Anogenital Warts

General Information

  1. Anogenital warts are caused by human papilloma virus (HPV), usually types 6 and 11 which are not associated with dysplasia or malignancy
  2. Infection with HPV is very common, most infections do not lead to visible anogenital warts and clear spontaneously
  3. Most HPV infection is acquired through sexual contact. Perinatal infection can occur but is rarely harmful to children
  4. The current HPV vaccination programme for adolescent girls is with a quadrivalent vaccine which protects against HPV 6 and 11 in addition to 16 and 18
  5. Individuals diagnosed with anogenital warts should be offered testing for other STIs including HIV, Hepatitis B, syphilis and gonorrhoea. Hepatitis C testing should be offered those with a history of injecting drug use and MSM, further information on this is available in the ICGP STI e-learning module.
  6. Further information on sample type and site for chlamydia and gonorrhoea testing is available on the ICGP STI e-learning module
  7. Anogenital warts are a notifiable disease. The complete list of notifiable diseases and information on the notification process is available at HPSC

Treatment options

Small volume warts may resolve without treatment. All treatments are associated with non-response, relapse and local skin irritation.

 

Treatment name

Comments

Topical treatment

Podophyllotoxin cream (Warticon®) or lotion (Condylline®) applied twice daily, 3 times per week and repeated for up to 5 cycles

In general soft, non-keratinised warts respond better to podophyllotxin while cryotherapy is more useful for keratinised warts

 

Aldara® cream is more expensive than Warticon® and Condylline®

 

The choice between Warticon® and Condylline® is dictated by patient choice and ease of administration of cream or lotion to the warts

 

Topical treatments are not for internal use

 

Cryotherapy is safe in pregnancy but treatment of warts may not be necessary in pregnancy, particularly if low volume

Imiquimod 5%(Aldara®) cream 1 sachet applied nightly Monday, Wednesday and Friday for up to 16 weeks

 

Physical Ablation

Cryotherapy to warts, weekly for up to 4 weeks


Useful resources


Patient information

Downloadable information and leaflet to order

We recommend patients use the website developed by HSE/ICGP/IPU partnership www.undertheweather.ie for tips on how to get better from common infections without using antibiotics, what you can do for yourself or a loved one and when to seek help.

The HSE Health A-Z website provides patient information on many hundreds of conditions and treatments.

Reviewed April 2017