- Treatment for external genital warts with Warticon cream
- Access Warticon cream following an online medical consultation
- What is Warticon cream?
- Genital warts and HPV: What you need to know
- Diagnosis before treatment: When to seek assessment first
- How podophyllotoxin works
- How to use Warticon cream
- Suitability and contraindications
- Side effects and precautions
- What to do if treatment does not work
- How DoktorABC works
- Active substance and excipients
Treatment for external genital warts with Warticon cream
Warticon cream is a prescription-only topical treatment for external genital warts (condylomata acuminata) affecting the penis or the external female genitalia. It contains podophyllotoxin 1.5 mg/g (0.15% w/w) as the active ingredient and is manufactured by Karo Healthcare. It is supplied as a homogeneous white cream in a 5 g tube and is applied by fingertip directly to visible wart tissue twice daily for three consecutive days, followed by a four-day treatment-free interval, repeated as necessary up to the limit specified in the PIL.
Access Warticon cream following an online medical consultation
Start the online consultation and complete the medical questionnaire. A UK-registered prescriber will review your answers and, where appropriate, approve a prescription for Warticon cream.
Important information
DoktorABC UK is a digital health platform that connects patients with independent, UK-registered prescribers. DoktorABC UK does not itself provide medical care, issue prescriptions, or dispense medicines. All clinical decisions are made by the UK-registered prescriber following an individual medical assessment.
What is Warticon cream?
Warticon cream is indicated for the topical treatment of condylomata acuminata affecting the penis or the external female genitalia. It is a prescription-only medicine (POM) in the UK and is not available without a valid prescription from a registered prescriber.
Warticon cream contains podophyllotoxin at a concentration of 0.15% w/w. A solution formulation is also available (Warticon solution, 0.5% w/v), which contains the same active ingredient at a higher concentration with applicators for more targeted application. This page covers the cream formulation only.
The cream contains several excipients that are relevant to safety: sorbic acid, stearyl alcohol and cetyl alcohol, which may cause local skin reactions such as contact dermatitis, and butyl hydroxyanisole, which may cause local skin reactions or irritation to the eyes and mucous membranes.
Genital warts and HPV: What you need to know
Genital warts are caused by certain strains of the human papillomavirus (HPV), most commonly HPV types 6 and 11. HPV is very common and is transmitted through close skin-to-skin contact, including sexual contact. The virus can be present and transmissible without any visible warts, which means it can be passed between people who are unaware they are carrying it.
Genital warts are the visible skin growths that appear when HPV causes localised changes in the skin surface. They may appear as single or multiple growths, vary in size, and can occur on the penis, vulva, around the vaginal opening, on the perineum, or in the perianal area.
Treatment removes visible warts, it does not eradicate HPV
Warticon cream works on the wart tissue itself. After a course of treatment, visible warts may resolve, but HPV can remain in the body and warts may recur. Recurrence is common and does not indicate treatment failure.
Condoms reduce but do not eliminate the risk of HPV transmission, as the virus can be present on skin not covered by a condom. HPV vaccination, available through the NHS for eligible groups, protects against the HPV strains most commonly associated with genital warts and certain cancers. People with a cervix should continue attending routine cervical screening in line with NHS programme guidance.
Diagnosis before treatment: When to seek assessment first
Warticon cream should only be used on lesions that have been diagnosed as genital warts by a clinician. Do not use it on uncertain or undiagnosed lesions. A sexual health clinic assessment is the most reliable way to confirm the diagnosis and test for other STIs at the same appointment.
Important: Do not use Warticon cream on:
- Lesions that have not been clinically confirmed as external genital warts
- Warts inside the vagina, urethra, or rectum
- Broken, bleeding, or inflamed skin
- Large wart areas
- Ordinary non-genital warts on other parts of the body.
A sexual health clinic can confirm the diagnosis, assess the size and extent of warts, and advise on whether self-applied treatment or a clinic-applied procedure is more appropriate for your circumstances.
How podophyllotoxin works
Podophyllotoxin is a plant-derived compound that works by inhibiting cell division within wart tissue. It interferes with the formation of the structures that cells need to divide and multiply, causing the cells in the wart to break down and die. Over successive treatment cycles, this leads to a reduction in wart tissue and, in many cases, resolution of visible warts.
Podophyllotoxin acts locally on the wart tissue to which it is applied. It does not treat HPV systemically, does not eliminate the virus from the body, and does not prevent recurrence.
Mild local reactions, including redness, irritation, and some erosion of the wart surface are expected during treatment and are a sign that the treatment is acting on the wart tissue. These are distinct from the more severe reactions that require stopping treatment.
How to use Warticon cream
The following guidance is based on the current UK SmPC for Warticon cream (Karo Healthcare, medicines.org.uk, last updated 2023). Always read the full PIL supplied with your medication before use.
Preparation:
- Wash the affected area thoroughly with soap and water and dry it carefully before each application.
- Wash your hands before and after applying the cream.
Application:
Using a fingertip, apply the cream twice daily, morning and evening (every 12 hours) for three consecutive days, using only enough cream to just cover each wart. Application to the surrounding normal tissue should be avoided.
- Apply the smallest amount needed to cover the wart surface only.
- Do not apply to the healthy skin surrounding the wart. If healthy skin contact occurs, wash the area with water immediately.
- Do not apply inside the vagina, urethra, or rectum.
Treatment cycle
The cream should then be withheld for the next four consecutive days. Residual warts should be treated with further courses of twice daily applications for three days at weekly intervals, if necessary, for a total of four weeks of treatment.
