Abstract

The evaluation of therapies for condylomata acuminata (genital warts) is imprecise because it is not possible to distinguish between relapse (reappearance of previously treated warts) and reinfection (appearance of new warts in a new location). Published trials use diverse criteria for patient selection, therapeutic response and follow-up period. A further complication is that current treatments aim to clear visible lesions, which is no proof of cure as human papillomavirus may persist in a latent state. Within these limitations, the advantages and disadvantages of current therapies are reviewed, including first-line therapies such as podophyllin solution, podophyllotoxin alcohol solution or cream, cryotherapy with liquid nitrogen, laser therapy (both carbon dioxide and NdYag), and trichloracetic acid. Second-line therapies, such as electrosurgery, excision, 5-fluorouracil and interferons, are also reviewed. In general, all available treatments for genital warts are more or less unsatisfactory, with recurrence rates of 30-70% at 6 months follow-up periods.