Genital Warts (Human Papillomavirus): Medications

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Medications

Medicine may be used to destroy bothersome genital warts, relieve your symptoms, and reduce the amount of area affected by warts, particularly when the warts are:

• Visible, bothersome, and growing in a small area.
• A cosmetic concern and you want them removed. Warts that are growing around the anus or on external genitals, such as on the penis or vulva, may be removed because they are unsightly. Some treatments that remove genital warts are more likely to leave scars. So cosmetic concerns about scarring may help guide the choice of treatment.

Topical medicine often is the first treatment. For safety, a doctor will apply the topical medicines that could damage the skin around the warts. You can apply other medicines at home. If warts return after one course of treatment with topical medicine, they are treated again only if there are clear reasons for retreatment.

Medicines are not used to treat abnormal cell changes found on a Pap test. For more information on treating abnormal cell changes caused by high-risk HPV, see the topic Abnormal Pap Test.

Medication Choices

Treatment applied at home

The following medicines can be applied to the affected area (topical treatment) at home:

Imiquimod (Aldara)

Podofilox lotion or gel (Condylox)

Sinecatechins (Veregen)

Do not use these medicines during pregnancy.

Imiquimod and podofilox appear to be the most effective medicine options that can be applied at home. Read the instructions carefully before using these medicines.

Treatment applied by a doctor

Treatment by a doctor can:

• Treat areas that you cannot reach easily.
• Treat a large area.
• Remove the warts quickly.
• Be expensive.
• Be painful.
• Have side effects.

Medicines applied by a doctor include:

• Trichloroacetic acid (TCA) or bichloroacetic acid (BCA).
• Podophyllin resin (Podofin).
• Intralesional (injected into wart lesion) interferon.
• Fluorouracil (Efudex, Fluoroplex).

Treatment during pregnancy

Treatment for pregnant women includes trichloroacetic acid (TCA) and bichloroacetic acid (BCA), which have been found to be both effective and safe. Podophyllin resin, interferon, and fluorouracil should not be used during pregnancy because they can harm the fetus.

What To Think About

Avoid sexual contact in the treated area until the area is completely healed.

Some medicine may be more expensive than others.

Warts on the vulva or penis that do not go away on their own or after treatment often are biopsied to rule out precancerous or cancerous conditions.

Recurrence

Removing genital warts does not cure an HPV infection. Although warts may go away with topical treatment, they may return because the HPV virus may still be in the body's cells.

Even if genital warts have been removed or destroyed:

• You may still be able to infect sex partners with HPV.
• You should continue to use condoms during sexual intercourse if you have multiple sex partners.

Last updated:	July 02, 2008
Author:	Sandy Jocoy, RN
Reviewed By:	Kathleen Romito, MD - Family Medicine, Jeanne Marrazzo, MD, MPH - Infectious Disease
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC