Warts – Anogenital

Patient-applied:  

Imiquimod 3.75% or 5% cream†  

OR  

Podofilox 0.5% solution or gel  

OR  

Sinecatechins 15% ointment†  

Provider-administered:  

Cryotherapy with liquid nitrogen or cryoprobe  

OR  

Surgical removal by tangential scissor excision, tangential shave excision, curettage, laser, or electrosurgery  

OR  

Trichloroacetic acid (TCA) or bichloroacetic acid (BCA) 80%–90% solution 

* Persons with external anal or perianal warts might also have intra-anal warts. Thus, persons with external anal warts might benefit from an inspection of the anal canal by digital examination, standard anoscopy, or high-resolution anoscopy.  

† Might weaken condoms and vaginal diaphragms. 

None

Cryotherapy with liquid nitrogen 

OR  

Surgical removal 

None

Cryotherapy with liquid nitrogen 

The use of a cryoprobe in the vagina is not recommended because of the risk for vaginal perforation and fistula formation.

OR  

Surgical removal  

OR  

Trichloracetic acid (TCA) or bichloroacetic acid (BCA) 80%–90% solution 

None

Cryotherapy with liquid nitrogen 

OR 

Surgical removal  

OR 

Trichloracetic acid (TCA) or bichloroacetic acid (BCA) 80%–90% solution  

Management of cervical warts should include consultation with a specialist. For women who have exophytic cervical warts, a biopsy evaluation to exclude HSIL should be performed before treatment is initiated. 

None

Cryotherapy with liquid nitrogen 

OR 

Surgical removal 

OR  

Trichloracetic acid (TCA) or bichloroacetic acid (BCA) 80%–90% solution  

Management of intra-anal warts should include consultation with a colorectal specialist. 

None

See Anogenital Warts in Pregnancy.

None