From the Guidelines
Treatment of HPV on the penis typically involves a combination of medical interventions and monitoring, with a focus on removing visible genital warts and reducing symptoms, rather than eliminating the virus itself. For visible genital warts caused by HPV, treatment options include topical medications such as imiquimod 5% cream, podofilox 0.5% solution or gel, or sinecatechins 15% ointment 1. For larger or numerous warts, in-office procedures may be necessary, including cryotherapy, surgical excision, or electrocautery. Some healthcare providers may use trichloroacetic acid (TCA) 80-90% applied carefully to warts weekly. It's essential to note that while these treatments remove visible warts, they don't eliminate the virus itself, and recurrence is common, occurring in about 25% of cases 1.
Key Considerations
- The immune system often clears the infection naturally over time, typically within two years in healthy individuals.
- Regular follow-up appointments are essential to monitor for recurrence.
- Partners should be informed about the infection, and condom use is recommended to reduce transmission risk, though it doesn't provide complete protection since HPV can infect areas not covered by condoms.
- Female sex partners of patients who have genital warts should be reminded that cytologic screening for cervical cancer is recommended for all sexually active women 1.
Treatment Options
- Topical medications: imiquimod 5% cream, podofilox 0.5% solution or gel, or sinecatechins 15% ointment.
- In-office procedures: cryotherapy, surgical excision, or electrocautery.
- Trichloroacetic acid (TCA) 80-90% applied carefully to warts weekly.
Important Notes
- Treatment of genital warts probably does not eliminate the HPV infection, and patients and sex partners should be cautioned that the patient might remain infectious even though the warts are gone 1.
- The use of condoms may reduce, but does not eliminate, the risk for transmission to uninfected partners 1.
From the FDA Drug Label
External Genital Warts Imiquimod has no direct antiviral activity in cell culture A study in 22 subjects with genital/perianal warts comparing imiquimod cream and vehicle shows that imiquimod cream induces mRNA encoding cytokines including interferon-ɑ at the treatment site. In addition HPVL1 mRNA and HPV DNA are significantly decreased following treatment.
The treatment option for Human Papillomavirus (HPV) infection on the penis is imiquimod cream. It works by inducing mRNA encoding cytokines, including interferon-ɑ, at the treatment site, which helps decrease HPVL1 mRNA and HPV DNA.
- Key points:
- Imiquimod cream has no direct antiviral activity
- It induces cytokines, including interferon-ɑ, to help decrease HPV DNA
- It is used to treat external genital warts, which can be caused by HPV infection on the penis 2
From the Research
Treatment Options for HPV Infection on the Penis
- Topical treatments:
- Podophyllin resin
- Imiquimod
- Trichloroacetic acid
- Podophyllotoxin 3
- Surgical or destructive therapies:
- Carbon dioxide laser
- Surgical excision
- Loop excision
- Cryotherapy
- Electrodessication 3
- Interferon can be injected locally or administered systemically to treat genital warts 3
- Patient-applied therapy such as imiquimod cream or podofilox is increasingly recommended 4
- The choice of therapy is based on the number, size, site, and morphology of lesions, as well as patient preferences, cost, convenience, adverse effects, and clinician experience 4
Prevention of HPV Infection
- Vaccination is the primary method of prevention 5
- Use of condoms and dental dams may decrease spread of the virus 5
- The nonavalent HPV vaccine is effective in preventing the development of high-grade precancerous cervical lesions in noninfected patients 5
- Vaccination is ideally administered at 11 or 12 years of age, irrespective of the patient's sex 5