This means the treatment cycle is three days on, four days off, repeated weekly as needed, for up to four weeks in total.
Missed applications
If you miss a dose, apply the cream as soon as you remember and continue the remaining applications in the three-day treatment phase. Do not apply a double amount to make up for a missed application.
Sex during treatment
It is recommended that patients refrain from sexual intercourse while treating warts with the cream and until the skin has healed. If a patient does engage in sexual intercourse, a condom must be used. This protects the partner from contact with podophyllotoxin, which is an irritant, as well as reducing the risk of HPV transmission.
Important: The applicator cannot be flushed. Do not get the cream near the eyes or mucous membranes. If eye contact occurs, rinse thoroughly with water and seek medical advice.
Suitability and contraindications
Warticon cream is not appropriate for everyone. The following circumstances require medical assessment before use, or mean that Warticon cream should not be used at all.
Pregnancy and trying to conceive
Warticon cream is not recommended during pregnancy or in women of childbearing potential not using contraception. Although systemic absorption from topical podophyllotoxin is limited, podophyllotoxin is known to be embryotoxic. Effective contraception must be used during treatment. If you are pregnant or trying to become pregnant, speak to your GP or sexual health clinician about alternative treatment options.
Breastfeeding
Speak to your prescriber before using Warticon cream if you are breastfeeding.
Age
The use of Warticon cream is not recommended for children under 18 years, as use in this age group has not been studied.
Allergies
Do not use if you are allergic to podophyllotoxin or any of the other ingredients listed in the PIL, including sorbic acid, stearyl alcohol, cetyl alcohol, or butyl hydroxyanisole.
Uncertain diagnosis
Do not use on lesions that have not been clinically confirmed as external genital warts.
Unsuitable sites
Do not use on internal warts (vaginal, urethral, or rectal), broken or inflamed skin, or large wart areas.
Side effects and precautions
Local reactions are expected and common during treatment with Warticon cream and are not necessarily a reason to stop. More severe reactions require stopping treatment and seeking advice.
Expected local reactions (common):
These include mild skin irritation, redness, burning sensation, itching, and erosion of the top layers of skin in the areas where the treatment has been used. They typically happen after two to three days of use and are usually signs that the treatment is working.
To protect healthy surrounding skin from these effects, apply the cream as precisely as possible to wart tissue only. Petroleum jelly or a similar barrier cream applied to the surrounding skin before each application can help reduce irritation to healthy tissue.
Reactions requiring stopping treatment and seeking medical advice:
Stop using Warticon cream and contact your prescriber or seek medical help if you experience:
- Severe pain, significant swelling, or ulceration at the treatment site
- Bleeding from the treated area
- Signs of infection including increasing redness, warmth, or discharge
- Any systemic symptoms including fever, nausea, or feeling generally unwell
Important: Do not apply Warticon cream to a larger area or for longer than directed in the PIL. Overapplication increases the risk of significant local reactions without improving treatment outcomes.
Report any suspected side effects to the MHRA via the Yellow Card scheme.
What to do if treatment does not work
If visible warts remain after completing the full four-week course of Warticon cream, contact your prescriber or sexual health clinic rather than repeating the course independently. Further treatment options are available and a clinician can advise on the most appropriate next step.
Comparison with other treatments:
| Treatment | Route | How it works | Key considerations |
|---|---|---|---|
| Warticon cream (podophyllotoxin 0.15%) | Self-applied topical cream | Inhibits cell division in wart tissue | Applied at home; up to four treatment cycles. Not suitable for large or internal warts |
| Imiquimod (Aldara 5% cream) | Self-applied topical cream | Stimulates the immune response to target wart tissue | Different mechanisms. Applied three times per week; may suit different wart types or people who do not respond to podophyllotoxin |
| Clinic-applied treatments (e.g. cryotherapy, trichloroacetic acid) | Applied by a clinician | Physical or chemical destruction of wart tissue | Suitable for larger, internal, or treatment-resistant warts; performed at sexual health clinics |
A sexual health clinic can assess which treatment option is most appropriate for the size, location, and number of warts, and whether clinic-applied treatment is preferable to self-applied treatment in your case.
How DoktorABC works
DoktorABC UK is a digital health platform that connects patients with independent, UK-registered healthcare professionals through a secure online process.
- Complete a short medical questionnaire covering your symptoms, medical history, and any relevant medicines.
- An independent UK-registered prescriber reviews your information and determines whether Warticon cream is clinically appropriate for you.
- If treatment is considered suitable, a prescription is approved by the UK-registered prescriber in accordance with UK regulations.
- Your medication is dispensed by a GPhC-registered pharmacy and delivered to your door in discreet packaging.
DoktorABC UK does not itself provide medical care, issue prescriptions, or dispense medicines. All clinical decisions are made by the independent prescribing healthcare professional following an individual assessment.
Active substance and excipients
Active substance: Podophyllotoxin 1.5 mg/g (0.15% w/w).
Other ingredients: Methyl parahydroxybenzoate (E218), propyl parahydroxybenzoate (E216), sorbic acid, phosphoric acid, stearyl alcohol, cetyl alcohol, butyl hydroxyanisole (E320), and purified water.
Product PIL: Available at medicines.org.uk/emc/product/1507/pil
Leaflet info
The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. It is written for patients and gives information about taking or using a medicine. It is possible that the leaflet in your medicine pack may differ from the PDF-version from this website because it may have been updated since your medicine was packaged or the medicine is from another brand.
