Treatment of genital warts
Treatment of genital warts is not essential or curative; however, warts can be extensive and painful, and most patients prefer treatment to reduce pain and for cosmetic reasonsOng, 2023.
Topical therapy and cryotherapy are effective cosmetic treatments for genital warts. Cryotherapy often needs to be repeated at intervals of 1 to 2 weeks. Cryotherapy is most useful when treating a small number of easily accessed lesions. Cryotherapy can also be used as an adjunct to topical therapy for refractory lesions.
Topical therapy is less painful than cryotherapy, and is ideal for numerous or bulky lesions. UseOng, 2023Workowski, 2021:
1imiquimod 5% cream topically, 3 times weekly on alternate days at bedtime (wash after 6 to 10 hours) until warts resolve (usually 8 to 16 weeks) imiquimod imiquimod imiquimod
OR
1podophyllotoxin 0.5% paint topically, twice daily for 3 days followed by a 4-day break; repeat weekly for 4 to 6 cycles until warts resolve. podophyllotoxin podophyllotoxin podophyllotoxin
Imiquimod can cause local inflammatory effects (eg burning, itch or erythema). Reducing the frequency of application can help manage these adverse effects.
The human papillomavirus (HPV) vaccine is not a therapeutic vaccine, but may provide protection from future acquisition of other HPV types; see Australian Immunisation Handbook for more information.
For general principles of sexually transmissible infection (STI) management, including counselling, and considerations for children in whom an STI is identified, see Principles of STI management.