How are genital warts treated?

  • There are several methods available to treat genital warts. The types of treatment approaches are divided into two categories: medical and surgical.
  • Certain medical treatments are prescribed and self-administered, meaning the patient themselves has control of their own treatment.
  • These treatments include: imiquimod (Aldara, Zyclara) sinecatechins (Veregen), and podophyllotoxin (Condylox).
  • Chemical treatments that are applied by the physician in the office include trichloracetic acid (TCA) and podophyllin.
  • Surgical treatments include removal by electrodessication, curettage, surgical excision, laser removal and cryotherapy (freezing).
  • The LEEP (loop electric excision procedure) is commonly used to treat internal growths in women. Ablative infrared coagulation has been used to treat HPV growths in the anal and rectal canal in men and in women.
  • The choice of the treatment approach depends on the patient’s clinical presentation and the treatment preferences of the physician. There are advantages and disadvantages to each treatment method.

A specific course of treatment will be recommended by the doctor depending upon the patient’s clinical presentation. Genital warts can be successfully treated with an excellent healing result when a methodical and comprehensive approach is used. HPV is a containable condition and when treated correctly patients with HPV can realistically look forward to a life free of daily stresses from this condition.

Should I be treated if I have genital warts?
Many cases of genital warts will resolve on their own without treatment. However, many cases require treatment in order to prevent them from spreading and infecting a partner. Patients may be highly contagious while they have an active HPV infection and must practice safe sex in order to minimize their chances of infecting a partner. The most conservative approach would be to have the growths removed ASAP in order to minimize the spread to others.

Should I get checked out if my partner has genital warts, but I do not?
If one person has an HPV infection there is a significantly increased chance that their partner also has an HPV infection. The partner should be evaluated by a qualified professional so that the infection can be identified and treated before it has the chance to further progress. The incubation period for an HPV infection has been observed to range from months to over a year. The previously uninfected partner should have periodic evaluations with their physician in order to ensure the early identification and treatment of a potential infection.

Will the genital warts recur after treatment?
Genital warts often recur after treatment. Recurrences occur in the areas that were treated as well as in the normal appearing surrounding skin which may already be infected and where the virus is still incubating. Genital warts can grow out in areas that are completely different from the original infection site. The patient should be evaluated by their physician at periodic intervals in order to identify potential recurrences or new growths. Genital warts are highly contagious

Should I treat the genital warts or first see if they go away on their own?
Many cases of genital warts spontaneously resolve on their own but there are risks to waiting to see if they do. First, although most cases of genital warts are caused by the low risk 6/11 strains, the high risk 16/18 strains can also present as genital warts. There is no definitive way to tell for certain visually which strains are in the genital warts. All parties would benefit if the growths containing high risk strains were removed..

Second, until the genital warts are removed, there is a high risk of infecting a partner. The infection may also spread on the body of an already infected individual to new previously uninfected areas on the same person. The infected individual can then be left with a more extensive infection that may eventually require more treatment than if the growths were removed at an earlier stage.

A person infected with genital warts must be especially mindful to practice safe sex until the warts are treated as well as for a certain period of time after treatment in order to ensure the early detection of an infection and to minimize the possibility of infecting a partner. A person with an HPV infection must be ever vigilant to take all possible precautions to not infect their partner.

Recurrence rates
Recurrence may occur more frequently when the immune system is compromised, when people are physically or emotionally stressed, tired, worn down, ill, or on immunosuppressive medications.

Stress will weaken the immune system and decreases resistance to infection. This may result in an increased chance of getting a recurrence by allowing the reactivation of an old HPV infection which may have been previously dormant.

Men and women have different rates of recurrence. Women build up an immunity and resistance to HPV infections as they grow older and consequently experience fewer outbreaks of HPV. Men do not build up an immunity to HPV infections as effectively as women and they consequently experience more frequent recurrences. This is because antibodies against HPV build up more effectively on the moist surfaces of the vagina and cervix than on the dry skin on the penis.

Is there a cure for HPV?
There is no cure for HPV. However, HPV is manageable and can be contained. Once a person has the infection they always have the chance of getting a recurrence. Patients are advised to schedule periodic follow-up appointments in order to make sure that they did not get a recurrence. HPV can be successfully managed. The chances of HPV recurring, progressing or infecting a partner can be effectively minimized. Safe sex and the use of condoms are critically important.

Patient should stay in good health, manage stress, and keep their immune system strong. HPV outbreaks are far more likely when the immune system becomes compromised and when they are severely stressed.