Genital warts are caused by low-risk HPV types and spread through skin-to-skin sexual contact. Medical treatment focuses on removing visible warts using topical agents (podofilox, imiquimod, TCA, sinecatechins) or procedures (cryotherapy, excision, laser). None reliably eliminate HPV from the body, so recurrence is common. Some topical agents are contraindicated in pregnancy. Vaccination prevents many wart-causing and cancer-causing HPV types; cervical screening remains important. Limit use of unproven home remedies and consult a clinician for safe care.
What causes genital warts
Genital warts are skin growths caused by certain types of human papillomavirus (HPV), most commonly types 6 and 11. They spread through skin-to-skin sexual contact. Warts can appear on the vulva, penis, scrotum, groin, thigh, perineum, or around and inside the anus. Anal warts can occur in anyone who has receptive anal sex and are not a reliable indicator of a person's sexual orientation.
Goals of treatment
Treatments remove visible warts, relieve symptoms, and reduce transmission risk. There is currently no medication that reliably eradicates HPV from the body, and recurrences are common. Management is therefore lesion-directed and preventive, not curative.
Topical medical treatments
Several prescription topical options are used by clinicians or self-applied under guidance:
- Podofilox (topical) and podophyllin resin are destructive agents that chemically remove wart tissue. They are effective but are contraindicated in pregnancy.
- Imiquimod (Aldara) is an immune response modifier applied by patients to stimulate local immune activity against warts. It can cause local inflammation and irritation and is generally not recommended during pregnancy .
- Trichloroacetic acid (TCA) is a caustic chemical applied by clinicians to burn off warts.
- Sinecatechins (a green tea extract ointment) is another prescription topical option for external warts; its use in pregnancy and during breastfeeding should be discussed with a clinician 1.
Procedural options
Clinician-performed procedures include cryotherapy (liquid nitrogen), surgical excision, electrocautery, and laser ablation. Interferon or topical cidofovir are reserved for difficult cases. All procedures remove lesions but do not guarantee prevention of recurrence or onward transmission.
Natural and over-the-counter remedies
Many herbal and home remedies (apple cider vinegar, plant juices, over-the-counter herbal creams) are marketed for genital warts. High-quality evidence supporting their safety and effectiveness is limited. Some household acids can cause burns and scarring. Discuss any alternative therapy with a clinician before use.
Prevention and screening
HPV vaccination (e.g., current multi-valent vaccines) prevents the HPV types that cause most genital warts and many cancers. Routine vaccination is recommended in early adolescence, with catch-up and shared decision-making options for some adults. Regular cervical screening (Pap and/or HPV testing) remains important for people with a cervix to detect precancerous changes.
When to see a clinician
Seek evaluation if you notice new growths in the genital or anal area, bleeding, pain, or if you are pregnant. A clinician can confirm the diagnosis, recommend safe treatment options, and discuss vaccination and screening.
- Confirm current pregnancy recommendations for imiquimod (Aldara) and update wording if needed.
- Confirm safety and manufacturer guidance for sinecatechins (green tea extract ointment) use in pregnancy and breastfeeding.
- Confirm which topical agents are explicitly contraindicated in pregnancy per current clinical guidelines (podofilox/podophyllin vs others).