Genital warts are a highly contagious, viral, sexually transmitted disease caused by the human papillomavirus. There are a large number of different strains, some of which cause cervical cancer, others genital warts, while infections with others can be asymptomatic. The virus penetrates through the skin and mucous membranes, especially during unprotected sex. The use of condoms greatly reduces the risk of infection, but does not eliminate it completely, since viral particles can also penetrate through microabrasions in the skin. Once inside the body, the virus can go into a latent state lasting from several months to decades. Even if a person does not show symptoms of infection, he can transmit the virus to others, especially to his sexual partners. Wart-causing strains have a strong affinity for skin cells. The viruses cause hyperkeratosis (cornification) of the epidermal cells and swelling of the dermal papillae, leading to the formation of the characteristic warts. Dermal papillae are folds at the border between the two topmost layers of skin that give each individual their unique fingerprints. Usually, the warts are clustered. In women, they are most often found around the outside and/or inside of the vagina, the cervix and around the anus, including its inside. In men, warts are mostly located around the head of the penis. However, it is possible that they also appear on his trunk, scrotum or anus. It is also possible for them to appear in the throat or mouth after oral sex with an infected partner. Preventive measures include practicing safe sex and getting vaccinated. It has a prophylactic, but not a therapeutic effect, i.e. its application is effective only before the onset of infection. Ideally, this happens before starting sex. The vaccine is polyvalent, i.e. it works against several different strains of the virus – both those that cause warts and those that cause cervical cancer. It is also approved for use in men in some countries, and its effectiveness and safety in men are still being studied. It is possible that existing warts disappear on their own, as well as turn into a small, fleshy growth on the surface of the skin. Since there is no way to predict which direction their development will take, the surest way to remove them is active treatment. It does not eliminate the virus from the body and the risk of recurrence of warts, but in addition to the purely aesthetic benefits, it also has an important prophylactic effect – it reduces the risk of infecting the sexual partner. Depending on the size and location of the warts, as well as the patient’s tolerance, one of the following alternatives is used. 1. Podophyllotoxin Medicinal forms for local application are used – gels, creams or ointments, with different concentrations. They are applied by smearing on the affected skin areas according to a certain scheme, which is repeated cyclically.The treatment is usually successful, causing minor side effects, mostly on the skin – irritation, redness, pain. NEWS_MORE_BOX 2. Imiquimod This is a topical preparation with a powerful immunostimulating effect. It is used to treat skin diseases – warts, keratoses, as well as some forms of cancer. It causes fewer skin reactions than podophyllotoxin. Podophyllotoxin should not be used during pregnancy as it may cause malformations in the newborn. 3. Non-pharmacological methods If, due to pregnancy or patient intolerance, podophyllotoxin or imiquimod cannot be used, one of the following non-pharmacological methods is used – burning the warts with liquid nitrogen, trichloroacetic acid, laser or their surgical removal. Relatively small warts can be treated with self-administered trichloroacetic acid solutions. Large warts require surgical removal. Stubbornly recurring warts can be treated using a laser, which is a very expensive procedure reserved for only the most stubborn infections.