From the Guidelines
If you notice a wart on your penile head, you should see a healthcare provider for proper diagnosis and treatment, as the most recent and highest quality study recommends a new formulation of imiquimod (3.75% cream) for anogenital wart treatment 1.
Diagnosis and Treatment
The growths are typically caused by human papillomavirus (HPV) and are considered a sexually transmitted infection. Treatment options include:
- Topical medications like imiquimod 3.75% cream
- Podophyllin resin (10-25% applied by a healthcare provider weekly)
- Podofilox 0.5% solution (applied twice daily for 3 days, followed by 4 days of no treatment, repeated for up to 4 cycles)
- Cryotherapy (freezing with liquid nitrogen)
- Surgical removal
- Laser therapy While waiting for treatment, avoid sexual contact to prevent transmission to partners. Do not attempt to remove these warts yourself as this can cause pain, bleeding, infection, or scarring.
Prevention and Transmission
Many genital warts will eventually clear on their own as your immune system fights the virus, but treatment speeds resolution and reduces transmission risk. Even after treatment, the virus may remain dormant in your body, potentially causing recurrence, so follow-up appointments are important 1.
Key Considerations
HPV vaccine is recommended routinely for 11- or 12-year-olds, as well as for young men through age 21 years and young women through age 26 years who have not previously been vaccinated 1.
From the FDA Drug Label
1.3 External Genital Warts Imiquimod Cream is indicated for the treatment of external genital and perianal warts/condyloma acuminata in patients 12 years old and older. The imiquimod cream can be used to treat a wart on the penile head as it is indicated for the treatment of external genital warts in patients 12 years old and older 2.
- Key points:
- Imiquimod cream is indicated for external genital warts
- Age restriction: 12 years old and older
- Specific location: external genital warts, which includes the penile head Alternatively, podofilox topical solution can also be used to treat external genital warts 3.
From the Research
Treatment Options for Wart on Penile Head
- Topical treatments include podophyllin resin, imiquimod, trichloroacetic acid, and podophyllotoxin 4
- Surgical or destructive therapies include carbon dioxide laser, surgical excision, loop excision, cryotherapy, and electrodessication 4
- Interferon can be injected locally or administered systemically to treat genital warts 4
- Imiquimod 5% cream is a topical treatment that stimulates the production of interferon-alpha and has indirect antiviral activity 5, 6
- Patient-administered therapies include podofilox (0.5%) solution or gel, imiquimod 3.75 or 5% cream, and sinecatechins (polypheron E) 15% ointment 7
- Clinician-administered therapies include podophyllin, cryotherapy, bichloroacetic or trichloroacetic acid, oral cimetidine, surgical excision, electrocautery, and carbon dioxide laser therapy 7
Considerations for Treatment
- The choice of treatment method should depend on the physician's comfort level with the various treatment options, the patient's preference and tolerability of treatment, and the number and severity of lesions 7
- The comparative efficacy, ease of administration, adverse effects, cost, and availability of the treatment modality should also be taken into consideration 7
- Approximately one-third of penile warts regress without treatment and the average duration prior to resolution is approximately 9 months 7
- Active treatment is preferable to watchful observation to speed up clearance of the lesions and to assuage fears of transmission and autoinoculation 7
Efficacy of Treatment Options
- Imiquimod 5% cream has been shown to have complete clearance of warts in 37 to 50% of immunocompetent patients with genital warts 5
- Partial clearance of warts (defined as a reduction in wart area of > or = 50%) was observed in 76% of recipients of imiquimod 5% cream 5
- Recurrence(s) of > or = 1 wart occurred in 13 to 19% of immunocompetent patients in whom complete clearance of warts had been achieved with imiquimod 5% cream 5