How is genital warts diagnosed?

Genital warts can be diagnosed through various methods, including naked-eye physical examination, acetic acid whitening test, histopathological examination, nucleic acid testing, and dermatoscopy. Each method has its own advantages. If suspicious skin lesions appear, do not attempt self-diagnosis; seek medical attention promptly upon noticing any abnormalities.

1. Naked-eye physical examination: The physician directly inspects the skin and mucosa of the genitalia and perianal region for cauliflower- or papilloma-like growths. Typical warts can often be preliminarily identified by visual inspection alone. However, very small lesions or those located in concealed areas may easily be missed during naked-eye examination, necessitating complementary diagnostic methods for confirmation.

2. Acetic acid whitening test: A solution of acetic acid is applied to suspected lesions, and local skin color changes are observed to aid screening. This test is simple to perform and suitable for initial screening. However, false-positive results may occur—for example, localized inflammation or skin breaks can also cause whitening—so this test alone cannot serve as a definitive diagnostic criterion.

3. Histopathological examination: A small sample of affected tissue is biopsied and sent for laboratory analysis—a highly accurate diagnostic method. Under microscopic examination, cellular morphology is assessed to determine whether it conforms to the characteristic histopathological features of genital warts. This method is typically reserved for cases with atypical lesion morphology or when other tests yield inconclusive results, serving as a critical confirmatory tool.

4. Nucleic acid testing: Exfoliated cells collected from the lesion site are tested for human papillomavirus (HPV) genotyping to determine whether an HPV infection is present. This test identifies specific viral subtypes and helps assess disease risk. A positive HPV test indicates infection but does not necessarily imply active disease; clinical correlation with visible lesions remains essential for comprehensive evaluation.

5. Dermatoscopy: Using a dermatoscope to magnify and examine subtle morphological features of skin lesions—including microvascular architecture—this technique is especially useful for detecting minute lesions difficult to distinguish by naked eye. It enhances detection rates for occult lesions and assists clinicians in differentiating common benign skin proliferations from genital warts, thereby reducing the risk of missed diagnosis.

Maintain good personal hygiene in daily life, avoid high-risk contact, and never attempt self-assessment of symptoms. Upon diagnosis, sexual partners should undergo concurrent screening, and appropriate protective measures must be implemented to minimize the risk of cross-infection.