidence of AGW was 1.4 per 100 person-years. Men living with human immunodeficiency virus with high CD4 count were more likely to clear AGW than those with low CD4 count (adjusted hazard ratio, 3.69; 95% confidence interval, 1.44-9.47).
- n Overall, 304 MLHIV 18 years or older were enrolled
- followUp followed up for a median (interquartile range) 1.4 years (0.5-1.7 years)
Sex Transm Dis · PMID 30985636 · Read it on PubMed ↗
Vender et al. 2013
Therapeutic options for external genital warts
Untreated warts may grow, persist, or clear on their ownNarrative reviewLow qualityRelated question
size not given2013
Left untreated, warts may grow, stay the same, or go away on their own as the immune system clears them; recurrence after treatment is common (one-quarter to two-thirds within 3 months)
Who was studied
People with external genital warts
Main outcome
Natural course of untreated warts (growth, persistence, or clearance)
Quality
This is a general narrative review statement about genital warts overall, not a study specifically measuring outcomes in untreated anal warts, so it carries little weight on its own.
Limitations
Abstract does not focus on anal warts specifically, gives no numbers, timeframes, or study design for the natural history claim, and is a general review statement rather than original data.
Taken word for word from the abstract
- population external genital warts (EGWs)
- primaryOutcome Left untreated, warts may grow, remain the same, or spontaneously regress as a result of being cleared by the immune system.
- result Left untreated, warts may grow, remain the same, or spontaneously regress as a result of being cleared by the immune system. However, recurrence is common with or without treatment and may occur within 3 months of ending treatment in one-quarter to two-thirds of cases.
J Cutan Med Surg · PMID 24388560 · Read it on PubMed ↗
Schneede et al. 2013
[Proven and new methods in the treatment of genital warts]
Often clears on its own in yearsNarrative reviewLow qualityRelated question
size not given2-5 years
spontaneous regression was observed in most cases within 2 to 5 years, though some warts persisted and resisted all treatments
Who was studied
people with genital warts (condylomata acuminata)
Main outcome
whether genital warts go away without treatment (spontaneous regression)
Quality
this is a brief statement in a general narrative review about wart treatments, not anal-specific, with no study details, numbers, or methods given
Limitations
not a systematic study of natural history; covers genital warts broadly rather than anal warts specifically; no data on how many people or how regression was measured
Taken word for word from the abstract
- population Anogenital warts are the most common clinical manifestation of human papillomavirus (HPV) infections
- primaryOutcome Spontaneous regression of genital warts has been observed mostly within 2-5 years
- result Spontaneous regression of genital warts has been observed mostly within 2-5 years; however, persisting condylomata may prove refractory to all current treatment options.
Urologe A · PMID 24026888 · Read it on PubMed ↗
Videla et al. 2013
Natural history of human papillomavirus infections involving anal, penile, and oral sites among HIV-positive men
Not directly studied here.Prospective cohortLow qualityRelated question
733 peoplebetween 2005 and 2009
HPV infection at the anal site cleared in 30% of cases, with higher clearance in heterosexual men (184 per 1000 person-years) than in MSM (125 per 1000 person-years); history of anal warts was linked to higher HPV prevalence at all three sites
Who was studied
HIV-positive men (both gay/bisexual men and heterosexual men)
Main outcome
Clearance of HPV infection at the anal, penile, and oral sites over time
Quality
This cohort study tracks HPV DNA infection clearance in HIV-positive men, not the clinical course of visible anal warts themselves, so it only indirectly addresses whether warts go away on their own.
Limitations
Studies HPV viral clearance by PCR testing rather than clinical resolution of visible warts; population limited to HIV-positive men, which may not generalize to the general population with anal warts; warts are only mentioned as a risk factor for HPV prevalence, not tracked for resolution themselves.
Taken word for word from the abstract
- population HIV-positive men who have sex with men (MSM) and heterosexual individuals
- n In total, 733 patients (538 MSM, 195 heterosexual) were included in the study between 2005 and 2009.
- primaryOutcome The prevalence, clearance, and incidence of HPV infection at anal, penile, and oral sites were studied
- result The prevalence, clearance, and incidence of HPV infection were 73%, 30%, and 36% at anal site
- result a lower clearance rate (125 vs. 184 cleared HPV-infected person per 1000 person-years [hazard ratio, 0.5; 95% CI, 0.3-0.9]) than did heterosexuals
- result History of anal warts was associated with higher HPV prevalence in the 3 body parts.
Sex Transm Dis · PMID 23250297 · Read it on PubMed ↗
Massad et al. 2011
Genital warts and vulvar intraepithelial neoplasia: natural history and effects of treatment and human immunodeficiency virus infection
Most warts cleared up on their own.Prospective cohortModerate qualityRelated question
3,744 peopleup to 13 years
warts regressed without treatment in 82% of HIV-positive women and 95% of HIV-negative women, most within the first year after diagnosis
Who was studied
women with and without HIV infection who developed genital (vulvar) warts
Main outcome
whether genital warts went away on their own over time (regression)
Quality
it is a large, long-running cohort with regular exams, but it studied vulvar warts in women rather than anal warts specifically, so it may not directly reflect anal wart behavior.
Limitations
studied vulvar/genital warts in women, not anal-specific warts; population heavily weighted toward HIV-infected women
Taken word for word from the abstract
- n A cohort of 2,791 HIV-infected and 953 uninfected women followed for up to 13 years
- population women with human immunodeficiency virus (HIV)
- primaryOutcome warts regressed in 410 (82%) seropositive and 41 (95%) seronegative women
- result warts regressed in 410 (82%) seropositive and 41 (95%) seronegative women (P=.02), most in the first year after diagnosis
Obstet Gynecol · PMID 21934446 · Read it on PubMed ↗
Schneede et al. 2006
[Condylomata acuminata: an indication for prophylactic HPV vaccination?]
Natural resolution not reportedRetrospectiveVery low qualityRelated question
1,792 people2006
The abstract states it reports on the natural course of condylomata but gives no specific data on whether untreated warts clear on their own; it only reports that after treatment, recurrences occurred in 30-70% of cases and partner infections were found in 50% or more.
Who was studied
men investigated at specialist HPV clinics for genital warts (condylomata acuminata)
Main outcome
the natural course of condylomata (genital warts)
Quality
This is a general review of HPV/genital-wart epidemiology and treatment outcomes, not anal-specific, and it provides no concrete data on spontaneous resolution of untreated warts.
Limitations
Abstract does not separate anal warts from genital warts generally, does not report untreated/spontaneous course data, and mixes epidemiology with treatment outcomes.
Taken word for word from the abstract
- population 5,392 urological investigations for HPV were carried out in 1,792 men in special HPV centres
- n 1,792 men
- primaryOutcome epidemiology and natural course of condylomata
- result recurrences occurred in 30-70% of cases
- result partner infections were diagnosed in 50% and more
Urologe A · PMID 17096125 · Read it on PubMed ↗

