Despite the various locations that can serve as a reservoir for human papillomavirus (HPV) and its DNA, the lion’s share of the virus and, by extension, the greatest chance for infection, is in the genital wart itself. Therefore most of the therapeutic interventions are designed to remove the wart and destroy the virus contained inside of them.
Not all treatments are equally effective at clearing the wart and not one is 100% effective. However, in some clinical studies, certain treatments were as high as 90% effective at eradicating the genital warts. Among the most successful treatments are cryotherapy, interferon placed on the wart, electrosurgery.
The various clearance rates of selected therapies are shown in the table. Note that there is significant discrepancy in the clearance rates listed for topical interferon (placed on the wart). The range of clearance rates across studies is 6 to 90%. In other words, while this may be a potentially successful treatment approach, it may not be terribly reliable and is not often used.
- Cryotherapy 63–88%
- Electrosurgery 61–94%
- Imiquimod 37–56%
- Interferon (topical) 6–90%
- Interferon (intralesional) 17–63%
- Laser surgery 23–52%
- Podofilox 45–77%
- Podophyllin 32–79%
- Surgical excision 35–72%
- Trichloroacetic acid 50–81%
- Placebo or no treatment 0–56%
The closest thing to a genital warts cure that researchers have developed to date is the vaccine against (HPV). While this vaccine, brand named Gardasil, is only directed against four types of HPV (there are likely more than 100 HPV types), the four that have been included are very important. Types 6 and 11 are particularly common causes of genital warts while the other two types included in the vaccine, HPV types 16 and 18, are the most common causes of cervical cancer and other cancers of the genitals and anus. Gardasil is not a genital wart cure, but if it is administered before human papillomavirus infection, it could potential reduce the incidence of genital warts by 90%.
Gardasil is currently only available for women and girls between the ages of 9 and 26. However, clinical studies are currently being conducted to study the safety and efficacy of extending immunizations to men and boys of the same age as well as extending the age in which the vaccine can be administered. Since infected men may be the most significant carrier or reservoir of human papillomavirus, it could greatly reduce infection and transmission if vaccination was extended to males as well.
It is important to note that some cases of genital warts may not be caused by human papillomavirus (HPV) since some lesions do not contain the HPV DNA. In cases such as this, directly destroying the genital wart may be the best approach to treatment and vaccines against HPV would have no effect.