The sexually transmitted human papillomavirus (HPV) causes genital warts. According to the Centers for Disease Control and Prevention (CDC), there is no preferred method of treatment for genital warts. Your choice should be based on the size and distribution of your warts and your preference for treating them at home or in your doctor's office. It is important to remember that the treatments remove the warts but do not rid your body of the virus, so warts can grow back and you can still spread the virus to sex partners.
At Home
If you have 10 or fewer small external warts that you prefer to treat yourself, you can ask your doctor to prescribe a gel or cream solution such as podofilox or imiquimod to remove the warts over several weeks. Podofilox is a solution or gel that you apply twice daily for three days, then wait four days and repeat for up to four cycles. Podofilox works by stopping cell division in the wart. You should not use podofilox if you are pregnant because it can harm the baby.
Imiquimod cream is used once daily, three times a week for up to 16 weeks. It stimulates local immune factors to destroy the wart.
Doctor's Office
Your doctor can apply a stronger version of podofilox, called podophyllin, to remove genital warts. You might need to repeat the once a week treatments for a few weeks. Like podofilox, podophyllin is not safe if you are pregnant. Trichloroacetic acid (TCA) treatment can "burn" warts off; again, this treatment can be repeated once a week if needed. To avoid damage to nearby healthy cells, both podophyllin and TCA should be used only over small areas.
Surgery can remove the warts in one visit, but this is obviously a more serious decision. If you have many internal warts, or many external warts spread over a large area, surgery might be your best option. Your doctor numbs the area with a local anesthetic and removes the warts with a sharp blade or laser, or by electrocautery (burning) or cryotherapy (freezing) with liquid nitrogen.
Alternatives
Some doctors inject interferons (immune stimulators) directly into warts, but because of side effects and its inconvenience, this is probably not a good choice for many people.
Genital warts often disappear with no treatment. There is no way to predict if they will grow or disappear, so waiting and watching is a reasonable option if the warts are not troubling you. Treating the warts can reduce but not eliminate the HPV virus. It is not clear if treating the warts makes you less likely to spread the virus.
