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Genital Warts Treatment – What You Need to Know

January 24, 2024

This post shares everything you need to know about Genital Warts Treatment.

Image showing a single lesion (genital warts treatment)

Genital warts are benign growths that multiply, occurring in the genital and anal areas and the tissues close beside them.

They are common and can affect you at any age, but are most common in young people in their early 20s.

Their cause? They happen due to infection with human papillomavirus, HPV – specifically the low-risk genotypes 6 and 11, which are different from the high-risk HPV strains that are implicated in cervical cancer. 

Even though they are benign and very unlikely to cause severe, life-threatening diseases, their location in intimate areas and the way they grow and spread can lead to a lot of discomfort, embarrassment and distress, especially when trying to get rid of them.

They are most commonly spread by sexual contact. Hence if you have anal, oral or vaginal sex with someone who has genital warts, you can catch them. You may also get them from sharing sex toys.

Sometimes they can also be spread from warts on your partner’s hands; or from a mum to the baby during a vaginal delivery.

Diagnosing Genital Warts

The diagnosis is usually by a physical examination where they can be seen on the skin with the following characteristics:

  • They may occur singly or in more than one cluster.
  • Occur in areas of high friction – where there is a lot of skin-on-skin rubbing or skin-on-clothing rubbing – genitals, between the thighs, anal opening between the cheeks of the bottom, etc. 
  • They can be soft and fleshy in moist, hairless areas or firm in dry, hairy areas.
  • They can look the same as your skin tone or, in some cases, appear lighter or darker.
  • They could grow close to the skin with a broad base, while some may have a slight stalk connecting them to the skin.

Sometimes, they can be confused with similar-looking lesions, and doctors will take a little bit of tissue, known as a biopsy, to examine in the lab to confirm what they are.

We do not diagnose genital warts with blood tests or scans.

When are you contagious – before, during, or after lesions develop?

Genital Warts Treatment Options

Before we begin, it is always best to see a medical professional if you think you have genital warts.

Whatever treatment option you choose, it’s essential to test for other sexually transmitted infections which might show up later and would require a different treatment for warts. 

Do Nothing…

No treatment. The first option is doing nothing, ie leaving the warts alone.

This choice may often discarded as unimportant, but 30% of warts that you can see disappear within six months.

The problem, of course, is that it’s a long time to wait, and it can affect your sexual relationships and body image. 

Topical (Skin) Preparations

Next are the more common options- skin preparations – applied as creams, ointments or liquids to the skin. There are a few. Some can be self-applied, though if you have warts over a large area, your doctor or nurse may help. For these, we have Podophyllotoxin, Imiquimod or Catephen.

Podophyllotoxin

Let’s start with Podophyllotoxin. You will find this under several brand names. The use of this cream requires medical supervision for genital warts in women and men if they have large warts.

This is because they can help you with the precise location of the warts and where to apply the treatments at home.

It comes as a cream or liquid preparation. Treatment usually happens for three days every week for a number of weeks – the number of courses required will depend on the nature and extent of your lesions, and your doctor will advise this.

The cream can lead to skin irritation that may develop on day 2 or 3 of starting treatment. It is mostly mild and goes away if you stop using the cream.

Sometimes, the skin can become very severe, or ulcers may develop using Podophyllotoxin. Be careful not to apply the cream on open wounds and avoid it near the eyes.

Also, watch the amount you are using – thin application is best, as excessive amounts don’t make it get better quicker but can lead to complications like bowel or kidney damage and more.

Pregnant and breastfeeding women should not use this medicine.                                                                    

Imiquimod

Next is Imiquimod cream, which may also have different brand names depending on your location.

The duration of treatment is lengthy – up to 4 months and using the cream thrice a week, best at night.

You apply the cream directly on the warts only (not on normal skin), rubbing thinly into the lesions and leaving the cream on for at least 6–10 hours.

Afterwards, wash off the cream with mild soap and water. It is also important to have medical supervision before you start here, as this cream is not for internal use.

It would be best to continue using the cream until all visible warts around the genitals have cleared – or for a maximum of 4 months.

Common side effects include redness and pain around the warts because Imiquimod quickly stimulates the immune system after a few applications.

