GENITAL WARTS / CONDYLOMATA ACUMINATA

Condylomata acuminata or genital warts are caused by HPV and are
transmitted by direct contact, usually through sexual intercourse,
sometimes by infected hands. Transmission is also possible from mother
to child during childbirth. Genital warts may show accelerated growth in
pregnancy followed by spontaneous reduction after childbirth. Excessive
growth occurs in immune suppressed patients. Patients should have
syphilis serology checked. Women with genital warts should have a Pap
smear taken.
Management of condylomata acuminata
- Podophyllin 10-25% solution. Protect the skin surrounding the warts with vaseline.
Apply podophyllin carefully to the warts with the back of a matchstick. Leave it on
for 4 to 6 hours then wash off with water and soap. Repeat weekly until cleared.
Podophyllin is contra-indicated in pregnancy!
- Trichlorocacetic acid 50-88% solution, applied in the clinic, may be used in pregnancy.
- Cryosurgery with liquid nitrogen .
- Cauterisation of large and/or refractive genital warts. This can be a very useful
procedure but is controversial in immune suppression because the warts tend to
recur quickly and extensive. When patients are severely disabled by their genital
warts, you may however not have much choice.
- Topical 5% 5-fluoro-uracil cream (Efudix) may be used once daily to once weekly for
up to 6 months after any of these treatments to prevent recurrences.
Efudix is contra-indicated in pregnancy.
- Examine partners and perform syphilis serology.