Genital warts are one of the most common sexually transmitted infections in the UK. They're caused by a virus that doesn't always cause visible symptoms, so it's possible to pass it on without knowing you have it.
When warts do appear, they can be unsettling. But there are effective prescription treatments available as part of genital warts care that can clear them.
Two first-line treatments are widely used in the UK: Aldara (imiquimod 5% cream) and Warticon (podophyllotoxin cream or solution). They work in completely different ways, and the right choice depends on the type and location of your warts.
This guide explains how each treatment works, what to expect while you're using them, and why warts sometimes come back after treatment.
The type and location of your warts usually decides the treatment. Soft or hard, genital or around the anus, all make a difference.
What causes genital warts?
Genital warts are caused by the human papillomavirus (HPV). Around 90% of cases are caused by the low-risk strains HPV-6 and HPV-11.1
These are called low-risk because they're very rarely linked to cancer. That's unlike high-risk strains, such as HPV-16 and HPV-18, which are linked to cervical and other anogenital cancers.
The virus spreads through skin-to-skin contact during sex. Many people with HPV never get visible warts, but they can still pass the virus on.
When warts do appear, they usually develop one to three months after infection, though it can take longer.
How does Aldara work?
Aldara contains imiquimod at a 5% strength. It's an immune response modifier rather than an antiviral. Instead of targeting the wart directly, it strengthens your body's own immune response in the treated area.
This triggers the local release of cytokines, signalling proteins that prompt your immune system to attack HPV-infected tissue and gradually break down wart cells.2
Because it relies on building an immune response, results take time. You apply Aldara three times a week (for example, Monday, Wednesday and Friday) before you go to sleep. Leave it on your skin for 6 to 10 hours, then wash it off thoroughly with mild soap and water.
Treatment can carry on for up to 16 weeks per episode, until visible warts have cleared.2 Each dose comes in a single-use sachet, which you throw away after one application.
Aldara is suitable for both soft and hard (keratinised) warts. It's licensed for external genital warts and external perianal warts (around the anus) in adults, which makes it the more versatile option for warts in that area.2
A skin reaction where you apply it (redness, itching, flaking or mild burning) is very common with Aldara, and is generally a sign the immune response is working.
Rare, more intense reactions, including broken skin and flu-like symptoms such as fever and muscle aches, mean you should pause treatment and speak to a clinician.2
Do not have sex while Aldara is on your skin. It can weaken condoms and diaphragms.
How does Warticon work?
Warticon works in a completely different way. Its active ingredient, podophyllotoxin, is a plant-derived compound that stops cells dividing (an antimitotic). It blocks the cell division that lets wart tissue grow and spread, so the wart cells die off over time.3
Warticon comes in two forms. The cream (0.15% podophyllotoxin) is applied with a fingertip. The solution (0.5% podophyllotoxin) comes with a precision applicator, which makes it easier to target individual warts without touching the skin around them.
It works on a seven-day cycle. Apply it twice a day (morning and evening, every 12 hours) for three days in a row, then leave it for four days.
If your warts are still there, you can repeat the cycle weekly for up to four weeks in total.3
Warticon is suitable for soft, external genital warts only. It isn't licensed for hard or keratinised warts, or for warts around the anus.
It isn't recommended during pregnancy, or if you could become pregnant and aren't using contraception, because podophyllotoxin can harm an unborn baby.3
Warticon solution is flammable. Do not smoke or go near an open flame while you're applying it or straight after.
Aldara vs Warticon: choosing the right treatment
The choice between Aldara and Warticon usually comes down to the type and location of your warts.
Of the two, Aldara is the only option for hard (keratinised) warts and warts around the anus. It means a longer commitment of up to 16 weeks, but its three-times-a-week schedule is manageable for most people.
Warticon suits soft, external genital warts if you'd prefer a more intensive, shorter approach. Treatment lasts up to four weeks, though applying it twice a day on treatment days takes more regular attention.
Neither treatment is suitable during pregnancy. Your prescriber or Pharmica clinician will help work out which option is right for you, based on the type and location of your warts and your medical history. You can view genital warts treatments available through Pharmica.
What to expect during treatment
With Aldara, skin reactions where you apply it (redness, itching and flaking) are very common and expected. They're usually a sign the treatment is working, not a reason to stop.