If this happens, stop using the cream until the redness settles, then restart gradually – this time, use it once or twice a week. Other side effects are joint and muscle aches and headaches.

Less commonly, they may cause tissue irritation, diarrhoea, and mood changes. It may also permanently cause skin darkening or lightening.

Please read the accompanying medication leaflet to learn how to use it and its potential side effects. When you have warts, you should abstain from sex until completely clear or use condoms.

However, be careful, as Imiquimod cream can damage or weaken latex condoms or diaphragms. You should also avoid having sex with the cream applied as it may irritate your partner’s skin.

Sinecatechin

Another wart cream that can be self-applied for external genital warts contains the green tea extract (epigallocatechin gallate) known as Sinecatechin. It is applied by hand thinly over the warts, and there is no need to wash it off following application.

Again, treatment should continue till the warts have cleared and last no longer than four months. It can also cause some skin irritation, and be careful not to use it on normal skin or have sex while you have the cream applied, as it can irritate your partner’s skin. The cream may also weaken latex condoms and vaginal diaphragms, so wash it off before using these before sex.

When using any of these active skin treatments for genital warts, please keep the following in mind:

  1. They may take 1–6 months to work, so be patient. You may see some improvement after 4-5 weeks on Podophyllotoxin and Sinecatecins, but it may be 2- 3 months before you start to see any benefits with Imiquimod. If there is no response at all in that time, you should change treatment.
  2. They may not be very effective, especially the first time around, and you may need more than one treatment course to eliminate an outbreak of the warts.
  3. After completing these treatments, warts can come back, i.e. a relapse, because they do not eliminate the human papillomavirus.
  4. It’s also good to know the treatments often involve discomfort and skin reactions.
  5. Using condoms to prevent the spread is important, and stopping smoking can improve your response to treatment.

Specialist Genital Wart Treatments

So now let’s look at treatments that require a specialist to be very closely involved.

These may be options if there’s been no response for months on the other treatments, the warts are extensive, or you have side effects from other treatments mentioned.

The first is a liquid solution known as TCA or Trichloroacetic acid, which requires a specialist’s application.

Next, cryotherapy/freezing involves applying liquid nitrogen directly to the warts to freeze the tissues and kill them off. This treatment may need to be repeated several times and can be painful. 

Next, the warts can be removed by cutting them off after using local anaesthetic to numb the skin area.

Alternatively, electric current, laser or heat treatments can achieve the same: removal of warts. These are quicker but can also have side effects, including bleeding, scarring, pain, soreness and irritation in the area.

Pregnancy with Genital Warts

A mention for pregnant women with genital warts.

They are not harmful while you are pregnant – but they can get bigger, become more easily irritated or inflamed, or be passed to your baby during birth, although this is rare. Most treatments for warts are not recommended during pregnancy, so unless they are very big, we usually do nothing about them until the baby is born.

Then, they usually disappear on their own within six weeks after the baby is born, so treatment is often delayed until after the birth.

So, this is how genital warts may be treated. 

You may be able to clear the warts with a healthy immune system after 18-24 months, but sometimes they can come back.

Last Thoughts

Don’t use salicylic or glycolic acid for genital warts treatment; they do not work, and neither do standard verruca or plantar wart treatments for hand/foot warts.

They also do not respond to antibiotics; you should not try scraping or scratching them off at home.

Finally, remember that the time you see the warts differs from when you were infected.

In other words, there is an incubation period after the initial infection when the virus grows in the body before it shows on the skin.

Many people may suspect their partners of cheating from the time they see the warts, but in fact, they may have been infected months previously, while the warts are only just showing now.

This incubation period between when you are infected with HPV and when you develop warts varies from person to person but is typically shorter in women than in men.

More Reading

Editing by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of healthcare conditions to provide evidence-based guidance and to help promote quality healthcare. 

The advice in our material is not meant to replace the management of your specific condition by a qualified healthcare practitioner.
To discuss your condition, don’t hesitate to get in touch with a health practitioner or reach us directly.

Image Credits: Canva

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Our educational content meets the standards set by the NHS in their Standard for Creating Health Content guidance.

Askawayhealth aims to deliver reliable and evidence based women's health, family health and sexual health information in a way that is easily relatable and easy for everyone to access.

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