All 20 studiesEvery study that answered the question, with its design, size and result.

The other 14 studiesEverything else the search returned, including anything retracted.

Langham et al. 2022
Paediatric Anogenital Condylomata Acuminata: An assessment of patient characteristics and the need for surgical intervention
Does not address spontaneous resolution.RetrospectiveLow qualityRelated question
66 people2022
HIV positive children needed significantly more surgical procedures to clear warts than HIV negative children; this abstract does not report on warts resolving without treatment
Who was studied
Children with anogenital warts treated at a hospital
Main outcome
Number of surgical interventions needed for clearance, by HIV status
Quality
This is a small retrospective chart review of treated surgical patients, not a study of untreated natural course, so it cannot answer whether warts resolve on their own.
Limitations
Only 30 of 66 patients had HIV status recorded; all patients described received surgical treatment, so no untreated/natural history comparison group is reported.
Taken word for word from the abstract
- population we treated 66 patients with AGCA . The average age was 4 years old (1-14)
- intervention type and number of surgical interventions
- primaryOutcome the total number of surgical interventions needed to achieve clearance was significantly more in those with HIV (p = 0.03)
- result HIV positive patients with AGCA require more surgical interventions compared to HIV negative individuals
- n we treated 66 patients with AGCA
J Pediatr Surg · PMID 34969525 · Read it on PubMed ↗
Gilson et al. 2020
2019 IUSTI-Europe guideline for the management of anogenital warts
No natural-course data reported.GuidelineVery low qualityRelated question
size not given2020
The abstract only states that background information on the natural history of HPV infection and anogenital warts was updated; it does not report any specific findings about whether warts resolve without treatment.
Who was studied
people with anogenital warts (not specifically anal warts)
Main outcome
natural course of untreated anogenital warts
Quality
This is a guideline summary that mentions updating natural history background information but gives no actual data, numbers, or findings about spontaneous resolution.
Limitations
The abstract covers anogenital warts generally (not anal warts specifically), is a guideline document rather than a primary study, and provides no actual natural-history data, rates, or timeframes.
Taken word for word from the abstract
- population anogenital warts
- primaryOutcome Updated background information on the prevalence, natural history and transmission of human papillomavirus (HPV) infection and anogenital warts.
- result Updated background information on the prevalence, natural history and transmission of human papillomavirus (HPV) infection and anogenital warts.
J Eur Acad Dermatol Venereol · PMID 32735077 · Read it on PubMed ↗
Larsen et al. 2018
[Ano-genital warts are more than benign lesions]
Clearance timeline described as uncertainNarrative reviewVery low qualityRelated question
size not given2018
the abstract says the timeline to clearance is uncertain and that this uncertainty, combined with variable treatment effect, causes psychological distress; it does not describe the natural course without treatment
Who was studied
people with anal or genital warts
Main outcome
whether warts clear up and how long that takes
Quality
this is a general narrative review focused on treatment side effects and vaccination, not a study of untreated wart resolution, so it gives no reliable data on natural course
Limitations
review discusses treated lesions and psychological burden rather than reporting on untreated natural history of anal warts specifically
Taken word for word from the abstract
- population Ano-genital warts are in general considered as benign lesions
- primaryOutcome an uncertain timeline to clearance
- result the varying effect of the treatments combined with an uncertain timeline to clearance are known to cause psychological distress
Ugeskr Laeger · PMID 29798751 · Read it on PubMed ↗
Park et al. 2015
Human Papillomavirus and Genital Warts: A Review of the Evidence for the 2015 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines
Not reported in this study.Narrative reviewLow qualityRelated question
size not given2015
The abstract summarizes HPV epidemiology, transmission, treatment (e.g., imiquimod), infection control, anal cancer screening, and vaccination, but does not state whether untreated anal warts go away without treatment
Who was studied
Sexually active people, with a focus on HPV and anogenital warts
Main outcome
The abstract does not report on whether untreated anal warts resolve on their own
Quality
It is a general narrative review assembled to update treatment guidelines, and it does not report any specific data on the natural course of untreated anal warts.
Limitations
The review covers broad HPV/genital wart topics (epidemiology, transmission, treatment, screening, vaccination) but does not isolate or report natural resolution rates for anal warts specifically.
Taken word for word from the abstract
- population Most sexually active persons will have detectable HPV at least once in their lifetime
- primaryOutcome (2) transmission and natural history
- result A new formulation of imiquimod (3.75% cream) is recommended for AGW treatment.