It can take anywhere from 4 to 16 weeks for warts to clear completely. If reactions become severe at any point, take a short break and contact your prescriber.2
With Warticon, mild irritation, redness and burning where you apply it are common, usually appearing after two or three days of the first cycle. Most people see their warts start to shrink within the first few weeks. If they haven't cleared after a full four-week course, a clinician can advise on next steps.
With both treatments, it's best to avoid sex while you're being treated. If you do have sex, use a condom to lower the risk of passing HPV to your partner, and to protect them from contact with the treatment.
Do genital warts come back after treatment?
Warts coming back after treatment is common. Around 30% of people find their warts return within three months of clearing.4
That's because neither Aldara nor Warticon gets rid of HPV itself. Both clear visible warts, but the virus can stay in the surrounding skin and trigger new warts in the following months.
If warts come back, the same treatment can usually be repeated. Using condoms consistently lowers the risk of passing HPV to partners, though it doesn't remove it completely, since the virus can be on skin a condom doesn't cover.
Your GP or sexual health clinic can advise if your warts keep coming back, or if you'd like to explore longer-term options.
When to seek further advice
Contact your GP or a sexual health clinic if:
- Your warts don't respond after completing a full treatment course
- New warts appear in a different area or in a hard-to-reach location
- You experience severe skin reactions, significant erosion, or flu-like symptoms during treatment
- You're pregnant or planning to become pregnant and need treatment for genital warts
- You're unsure which treatment is right for your situation
Frequently asked questions
Do genital warts go away on their own?
Some do. Studies suggest around 20–30% of genital warts resolve without treatment within a few months. However, this can take time, warts may grow or spread in the meantime, and the virus remains transmissible throughout. Treatment with Aldara or Warticon speeds up clearance and reduces the period during which you can pass on HPV.
Can genital warts cause cancer?
Almost all genital warts are caused by HPV-6 and HPV-11, which are classed as low-risk strains and very rarely linked to cancer. The HPV types associated with cervical, anal, and other anogenital cancers are different high-risk strains, primarily HPV-16 and HPV-18. If you have concerns about HPV and cancer risk, speak to your GP or sexual health clinic.
Are genital warts permanent?
The visible warts can be cleared with treatment, so they aren't permanent in that sense. However, HPV can persist in the skin after warts have gone, which is why new outbreaks are possible weeks, months, or sometimes years later. Some people's immune systems clear the virus entirely over time; others experience occasional recurrences that can be retreated.
Can genital warts come back years after treatment?
Yes. HPV can remain dormant in skin tissue for an extended period, and warts can reappear long after a previous episode has cleared. Recurrence within the first three months is most common, but later outbreaks do occur. Both Aldara and Warticon can be used to treat new episodes. If warts are recurring frequently, a GP or sexual health clinic can advise on management.
Can you have sex during genital warts treatment?
A: It's advisable to avoid sexual intercourse while using Aldara or Warticon. If you do have sex, you must use a condom - both to reduce the risk of transmitting HPV to your partner and to protect them from contact with the active ingredient in the cream or solution. Bear in mind that condoms reduce but don't eliminate the risk of HPV transmission.
References
- Sonnex C, et al. Protocol for a randomised controlled trial of imiquimod cream (5%) versus podophyllotoxin cream (0.15%), in combination with quadrivalent human papillomavirus or control vaccination: HIPvac trial. BMC Medical Research Methodology. 2018;18(1):141. doi:10.1186/s12874-018-0581-z
- Viatris (formerly Mylan or Upjohn). Aldara 5% Cream Summary of Product Characteristics. Electronic Medicines Compendium (eMC). Updated 15 Oct 2025. medicines.org.uk/emc/product/823/smpc
- Summary of Product Characteristics: Warticon Cream 0.15% (emc product 1507); Warticon Solution 0.5% (emc product 1506). Electronic Medicines Compendium (eMC). medicines.org.uk/emc/product/1507/smpc
- Unger ER, Fajman NN, Finkel DA, et al. Chapter 5: Human papillomavirus. In: Centers for Disease Control and Prevention. Manual for the Surveillance of Vaccine-Preventable Diseases. Updated 2021. cdc.gov/surv-manual/chapter-5-human-papillomavirus
This article is intended for informational purposes only and does not replace professional medical advice. Always read the patient information leaflet supplied with your medication and speak to a healthcare professional if you have specific concerns.