The treatment your doctor selects for genital warts depends on several factors, including the severity of your symptoms. Patients with large warts that obstruct the vaginal canal for example will need more aggressive therapy than those patients with a few small lesions.
It is important that you discuss your personal medical history and medical preference with your doctor so together you and your doctor can select the best method for treating your genital warts.
The treatments for genital warts can either be chemical or surgical. Here we will discuss both treatment approaches.
Medical Treatments for Genital Warts
Chemical treatments for genital warts usually work by interfering with the cell development of the Human Papilloma Virus ( HPV) that causes the warts. These agents often stop the cell growth of the virus and cause warts to die. Many chemical treatments are available and are successful in treating external venereal warts.
Medical Treatments for Genital Warts
In the Privacy of your Home
Podofilox (Podophyllotoxin)
Podofilox is an agent created from podophyllin that you apply to warts in the privacy of your home. It is available in two concentrations, 0.5 and 0.15 percent solutions. Podofilox is used on an every other day basis for three weeks, or twice daily for three days (followed by four days without treatment) for a total of three to four weeks. Side effects are mostly mild and include vaginal burning, redness, and irritation. The agent should not be used in pregnancy.
Aldara (Imiquimod)
Aldara is the most common form of immune modulator used to treat genital warts. A doctor usually prescribes Aldara as a 5 percent topical cream. It usually helps remove genital warts in as many as 84 percent of patients with recurrences limited to 19 percent or fewer or patients. Patients can’t use this cream to treat internal warts. Aldara topical cream is applied to the warts three times per week at bed time and washed off in the morning. Treatment with Aldara cream requires 8-12 weeks and sometimes up to 16 weeks before the warts clear. The side effects are mild and include irritation and redness.
Medical Treatments for Genital Warts
In the Doctor's Office
Podophyllin
Podophyllin is a chemical agent that stops the growth of warts by causing the Human Papilloma Virus cells to die. Your doctor will apply podophyllin topically typically as a 10 or 25 percent solution to help destroy warts. It is usually applied directly on the wart once weekly and washed off within 12 hours of the application. Therapy is typically continued for four weeks. The use of podophyllin is decreasing because of the significant side effects, of which the most common is chemical burns. Podophyllin can not be used in pregnancy.
Trichloroacetic acid
Your doctor may apply Trichloroacetic acid in concentrations up to 90 percent. This agent destroys genital wart on contact. It is applied directly to the warts with a cotton tip applicator each week for four consecutive weeks. Trichloroacetic acid or TCA is suitable for small warts only. The acid is associated with local burning that is immediate and lasts for a few minutes. Usually patients need repeat sessions to clear genital warts. Unlike podophyllin, this agent can also destroy internal vaginal warts.
5-fluorouracil epinephrine gel
This gel, termed 5-FU for short, prevents HPV DNA synthesis, which causes the cells that form genital warts to die. 5-FU is available as a 5% cream applied topically to the warts for five to seven days and is washed off 3 to 10 hours after it is applied. 5-FU can be used to treat intravaginal warts, but is not widely used because of the substantial burning it produces. The recurrence rate for fluorouracil is about 50 percent after three months.
Interferon alfa
This immune therapy can reduce anal warts or condyloma in up to 80 percent of patients, however it is commonly associated with side effects and recurrences.
Surgerical Treatment for Genital Warts
Most doctors consider surgery when other medical or drug therapies have not succeeded in removing genital warts. Here are the common forms of surgery available to remove genital warts.
Cryotherapy
Cryotherapy is an in office procedure where your doctor places liquid nitrogen spray on warts to destroy them. This procedure is valuable because doctors can perform it even during pregnancy. Side effects include some pain at the application site and inflammation following the procedure. Repeat application is often necessary.
Laser Therapy
Your doctor can perform laser therapy at a surgical center. Patients undergoing treatment with Laser therapy for removal of genital warts need anesthesia. Condyloma tissue absorbs energy from the laser, which heats up and evaporates the wart. Usually laser therapy results in a 100 percent clearing of genital warts, but recurrence rates may be as high as 45 percent.
Excision procedures
Your doctor may also excise genital warts using anesthesia. Complications from
excision include infection and bleeding. This may be an alternative for patients
where large warts do not respond to chemical treatments.
New Approaches to Treat Genital Warts
Topical antimicrobials are a newer approach to treat genital warts, but the FDA does not yet approve these therapies for use. Here are the names of some antimicrobials researchers are still studying as a treatment for genital warts.
Cidofir
Cidofir in a double-blind randomized trial of this agent showed that patients using Cidofir were more likely to have fewer warts or no warts after treatment with this drug after six months of therapy. The study conducted was small, thus further studies need be conducted to prove the efficacy and safety of this drug.
Bacillus Clamette Guerin
In one study topical bacillus bacteria was applied to patients with a decrease of warts in most cases. Like the cidofir trial, this study was small.
Infrared Coagulation
Infrared
coagulation works by focusing an infrared light on genital warts. The FDA has
already approved this treatment for removing hemorrhoids and removal of warts
other than genital warts. So far this seems the most promising agent of these
three. Roughly 82 percent of patients in one study realized a relief of genital
wart symptoms.
If you or someone you know suffers from genital warts caused by the Human Papilloma Virus ( HPV), be sure to consult with your doctor about your various treatment choices. Genital warts is a common STD affecting millions of people every year. Fortunately there are many treatment choices available for patients with this condition.