Clin Infect Dis · PMID 26602622 · Read it on PubMed ↗
Ma et al. 2013
Expression of dendritic cell lysosome-associated membrane protein and dendritic cell-specific intercellular adhesion molecule-3 grabbing nonintegrin in condyloma acuminatum lesions
No direct evidence on natural resolutionRetrospectiveVery low qualityRelated question
30 people2013
the two immune proteins were found at higher levels in wart tissue than normal skin, and their levels were inversely related to how long the warts had been present, suggesting immune cells may help clear the virus over time
Who was studied
men with genital warts (condyloma acuminatum) on the penis/foreskin, not specifically anal warts
Compared with
normal foreskin tissue from healthy male volunteers
Main outcome
levels of two immune-cell proteins (DC-LAMP and DC-SIGN) in wart tissue and their relationship to how long the disease had been present
Quality
this is a small laboratory tissue study looking at immune markers, not a clinical study following patients to see if their warts actually went away on their own, and it studied genital (foreskin) warts rather than anal warts specifically
Limitations
small sample size, lesions were from the penis/foreskin not the anus, correlation with duration does not show actual clearance or regrowth of warts over time, retrospective and observational design
Taken word for word from the abstract
- n condyloma acuminatum lesions (n = 30 samples) compared with normal skin samples (n = 13)
- population Condyloma acuminatum lesion samples were collected from male patients with the condition
- comparator compared with normal foreskin samples from male volunteers
- primaryOutcome their relationship with duration of the disease
- result Levels of DC-LAMP and DC-SIGN protein and duration of disease were inversely correlated.
J Int Med Res · PMID 23569139 · Read it on PubMed ↗
Gormley et al. 2012
Human papillomavirus-related genital disease in the immunocompromised host: Part I
No specific data reported.Narrative reviewVery low qualityRelated question
size not given2012
The abstract does not report specific findings on whether anal warts resolve without treatment; it only states that understanding the natural history and immune clearance of HPV lesions is needed for counseling patients
Who was studied
People with HPV-related genital disease, especially immunocompromised patients
Main outcome
Natural history and clearance of HPV lesions including condyloma acuminata
Quality
This is a general review overview without specific data, study details, or outcomes on the natural course of anal warts.
Limitations
The abstract provides no specific data on anal warts' natural course, only a general statement that counseling requires understanding of natural history and immune clearance.
Taken word for word from the abstract
- population with an emphasis on presentation of these HPV-mediated diseases in the immunocompromised host
- primaryOutcome natural history of HPV, transmission and infectivity, risk of malignancy, and the role of the host immune response in clearing HPV lesions
- result Counseling patients about these conditions requires a thorough understanding of the epidemiology, natural history of HPV, transmission and infectivity, risk of malignancy, and the role of the host immune response in clearing HPV lesions.
J Am Acad Dermatol · PMID 22583720 · Read it on PubMed ↗
Echenique et al. 2011
Anal warts and anal intradermal neoplasia
Abstract doesn't say if warts resolve.Narrative reviewVery low qualityRelated question
size not given2011
The abstract states HPV infection can progress stepwise from normal cells to dysplastic cells to invasive anal cancer, but does not report whether anal warts resolve on their own or describe their natural course without treatment.
Who was studied
People with HPV infection and anal warts
Main outcome
Natural progression of HPV infection and anal warts over time
Quality
This is a general narrative review that mentions disease progression only in passing and provides no specific data on untreated anal warts resolving or persisting.
Limitations
The abstract does not specifically address the natural history of untreated anal warts; it focuses broadly on diagnosis, management, and treatment, with progression to dysplasia/cancer mentioned only generally for HPV infection.
Taken word for word from the abstract
- population Anogenital human papillomavirus (HPV) infection is the most common sexually transmitted disease in the United States and is increasing in incidence.
- primaryOutcome HPV infection can lead to a stepwise transition from normal cells to dysplastic cells and then to invasive anal cancer
- result HPV infection can lead to a stepwise transition from normal cells to dysplastic cells and then to invasive anal cancer.
Clin Colon Rectal Surg · PMID 22379403 · Read it on PubMed ↗
Giuliano et al. 2011
Incidence and clearance of genital human papillomavirus infection in men (HIM): a cohort study
HPV infections often clear within monthsProspective cohortLow qualityRelated question
1,159 people27.5 months (median)
Typical genital HPV infection lasted about 7.5 months before clearing, and HPV type 16 lasted about 12 months
Who was studied
Men aged 18-70 without HIV, from Brazil, Mexico, and the USA
Main outcome
How often new genital HPV infections occurred and how long they lasted before clearing
Quality
This study tracked genital HPV infection (by lab testing of skin swabs) in men generally, not anal warts specifically, so it only indirectly suggests how warts might behave.
