Warts are caused by the human papilloma virus or HPV. At present, around 80 types of HPV have been isolated and identified in individuals with genital warts. HPV types 16 and 18, considered as high-risk types, have been the most extensively studied since there is strong evidence that these types are the causative agents in the development of cancers of the uterine cervix and external genitalia. Genital warts may appear as small, flat, velvety, hyperpigmented papules present on the genitalia, perianal skin or extragenital areas. HPV infections are also associated with squamous cell carcinomas in the extragenital skin.

Various treatment regimens are available to eliminate genital warts, but there is no single therapy has been recommended. Several factors should be considered before deciding on the treatment modality. Factors such as the location of the warts, the age of the patient, the extent of the infection, the health status of the patient, and most important of all, is the willingness of the infected person to be treated. Instituting treatment reduces the severity of the infection, however, it does not totally eliminate the virus from the body.

There medications, both natural and synthetic, that can be applied in the convenience of your home, but one must follow the label instructions carefully and be very cautious in using these solutions. Some are known to cause allergic reactions, and so, it is important to consult your physician before beginning any drug treatment to control the growth of genital warts.

The majority of genital warts have been observed to respond to treatment within three months of therapy. If this is not achieved, a visit to a doctor is again recommended in order to change the treatment regimen or to do a biopsy to differentiate the common genital warts from those that are strongly associated to carcinomas.

For complicated and untreatable genital warts, the following have been recommended:

1. Cryotherapy with liquid nitrogen
   For advanced and complicated cases of genital warts, cryotherapy is usually recommended by physicians. The success rate of genital wart control is high through cryosurgery. This procedure utilizes extreme cold to destroy abnormal growths on the skin, which include genital warts. It literally freezes the genital warts to destroy and eliminate them. It is important to emphasize that this procedure should only be done by a licensed physician as it can be excruciating and unsafe without the use of appropriate methods.

   Liquid nitrogen is usually utilized to treat genital warts. To achieve wart removal, the genital warts are either directly applied with a cotton swab soaked in liquid nitrogen or sprayed on with liquid nitrogen. This substance causes rapid freezing of the warts, and subsequently, causes tissue destruction. Initially, blisters form around warts. As the blisters heal, they fall off together with the genital warts. Complete destruction of the genital warts require several cryotherapy sessions. The procedure is usually repeated after one to two weeks. Because it is minimally invasive, cryosurgery is also recommended to pregnant women with genital warts. Additionally, side effects and complications of this procedure are at a minimum, which makes it one of the most effective and safest procedures to control wart growth.

2. Surgical removal.
   Removal of genital warts is also done through excision or laser surgery. Laser surgery destroys genital warts by burning them with through a laser. These modalities are advantageous for it eliminates the warts in just one visit. Patients who have a lot of genital warts will most benefit from this modality.

Because no single therapeutic modality has been proven to be effective, many clinicians employ combination therapy to treat genital warts, although some doctors believe that this also increases the risks of complications.