Treating Condyloma Acuminatum (Genital Warts) - IDSA
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Treating Condyloma Acuminatum (Genital Warts) - IDSA

Patients with HIV may have larger or more numerous warts, may not respond as well to therapy for genital warts, and have a higher risk of recurrence after treatment than HIV-negative individuals. More than one treatment option maybe required for refractory or recurrent lesions. Intra-anal, vaginal, or cervical warts should be treated and managed by a specialist.

Patient-Applied Therapy - For Uncomplicated External Warts that can be Easily Identified and Treated by the Patient:

 • Imiquimod 5% cream: Apply to lesions at bedtime on 3 non-consecutive nights a week and wash the treatment area with soap and water 6–10 hours after application (BII), repeating the cycle until lesions are no longer seen, for up to 16 weeks, or

 • Sinecatechins 15% ointment: Apply to area 3 times daily for up to 16 weeks, until warts are not visible. (BIII)

Provider-Applied Therapy - For Complex or Multicentric Lesions, Lesions Inaccessible to Patient-Applied Treatments, or Patient/Provider Preference:

 • Cryotherapy (liquid nitrogen or cryoprobe): Apply until each lesion is thoroughly frozen; repeat every 1–2 weeks for up to 4 weeks until lesions are no longer visible. Some specialists allow the lesion to thaw, and then freeze a second time in each session

 • TCA or BCA cauterization: 80% to 90% aqueous solution, apply to warts only and allow the area to dry until a white frost develops. If an excess amount of acid is applied, the treated area should be powdered with talc, sodium bicarbonate, or liquid soap to remove unreacted acid. Repeat treatment weekly for up to 6 weeks until lesions are no longer visible.

 • Surgical excision or laser surgery can be performed for external or anal warts.

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Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: | Twitter:
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