From the Guidelines
Treatment options for Condyloma acuminata (genital warts) include patient-applied therapies, provider-administered therapies, and surgical therapy.
Treatment Options
- Patient-applied therapies: include podofilox and imiquimod 1
- Provider-administered therapies: include cryotherapy, podophyllin resin, trichloroacetic acid (TCA), bichloroacetic acid (BCA), interferon, and surgery 1
- Surgical therapy: has the advantage of usually eliminating warts at a single visit, but requires substantial clinical training, additional equipment, and a longer office visit 2, 3 ### Factors Influencing Treatment Selection
- Wart size
- Wart number
- Anatomic site of wart
- Wart morphology
- Patient preference
- Cost of treatment
- Convenience
- Adverse effects
- Provider experience 1, 4 ### Treatment Efficacy and Recurrence
- Currently available therapeutic methods are 22%-94% effective in clearing external exophytic genital warts 5
- Recurrence rates are high (usually at least 25% within 3 months) with all modalities 5
- Treatment is more successful for genital warts that are small and that have been present less than 1 year 5
From the Research
Treatment Options for Condyloma Acuminata (Genital Warts)
The treatment options for Condyloma acuminata (genital warts) are numerous and can be categorized into several types, including:
- Topical treatments: + Podophyllin resin + Imiquimod + Trichloroacetic acid + Podophyllotoxin 6
- Surgical or destructive therapies: + Carbon dioxide laser + Surgical excision + Loop excision + Cryotherapy + Electrodessication 6
- Interferon therapy: can be injected locally or administered systemically 6, 7
- Other therapies: + 5-fluorouracil/epinephrine collagen gel + Sinecatechin (polyphenon E) ointment 7, 8
Efficacy and Choice of Therapy
The choice of therapy depends on the number, size, and location of lesions, as well as the side effect profile, cost, effectiveness, and convenience of the treatment 6. Cryotherapy is often considered a first-line destructive treatment, while surgery and electrodessication are more effective 6. Imiquimod and podophyllotoxin are commonly used as first-line topical treatments 6, 9. However, the efficacy of these treatments can vary, and recurrence rates are common, ranging from 30-70% at 6 months follow-up periods 10.
Combination Therapies
Combining imiquimod with other therapies may increase its efficacy, and recent literature suggests exploring this approach to improve treatment outcomes for genital warts 8.