Limitations
The abstract reports HPV DNA detection and clearance at penile/scrotal sites, not visible anal warts or their resolution; it does not describe wart appearance or disappearance at all.
Taken word for word from the abstract
- population Men (aged 18-70 years), residing in Brazil, Mexico, and the USA, who were HIV negative and reported no history of cancer were recruited from the general population, universities, and organised health-care systems.
- n In 1159 men, the incidence of a new genital HPV infection was 38·4 per 1000 person months
- primaryOutcome The goal in this study was to estimate incidence and clearance of type-specific genital HPV infection in men
- result Median duration of HPV infection was 7·52 months (6·80-8·61) for any HPV and 12·19 months (7·16-18·17) for HPV 16.
Lancet · PMID 21367446 · Read it on PubMed ↗
Low et al. 2011
Genital warts and infection with human immunodeficiency virus in high-risk women in Burkina Faso: a longitudinal study
More frequent, persistent warts with HIV.Prospective cohortLow qualityRelated question
765 people27 months
Genital warts were much more common and appeared more often in women with HIV, especially those with low immune cell counts; taking HIV medicine did not lower the chance of new or persisting warts
Who was studied
high-risk women in Burkina Faso being tested for genital warts and HIV
Main outcome
how often genital warts newly appeared or persisted over time, and whether this related to HIV status
Quality
This study tracked genital warts (not anal warts specifically) and HIV-related risk factors rather than tracking whether untreated warts resolve on their own, so it does not directly answer the question asked.
Limitations
Studies genital warts broadly rather than anal warts specifically, and focuses on HIV-related incidence/persistence rather than spontaneous resolution without treatment.
Taken word for word from the abstract
- population A prospective study of 765 high-risk women who were followed at 4-monthly intervals for 27 months in Burkina Faso.
- n A prospective study of 765 high-risk women
- primaryOutcome Logistic and Cox regression were used to identify factors associated with prevalent, incident and persistent genital warts, including HIV-1 serostatus, CD4+ count, and concurrent sexually transmitted infections.
- result Genital warts occur much more frequently among HIV-1 infected women in Africa, particularly among those with low CD4+ counts. Antiretroviral therapy did not reduce the incidence or persistence of genital warts in this population.
BMC Infect Dis · PMID 21251265 · Read it on PubMed ↗
Insinga et al. 2009
Epidemiologic natural history and clinical management of Human Papillomavirus (HPV) Disease: a critical and systematic review of the literature in the development of an HPV dynamic transmission model
No data on anal wart resolutionSystematic reviewVery low qualityRelated question
size not given2009
The review found that data on the natural history of genital warts specifically were limited, and no data were found on how long immunity lasts after HPV infection or on what proportion of anogenital warts are treated; it did not report whether anal warts resolve without treatment
Who was studied
People with HPV-related disease, including cervical disease and genital warts
Main outcome
Natural history of HPV disease, including progression and regression of lesions
Quality
This review focused on general HPV natural history modeling and cervical disease, not specifically on anal warts, and it explicitly states that data on genital wart natural history were lacking.
Limitations
Review was confined to cervical disease and genital warts broadly, not anal warts specifically; many data gaps noted by the authors themselves, including lack of data on anogenital wart treatment proportions and immunity duration
Taken word for word from the abstract
- design critical and systematic review of the evidence base
- population the literature review was confined to cervical disease and genital warts
- primaryOutcome Natural history models of human papillomavirus (HPV) infection and disease
- result data concerning the natural history of HPV disease due to specific HPV types were often lacking
- result data were observed to be lacking on the proportion of clinically manifest anogenital warts that are treated
- result No data were found on the duration of immunity following HPV infection.
BMC Infect Dis · PMID 19640281 · Read it on PubMed ↗
Garland et al. 2009
Natural history of genital warts: analysis of the placebo arm of 2 randomized phase III trials of a quadrivalent human papillomavirus (types 6, 11, 16, and 18) vaccine
New warts appeared, but clearance not reported.Prospective cohortModerate qualityRelated question
8,800 people3.6 years
298 of 8800 women (3.4%) developed genital warts linked to HPV-6 or HPV-11, an incidence rate of 0.87 cases per 100 person-years; the abstract does not report whether existing warts cleared on their own
Who was studied
Women enrolled in the placebo group of HPV vaccine trials, examined for genital warts over about 4 years
Main outcome
Whether women developed new genital warts (HPV-6/11 related) over the study period
Quality
Large number of women were tracked carefully with repeated exams and blinded lab testing, but the study tracked new wart occurrence rather than whether existing warts went away.
Limitations
