Genital warts treatment

Genital warts are a sexually transmitted infection (STI) that is passed on through sexual contact, like oral, vaginal, or anal sex, or by sharing sex toys. They look like small, rough lumps that appear around the vagina, penis, or anus, and can sometimes cause other symptoms like itching, pain, or discomfort.

Genital warts are the most common viral STI in the UK and are caused by the human papillomavirus (HPV), the same virus that causes cervical cancer. In 2019, there were almost 51,000 new genital warts cases, which is around 10% of all newly diagnosed STIs.

If you notice any of the following common genital warts symptoms, speak to your doctor as you may need treatment:

• single or groups of warts (groups can resemble a cauliflower)
• soft or firm lumps that are red, flesh-coloured, or darker than your surrounding skin
• pain or discomfort during sex
• difficulty peeing or blood in your pee
• soreness or itchiness in the affected area

Many people who carry the HPV virus do not know they have it, but can still pass it on without knowing. Genital warts can take between a few weeks to several months to appear after infection. In some cases, they can take years to develop or not at all.

Treatment is available for genital warts, although it’s not always needed. If treatment is required, different types can be used, including:

• creams, liquids, or ointments – these are usually prescription-only treatments that are applied to the affected area by yourself and work either by killing the virus that causes genital warts or stimulating your immune system to fight it
• freezing (cryotherapy) – liquid nitrogen is applied to the area by a medical professional to freeze genital warts in people who have a small to moderate outbreak or who are pregnant, but it may require several sessions to work
• surgery – warts are cut out after the area is numbed with local anaesthetic, or they can be removed using heat or laser therapy, but this method can cause pain, irritation, and scarring

The effectiveness of genital warts treatment varies, depending on the type you are given. Here is a comparison of the average effectiveness of each of the main treatments:

Here’s how long it takes for genital warts treatments to work, on average:

• excision surgery – immediate removal as warts are physically cut out
• cryotherapy – several weeks to months across weekly treatments
• topical solutions – around 4 to 8 weeks to completely clear the warts

Can genital warts come back after treatment?

Yes, genital warts can come back after treatment because although it may remove the visible warts, the virus that causes them (HPV) can remain in the body. Genital warts can return within 3 months of treatment for some people, even if you have applied the treatment correctly.

HPV can lie dormant in the body, causing no symptoms, but the body’s immune system clears 90% of cases within 2 years of initial infection.

Several different genital wart treatments are available. At ZAVA, we can prescribe:

Warticon

What is it?

Warticon is a prescription-only topical cream that contains the active ingredient podophyllotoxin, a natural plant extract that can successfully treat soft genital warts.

How does it work?

Podophyllotoxin works by penetrating the wart cells and stopping them from growing and multiplying. Warticon does not cure the HPV infection that causes genital warts, instead, it treats the visible warts.

How effective is it?

Podophyllotoxin cream has a 70% clearance rate for genital warts.

How do you use it?

Warticon cream is applied twice a day for 3 days, followed by a 4-day break. If any warts are remaining after 7 days, you will need to repeat the treatment course. A maximum of 4 treatment courses can be applied. If you still have genital warts after this, you will need to contact your doctor for advice.

Aldara

What is it?

Aldara is a prescription-only topical cream that contains imiquimod.

How does it work?

Imiquimod acts as an immune response modifier, which means it helps your immune system to produce natural substances to fight the infection that causes genital warts, getting rid of visible warts.

How effective is it?

Research shows that it has a clearance rate of 60% in women and 23% in men, and can take 8 to 12 weeks to work completely.

How do you use it?

For genital warts, Aldara cream is applied just before going to bed, 3 times a week, until your warts have completely gone. It should not be used for more than 16 weeks.

Other genital warts treatments

As well as topical solutions and creams, other medical treatments are available, such as:

Cryotherapy

Cryotherapy is a type of freezing that uses liquid nitrogen to freeze and destroy the wart tissue. The freezing and thawing process of cryotherapy damages the wart cell, so that it is eventually removed.

Cryotherapy has a high success rate, but it can take several sessions to be successful. Research shows that 50% of genital warts are cleared after 3 sessions.

Cryotherapy is one of the safest methods for treating genital warts in pregnancy.

Surgery

Surgery involves the genital warts being cut out, burned, or removed with a laser. It’s usually performed under local anaesthetic and is generally recommended for large warts or those that have been resistant to other treatments. Although it has high success rates, surgery can be painful and cause scarring.

What’s the best treatment for genital warts?

