HPV Vaccine Does Not Clear Existing Skin Warts

The HPV vaccine does not have any therapeutic effect on existing warts and will not clear warts that are already present on the skin. 1

Mechanism of HPV Vaccines and Existing Infections

HPV vaccines are preventive, not therapeutic, designed to prevent new infections with specific HPV types but not to treat or clear existing HPV infections or related conditions 1
The quadrivalent HPV vaccine contains virus-like particles (VLPs) prepared from the L1 proteins of HPV types 6,11,16, and 18, which stimulate an immune response against these specific types 1
The newer nonavalent vaccine covers HPV types 6,11,16,18,31,33,45,52, and 58, potentially preventing approximately 90% of cervical and other HPV-related cancers 2
Clinical trials have consistently shown that HPV vaccines have no therapeutic effect on existing HPV infections, cervical lesions, or genital warts 1

For individuals with a history of genital warts or clinically evident warts, the vaccine will only provide protection against HPV types not already acquired 1
The Advisory Committee on Immunization Practices (ACIP) explicitly states that "results from clinical trials do not indicate the vaccine will have any therapeutic effect on existing HPV infection or genital warts" 1
Treatment for existing warts is directed at the HPV-associated lesions rather than the infection itself 1
Standard treatments for cutaneous warts include topical medications, cryotherapy, electrocautery, laser therapy, and surgical excision 3

While some case reports suggest potential therapeutic benefits of HPV vaccination for recalcitrant warts 4, these are isolated cases and not supported by larger clinical trials or guidelines
A 2020 literature review indicated preliminary data on HPV vaccine as a potential treatment for cutaneous warts, but this remains investigational and is not recommended in current clinical guidelines 5
The 2021 German research explicitly states that "in case of already acquired HPV infection or existing HPV-induced lesions prophylactic vaccination does not lead to accelerated HPV elimination or clearance of lesions" 6

Treatment options for existing warts include various local approaches such as:
- Cryotherapy with liquid nitrogen 1
- Topical treatments like salicylic acid, trichloroacetic acid, or podophyllin 1, 7
- Surgical removal or electrocautery 1
- Immunomodulatory compounds with antiviral properties 7
None of these treatment modalities have been proven superior to others 7
Treatment focuses on the alleviation of signs and symptoms rather than curing the underlying HPV infection 7

HPV vaccination is recommended for prevention in:
- Females and males aged 11-12 years (can start as early as age 9) 2
- Catch-up vaccination for females through age 26 and males through age 21 (through age 26 for MSM and immunocompromised persons) 2
Condom use may reduce the risk of acquiring new HPV infections by up to 70% when used consistently and correctly 2
Abstaining from sexual activity or maintaining a monogamous relationship with an uninfected partner are the most effective strategies for preventing future HPV infections 2

A common misconception is that the HPV vaccine might have therapeutic effects on existing warts or HPV infections 2
Neither routine surveillance for HPV infection nor partner notification is useful for HPV prevention since the majority of partners of persons with HPV infection are likely already infected 2
HPV vaccines should not be delayed in hopes of treating existing warts, as they remain valuable for preventing new infections with other HPV types 1