Your doctor usually can diagnose warts by examining the area. By looking at the area, your doctor also can determine what treatment may be necessary. In general warts don't need to be biopsied. However, if your doctor is concerned that the changes could be cancerous, a skin biopsy may be needed. In a biopsy, a small piece of tissue is removed and examined under a microscope.
People with plantar warts may complain of pain on the bottom of their feet when walking. If you have possible plantar warts, your doctor will examine your affected foot. He or she will want to be sure there are no bone, joint or tendon problems that would explain the pain. Plantar warts might not be the actual cause of foot pain.
If you have possible genital warts, your doctor will ask about your sexual practices, including condom use and anal sex. Condoms help decrease the risk of getting infected with HPV and spreading it to partners. But the HPV might exist on areas not covered by a condom. If you engage in anal sex, your doctor will examine the area around and inside the anus for warts and other skin changes from HPV.
In women with genital warts, the doctor will do a pelvic and rectal exam. A Pap smear will be done to look for microscopic pre-cancer or early cancer of the cervix caused by HPV.
Your doctor may also do colposcopy to get a more detailed look at the surface of the cervix and vagina. This tube-like instrument has a light and lenses to give the doctor a magnified view of the cervix and nearby vaginal skin. A biopsy of abnormal cervical tissue may be necessary to look for cervical cancer.
DNA tests can identify the specific types of HPV infection in cells taken from a woman's cervix. The test helps to identify women who have the types of HPV infection associated with the development of cervical cancer.
HPV testing is not routinely needed. If a PAP smear is abnormal or inconclusive, a DNA HPV test can help determine whether a woman has a higher risk of developing cancer. Women with strains of HPV that pose a higher cancer risk may need colposcopy and biopsies. A woman with a low risk HPV strain probably will need only repeat PAP smears.