The abstract measures new wart development in women (vulva, vagina, perianal area combined), not resolution of existing anal warts, and does not separate anal-specific outcomes or report natural clearance rates.
Taken word for word from the abstract
- n Women enrolled in the placebo arm (n = 8800) of 2 randomized trials
- population Women enrolled in the placebo arm (n = 8800) of 2 randomized trials of a quadrivalent vaccine were examined for the presence of GW for up to 9 visits over approximately 4 years.
- primaryOutcome Overall, 298 (3.4%) of 8800 participants developed GW related to HPV-6 or HPV-11
- result Overall, 298 (3.4%) of 8800 participants developed GW related to HPV-6 or HPV-11 (incidence rate, 0.87 cases per 100 person-years-at-risk).
- followUp Women were followed up for an average of 3.6 years (range, 0-4.9 years).
J Infect Dis · PMID 19199546 · Read it on PubMed ↗
Meyer-Hoffert et al. 2008
Expression of human beta-defensin-2 and -3 in verrucae vulgares and condylomata acuminata
No direct evidence on natural clearanceLaboratory studyVery low qualityRelated question
15 people2008
Most wart samples showed some defensin protein present, but less than in common skin warts, and the abstract only speculates this might relate to wart regression without measuring whether warts actually cleared
Who was studied
People with anal/genital warts (condylomata acuminata) whose wart tissue samples were examined
Main outcome
Presence of antiviral skin proteins (human beta-defensin-2 and -3) in wart tissue
Quality
This is a small laboratory tissue-staining study that measured a protein marker, not whether warts actually went away over time, so it cannot show the natural course of anal warts.
Limitations
Retrospective, small sample, no clinical follow-up or regression data; only tissue protein expression was measured, and the link to spontaneous regression is speculative
Taken word for word from the abstract
- population condylomata acuminata (n = 15)
- primaryOutcome we investigated lesions of verrucae vulgares and condylomata acuminata for the presence of hBD-2 and hBD-3 by immunohistochemistry
- result The specimens of condylomata acuminata (n = 15) exhibited expression for hBD-2 and hBD-3, with the exception of three and two samples, respectively.
- result Their tendency for spontaneous regression could be caused by antiviral proteins like defensins.
- n condylomata acuminata (n = 15)
J Eur Acad Dermatol Venereol · PMID 18355203 · Read it on PubMed ↗
Palefsky 2007
HPV infection in men
No information on natural course.Narrative reviewVery low qualityRelated question
size not given2007
The abstract states that anal HPV infection and disease remain poorly understood, and does not report whether anal warts resolve on their own or how long they last.
Who was studied
men
Main outcome
natural history of anal and genital HPV infection and disease in men
Quality
This is a general narrative review of male HPV infection that explicitly says the natural history of anal HPV disease is poorly understood, and it gives no data on anal wart resolution.
Limitations
No original data on anal warts specifically; discusses HPV infection broadly and notes lack of knowledge about natural history in men; relies on future cohort studies for answers.
Taken word for word from the abstract
- population relatively little is known about the natural history of anogenital HPV infection and diseases in men
- primaryOutcome Anal HPV infection and disease also remain poorly understood.
- result Anal HPV infection and disease also remain poorly understood.
Dis Markers · PMID 17627061 · Read it on PubMed ↗
Azim et al. 2004
Local expression of tumor necrosis factor-alpha and interleukin-4 mRNA in different types of warts
No data on anal warts clearingLaboratory studyVery low qualityRelated question
30 people2004
The study found higher TNF-alpha expression in warts than healthy tissue, but found no simple relationship between this immune pattern and whether warts cleared; it did not report actual rates or timing of spontaneous wart clearance for anal warts specifically
Who was studied
Patients with different types of viral warts (common, plane, plantar, and anogenital)
Main outcome
Local expression of TNF-alpha and IL-4 cytokine mRNA in wart tissue, examined in relation to wart clearance
Quality
This is a small lab study of mixed wart types mainly looking at cytokine biology, not a study that tracked anal warts over time to see if they resolved.
Limitations
Small sample of 30 patients with mixed wart types (common, plane, plantar, anogenital) rather than anal warts specifically; focuses on immunology mechanisms rather than directly observing or reporting clearance rates or timelines.
Taken word for word from the abstract
- population A total of thirty patients suffering from different types (common, plane, plantar and anogenital) of viral warts were included.
- n A total of thirty patients suffering from different types (common, plane, plantar and anogenital) of viral warts were included.
- primaryOutcome Local expression of TNF-alpha (Th1) and IL-4 (Th2) in wart tissue was determined using in-situ hybridization technique.
- result However, it does not appear to be a simple causal relationship between expression of a Th-1 pattern and clearance.
- result The natural history of warts shows considerable variations between individuals, ranging from spontaneous regression to prolonged persistence.
Egypt J Immunol · PMID 15724382 · Read it on PubMed ↗

