Viral Infections
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
VIRAL WARTS/ANOGENITAL WARTS
B07/A63.0
DESCRIPTION
Superficial muco-cutaneous infection caused by the human papilloma virus.
GENERAL MEASURES
Patients with anogenital warts are at an increased risk of other STIs.
If the patient has anogenital warts:
- Pap smear should be offered to women to screen for cervical pathology.
- Screen for HIV and other STIs.
MEDICINE TREATMENT
Cutaneous warts
Treatment is seldom indicated.
Anogenital warts
- Podophyllotoxin 0.5% solution (patient application)
- Wash the affected areas with soap and water, and dry thoroughly with your own towel
- Apply petroleum jelly to surrounding skin and mucous membranes for protection
- Apply podophyllotoxin 12 hourly for 3 consecutive days until lesions disappear
- Treatment may be repeated at weekly intervals for a total of four 3 day treatment courses if necessary
OR
- Podophyllin 20% in compound benzoin tincture, topical (health care professional application)
- Apply petroleum jelly to surrounding skin and mucous membrane for protection
- Apply at weekly intervals until lesions disappear
- Wash the solution off after 4 hours
LoE:IIbxvi
Note
- Podophyllin and podophyllotoxin are cytotoxic agents.
- Avoid systemic absorption.
CAUTION
Podophyllotoxin containing agents are contraindicated in pregnancy.
REFERRAL
- Extensive or recurrent anogenital warts.
SHINGLES (HERPES ZOSTER)
See Zoster (shingles).
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.0_07 November 2024
Chapter 4 Dermatology_4.11 Viral Infections