Genital Warts (Condylomata Acuminata)

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External, Genital, Perianal:

Medicine	Adult dose	Frequency	Duration
podophyllin paint 20%	wash off after 4 hrs	once a week	Review
imiquimod 5% cream	apply at bedtime and leave overnight	three times a week	Max 4 months
trichloro-acetic acid	apply with a stick to warts only	once a week

CAUTIONS: For external use only. Do NOT use podophyllin in pregnancy. Do not apply to the cervix, urethra or anal mucosa. Do not use imiquimod cream for genital warts on children under 12 years.

If patient fails to respond, refer for cryotherapy

Cervical, urethral, rectal and vaginal warts:

Do not use podophyllin. Treat by cryotherapy, electro-cautery, or by surgical excision.

If the lesions are very extensive and large then the patient should be offered HIV testing and counselling, referred to the OI Clinic or for specialist attention.