Optimum treatment of genital warts.

Genital warts (condylomata acuminata) must be treated and controlled carefully because of their frequent relapses and the risk of malignancy. Treatment is by destruction of the lesions. The most frequently used treatment for external warts is podophyllin 20% in ethanol which is applied to the affected area and then carefully washed off after 4 to 6 hours. The effectiveness of this method of treatment varies between 20 and 98%, with the warts generally disappearing in 3 to 4 days. If podophyllin is ineffective or is contraindicated (e.g. in pregnancy), other measures such as surgical removal, electrocautery, cryo-surgery or laser treatment can be used independently or in combination. Other treatments that have been used include topical application of 5-fluorouracil and intralesional or systemic use of interferons. Patients and their sexual partners should be followed for several months after treatment. A Papanicolaou smear should be obtained from women prior to treatment because of the association of human papilloma virus infection with cervical invasive neoplasia.