There is no clear ‘best’ treatment for genital warts, because what treatment works best and is available to you will depend on the number of warts you have, their size, and how severe your symptoms are. Topical medications, like Aldara and Warticon, which contain the active ingredients imiquimod and podophyllotoxin, are suitable home treatments for small warts. If you have large warts, you may need a different treatment method.

It’s important to get a diagnosis from a doctor if you suspect you may have genital warts, so that they can advise the best course of treatment for you. When you request treatment with ZAVA, we’ll ask for some confidential pictures of the affected area, so one of our doctors can diagnose genital warts before prescribing treatment.

Genital warts treatment can be obtained via a private or NHS prescription. You can choose to request treatment from trusted online doctor services, or you can make an appointment with your GP or visit a sexual health clinic.

Can I buy genital warts treatment online?

Yes, you can request genital wart treatments online from reputable online doctor services like ZAVA. There is no need to wait for a face-to-face appointment, and the whole process can be completed at home. Once your order is approved, your medication will be delivered quickly and discreetly to your home address.

To order genital warts treatment from ZAVA, simply:

1. Fill out a short online health questionnaire for one of our doctors to review. This includes sending some photos of the area, so our doctors can make sure you’re getting the right treatment, especially if you have not been diagnosed yet.
2. Choose your preferred medication.
3. Once approved, your medication will be delivered by Royal Mail, or you can choose to collect it from your local Post Office.

Can I get genital warts treatment over the counter?

No, the medications prescribed to treat genital warts are prescription-only, so you will need a doctor’s approval to get them.

Can I get genital warts treatment on the NHS?

Yes, treatment for genital warts can be obtained through the NHS. You will need to visit your GP or a sexual health clinic to get a prescription, as a doctor or nurse will need to look at the affected area first before prescribing treatment.

Like all medications, there is a chance of side effects when using genital warts treatments, although not everyone will get them.

Warticon side effects

Very common side effects, affecting more than 1 in 10 people, include:

• wearing away of the top layers of skin
• application site reactions, including redness, itching, or burning

Other Warticon side effects include:

• allergic reaction
• pain
• swelling
• bleeding
• weeping wound
• skin ulcer
• scabs
• skin discolouration
• dry skin
• blisters

It’s important to note that Warticon can cause mild irritation to the treatment areas after 2 to 3 days, but this is a sign that it’s working. However, if you get a severe skin reaction, wash off the cream, stop using Warticon, and speak to a doctor straight away.

Aldara side effects

Very common side effects include:

• redness
• wearing away of the skin
• flakiness and swelling
• hardening under the skin
• small open sores
• crust that forms during healing
• itching
• burning sensation or pain where you have applied the cream

Common side effects include:

• headache

Uncommon side effects include:

• flu-like symptoms
• prolapse of the womb
• pain during sex
• erectile dysfunction
• sweating
• feeling sick
• stomach and bowel issues
• ringing in the ears
• flushing
• dizziness
• tiredness
• migraine
• pins and needles
• insomnia
• depression
• loss of appetite
• swollen glands
• bacterial, viral, and fungal infections
• vaginal infection, including thrush
• cough and colds with a sore throat

If you get mild skin reactions like redness, swelling, and itching where you applied the cream, this means Aldara is working and your immune system is trying to get rid of the infected cells.

How long do these side effects last?

Most of the side effects caused by topical treatments are temporary and affect the area where they were applied. They will usually disappear within 2 weeks of stopping treatment.

What to do if you get side effects

If you experience side effects while using a topical genital warts treatment, wash it off your skin immediately with soap and water, and contact your doctor for further advice. They may recommend an alternative treatment that is more suitable for you.

When applying a topical treatment, it’s essential to apply it directly to the wart and not to the surrounding skin. This can help lower the chance of adverse reactions.

Genital warts treatment may not be suitable for everyone, so you should discuss the most suitable options with a doctor to find the right medication for you.

Genital warts treatment may not be suitable for you if you:

• are allergic to any of the ingredients listed in the patient information leaflet
• are under 18
• have warts on broken or damaged areas or bleeding skin
• are already using a medication that contains podophyllotoxin or imiquimod
• have internal or large warts
• are pregnant, trying to get pregnant, or breastfeeding
• have an autoimmune disorder
• have had an organ transplant

Can genital warts go away without treatment?

Yes, genital warts can go away without treatment. However, there is no cure for HPV, the virus that causes genital warts, so even though treatment may get rid of the physical signs, the virus may still be present in your body. However, the body’s immune system clears 90% of genital warts cases within 2 years of initial infection.