How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.

Searched: PubMed · ClinicalTrials.gov · Crossref on 2026-10-26
The exact search — paste this into PubMed to repeat it: ("condylomata acuminata"[MeSH] OR "anal warts"[tiab] OR "perianal warts"[tiab]) AND ("spontaneous regression"[tiab] OR "natural history"[tiab] OR "natural course"[tiab] OR "untreated"[tiab] OR "watchful waiting"[tiab] OR "self-limiting"[tiab] OR "clearance"[tiab]); PubMed expanded that to: ("condylomata acuminata"[MeSH Terms] OR "anal warts"[Title/Abstract] OR "perianal warts"[Title/Abstract]) AND ("spontaneous regression"[Title/Abstract] OR "natural history"[Title/Abstract] OR "natural course"[Title/Abstract] OR "untreated"[Title/Abstract] OR "watchful waiting"[Title/Abstract] OR "self-limiting"[Title/Abstract] OR "clearance"[Title/Abstract])
What came back: 352 records found · 200 read · 20 answered the question
Included: Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded: Records about a different condition or intervention
Studies mainly about Treated warts (surgical excision, cryotherapy, topical therapy)
Studies mainly about Genital warts at other sites (penile, vulvar) unless anal-specific data reported
Studies mainly about Cervical HPV infection and cervical dysplasia
Records reporting no outcome
Retracted publications, which are listed but excluded from every count
Limits: Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.

