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==== Management ==== * '''The goal of treatment is removal of the warts; treatment will not eradicate the infection.''' ** '''Treatment is guided by wart size, number, and location, and patient preference.''' * '''Options classified as patient-applied vs. provider-administered modalities''' ** '''Patient-applied (3):[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6620174/table/t1-cuaj-6-s2/?report=objectonly Β§]''' **# '''Imiquimod cream, 3.75 or 5%, should be applied for 8 hrs daily for 2 weeks''' **##'''Maximum of 8 weeks for 3.75% vs. 16 weeks every other day for 5% imiquimod''' **# '''Podofilox cream, 0.5%, applied twice daily for 3 consecutive days each week, can repeat up to 4 weeks with at least 4 days in between''' **# '''Sinecatechins ointment, 15%, applied 3 times daily for up to 16 weeks''' ** '''Provider-administered (4):''' **# '''Podophyllin''' (less refined form of podofilox) **# '''Trichloroacetic acid''' **# '''Cryotherapy''' **# '''Surgical therapy including direct excision with scissors, tangential shave excision, curettage, or laser therapy using a CO2 laser''' * '''HPV vaccine''' ** '''Designed to prevent infection and are not effective in clearing an infection once established''' ** '''Recommended for females AND males age < 26''', preferably to start before onset of sexual activity. ** '''Gardasil''' *** '''Quadrivalent HPV vaccine that provides protection against HPV types 6, 11, 16, and 18.''' ** '''Cervarix''' *** '''Bivalent HPV vaccine that provides protection against HPV types 16 and 18'''
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