Management of external genital warts

Am Fam Physician. 2014 Sep 1;90(5):312-8.


Genital warts affect 1% of the sexually active U.S. population and are commonly seen in primary care. Human papillomavirus types 6 and 11 are responsible for most genital warts. Warts vary from small, flat-topped papules to large, cauliflower-like lesions on the anogenital mucosa and surrounding skin. Diagnosis is clinical, but atypical lesions should be confirmed by histology. Treatments may be applied by patients, or by a clinician in the office. Patient-applied treatments include topical imiquimod, podofilox, and sinecatechins, whereas clinician-applied treatments include podophyllin, bichloroacetic acid, and trichloroacetic acid. Surgical treatments include excision, cryotherapy, and electrosurgery. The quadrivalent human papillomavirus vaccine is active against virus subtypes that cause genital warts in men and women. Additionally, male circumcision may be effective in decreasing the transmission of human immunodeficiency virus, human papillomavirus, and herpes simplex virus.

MeSH terms

  • Administration, Topical
  • Adult
  • Antineoplastic Agents / therapeutic use*
  • Combined Modality Therapy
  • Condylomata Acuminata* / diagnosis
  • Condylomata Acuminata* / etiology
  • Condylomata Acuminata* / physiopathology
  • Condylomata Acuminata* / therapy
  • Cryotherapy / methods
  • Diagnosis, Differential
  • Electrosurgery / methods
  • Female
  • Human papillomavirus 11 / immunology*
  • Humans
  • Keratolytic Agents / therapeutic use*
  • Male
  • Papillomavirus Infections* / diagnosis
  • Papillomavirus Infections* / etiology
  • Papillomavirus Infections* / physiopathology
  • Papillomavirus Infections* / therapy
  • Papillomavirus Vaccines / therapeutic use*
  • Precancerous Conditions / pathology*
  • Urogenital Surgical Procedures / methods


  • Antineoplastic Agents
  • Keratolytic Agents
  • Papillomavirus Vaccines