352records came back from the search
200were read
20actually answered the question

Risks and safetyReported side effects and who should be careful.

A review notes that left untreated, warts may grow larger, stay the same, or spontaneously clear as the immune system responds — the review describes these as three possible outcomes, not warts worsening instead of clearing.
Genital and anal warts can be passed to sexual partners; one study found partner infection in half or more of cases after someone was diagnosed.

Why people askWhat brings people to this question.

Anal warts can feel embarrassing, so people hope they will disappear without needing to see a doctor.
Treatment can be uncomfortable, repeated, or costly, so waiting feels like the easier option.
Some people have seen ordinary skin warts go away on their own and assume anal warts work the same way.
Stigma around anal or genital symptoms can delay people from seeking care in the first place.

Common questionsShort answers, drawn from the same studies.

Are anal warts always HPV? Can they go away on their own?: Yes, anal warts are caused by HPV (human papillomavirus). Whether they go away on their own in the anus specifically hasn't been directly studied — related research on genital and vulvar warts found many clear without treatment over months to years, but that evidence isn't anal-specific.
Do anal warts go away without treatment?: No study has followed people with untreated anal warts to find out. In similar conditions — vulvar warts and genital warts generally — many cases cleared on their own without treatment, but anal warts themselves haven't been studied this way.
Do anal warts go away naturally?: Possibly, based on how similar warts behave elsewhere on the body, but there's no direct research confirming this for anal warts. Related studies suggest the immune system can clear warts over time in some people, taking anywhere from months to a few years.
What happens if I don't treat anal warts?: Based on indirect evidence, warts can grow, stay the same, or clear up on their own — all three have been described in reviews of genital warts. Nothing in the research tells you which is likely to happen in your case, so it's reasonable to get warts checked rather than guess.
Should I see a doctor instead of waiting?: Since no study has measured how often untreated anal warts clear up, waiting without any confirmation of diagnosis is a gamble. A clinician can confirm it is a wart, rule out other causes, and discuss whether treatment makes sense for you.

What has changedEvery re-check, and whether it changed the answer.

2026-10-26
Clear the 'Under re-review' backlog: rebuild every remaining first-method (ev-1) page under the current method. 11 new studies · 66 no longer retrieved · evidence strength moderate → very low · conclusion no meaningful benefit → not applicable.
How certain we are changed. The conclusion changed.

This is information, not advice

This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.

Contact the office

Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.

Allen Kamrava, MD, MBA, FACS, FASCRS · 435 N. Bedford Dr., Suite 308, Beverly Hills, CA 90210 · 424.279.8222

Educational information — not medical advice.