The two main types of treatment for genital warts are:
- topical treatment, such as a cream, ointment or lotion
- and destroying the wart by freezing or heating (ablation).
The option used can often depend on the severity and texture of the warts. For example, topical treatments work better on softer warts, whereas ablation works better on harder warts.
On this page, we’ll discuss:
- the different types of topical treatments
- the different types of ablation treatment
- and whether treatment for warts is always necessary.
Topical medications for warts include:
The brand names for this treatment are Warticon and Condyline. Warticon is available as a cream or solution, whereas Condyline comes only in solution form. They’re used to treat small groups of warts which appear externally on the penis or vagina.
The human papillomavirus causes warts when its cells divide and multiply in the body. Podophyllotoxin works by preventing the viral cell from producing a substance it needs to replicate itself. When it cannot multiply, the cells die off and the infection goes into remission.
The solution is applied with an applicator, whereas the cream is applied using the fingertip. This is one twice a day, in doses, twelve hours apart for three consecutive days; followed by a period of four rest days. The cycle is repeated usually up to three or four times to clear the warts.
The brand for this treatment is Aldara. This cream is used to treat larger sized warts, and works in a slightly different way to podophyllotoxin. Imiquimod works by binding to immune cells in the skin, and helping them to combat the virus.
It is applied with the fingertip, three times per week on alternating days, usually before bedtime. The course can last for up 16 weeks.
Catephen is an ointment made from green tea leaves.
It is applied three times a day, for no longer than 16 weeks. NICE recommends this as a treatment for warts in people who are immunocompromised.
This treatment is recommended is usually used to treat smaller, harder warts. Trichloroacetic acid is applied by either a nurse or doctor at a GUM clinic, as misapplication can damage the skin. This course of treatment is applied once a week.
Where topical treatments are not successful, surgical removal (ablation) may be considered. These are performed by a healthcare professional in a clinical setting.
Cryotherapy involves freezing the warts with liquid nitrogen, usually those which are in a small bunch. The procedure, typically repeated weekly for four weeks, will cause a burning sensation, and mild to moderate irritation may occur. For the following weeks after treatment there may be some pain whilst the skin is healing.
This is the process of cutting the warts away, usually when they are harder in texture. This procedure involves a local anaesthetic being applied to the affected area, followed by the removal of the warts with a scalpel. This can leave scarring to the area, so it is not recommended for large warts (as the resulting scarring could be more severe).
Electrosurgery is used in very particular circumstances, usually when topical treatments have not worked and other ablation methods are not suitable. Firstly the majority of large warts are removed by excision, followed by an electrical current being passed through a metal loop which is placed against the remainder of the wart. This procedure can be painful and will sometimes need a general anaesthetic.
When warts have not responded to other treatment methods, laser surgery may be considered. This could be due to the fact that the warts are in a location which is difficult to access. The laser essentially burns off the warts, and then the affected area is allowed to heal.
Genital warts aren’t usually serious, but can cause considerable discomfort, and can easily be passed onto others; so it’s advisable to seek treatment for them.
If you think you may be developing genital warts for the first time, you should go to a GUM clinic. A doctor or nurse specialising in sexual health should be able to diagnose genital warts based on symptoms, and give guidance on treatment.