Laser Genital Wart Treatment Sydney

An analysis of the BEACH study (Australia) showed that both men and women can get genital warts, but around 67% of patients are female. The highest incidence of genital warts was in women aged 20 to 24, with 8.61 cases per 1,000, and in men aged 25 to 29, with 7.40 cases per 1,000.

Source: Genital warts incidence and healthcare resource utilisation in Australia (Sexually Transmitted Infections)

A study of Pap smears in a general population in Taiwan which integrated HPV study on all routine Pap smear tests found that 11.7% had HPV, but most people with the virus don’t show any symptoms.

Source: Cervical cancer screening program integrating Pap smear and HPV DNA testing: a population-based study (PDF)

A study was conducted on healthy men from the US, Mexico, and Brazil, following 1,159 participants over time to determine the incidence rate of HPV infection. The researchers found that the incidence of new genital HPV infections was 38.4 per 1,000 person-months. In practical terms, this means that for every 1,000 men observed for one month, approximately 38 would acquire a new genital HPV infection.

Source: Incidence and clearance of genital human papillomavirus infection in men (HIM): a cohort study (PubMed Central)

HPV (human papillomavirus) can be confusing for some people, especially when it comes to understanding the different types. HPV is a group of viruses, and some types cause genital warts, while others are linked to cervical cancer. The genotypes of HPV that cause these two conditions are different:

• Genital warts are mostly caused by HPV types 6 and 11, which are low-risk because they don’t cause cancer.
• Cervical cancer is mainly caused by HPV types 16 and 18, which are high-risk and can also cause cancers in areas like the anus, penis, and throat.

We don’t usually test for specific HPV types. However, having one type means you’re more likely to have another. Our focus is on treating visible genital warts on the skin.

• Genital warts are highly contagious, with a transmission rate of nearly 65%.
• After infection, HPV’s incubation period can range from 3 weeks to 8 months.
• Only about 10% of people infected with HPV will develop warts.
• Warts usually appear 2 to 3 months after infection.

• Only a small number of people with HPV develop visible genital warts.
• These warts are small, non-cancerous growths that can appear as single or multiple spots of different sizes in the genital area (as shown in photos on this webpage).
• They are mostly caused by HPV types 6 and 11, which account for about 95% of cases.
• It’s common for more than one wart to be present in the same area.

Source: The Lancet Regional Health – Western Pacific

There is a vaccine for HPV called Gardasil.

Gardasil can protect individuals from HPV viruses of many genotypes including both malignant and for genital warts.

The treatment is recommended to prevent GW and cervical cancers. Countries with established HPV vaccination programs have seen a significant decline in genital warts, with Australia experiencing the most notable and lasting reductions. New cases dropped from 2,930 in 2004 to 1,082 in 2018. However, 1,082 new cases are still reported in Australian Sexual Health Clinics each year. The actual number of cases is likely much higher, as many people with genital warts may not seek medical care at STD clinics.

In Australia, the Therapeutic Goods Administration has approved Gardasil®9 for use in females aged 9 to 45 and in males aged 9 to 26. The HPV vaccination is free for Australians aged 12 to 25.

Source: How to get the HPV vaccine (hpvvaccine.org.au)

HPV vaccine is not recommended as a treatment of GW. Trials have so far failed to demonstrate a significant therapeutic benefit of vaccine for those with existing warts either for clearance of warts or a reduction in subsequent recurrence. A prospective randomised clinical trial involving 171 men with genital warts (GW) assigned participants to either a treatment group (receiving Gardasil injections) or a placebo group. After 12 months of follow-up, no significant difference was observed between the two groups.

Source: Impact of the quadrivalent HPV vaccine on disease recurrence in men exposed to HPV infection: a randomized study (PubMed)

• Doctors typically diagnose genital warts by examining them.
• Although genital warts are not cancerous, there is a small risk of cancer developing in the same area.
• Additional tests are usually not needed to diagnose genital warts unless the symptoms suggest warts but their appearance is not typical.
• If there is uncertainty about the diagnosis or a rare concern that the warts could have developed into cancer, a skin biopsy can be easily performed in our clinic.

• Treatment for genital warts is usually for cosmetic reasons.
• Available options include applying chemical irritants, using prescription ointments, freezing the warts with cryotherapy, electrocautery, laser treatment, or surgical excision.
• We specialise in laser wart treatments.
• Each of these options has different success rates in clearing the warts. In our experience, laser wart therapy is the most effective way to treat genital warts.

Laser removal of genital warts involves the following steps:

1. Diagnosis involves identifying and assessing the number of warts that need treatment. If there is any uncertainty, a skin biopsy may be performed first to confirm the diagnosis.
2. Injecting local anaesthesia to the wart.
3. Performing laser treatment until all the wart and its roots are completely eliminated.

• The healing time for the wounds varies: smaller warts usually take 5 to 7 days to heal, while larger lesions may take 2 to 3 weeks.
• We ask patients to return after 4 weeks to determine if they need to apply prescription cream to reduce the recurrence of genital warts.

• Most patients have already tried other treatments without success, including cryotherapy and various prescription or over-the-counter creams.
• For those whose warts haven’t responded to other therapies, we often use laser treatment, which has a high success rate—clearing nearly 90% of warts.
• However, there is still a risk of recurrence, with 17-19% of cases returning within 12 weeks and 66% within a year.

• Prescription creams: Imiquimod or Podophyllin (solution or cream) can be used to treat genital warts, with the goal being the complete removal of the wart. If the wart does not reduce in size by more than 50% after 4 weeks of application, the treatment is considered unsuccessful, and alternative treatment options should be explored. Source: British Association for Sexual Health and HIV national guideline for the management of anogenital warts in adults (2024)
• Cryotherapy is used with the aim of completely resolving the genital wart. If the wart recurs after 2-3 sessions, the treatment is considered a failure, and an alternative treatment should be pursued.
• Electrosurgery and surgical excision. They are not very popular with the introduction of laser GW removal.

You have a choice to either treat or not to treat the skin in the genital area after you had laser treatment.

Some studies have shown that after laser therapy and sufficient wound healing, administration of imiquimod 5% cream three times/week appears to be safe and to reduce the incidence of wart recurrences.

Source: Effect of adjuvant imiquimod 5% cream on sustained clearance of anogenital warts following laser treatment (PubMed Central)

We recommend either Imiquimod or Podophyllin cream to be used after the laser treatment. Dr Kim will give you instruction on how to use these creams and the follow-up interval.

• You do not need a referral.
• The consultation fee is $150, with a Medicare rebate of $82.90 (Item number 36).
• The standard cost for genital wart removal is $750 for multiple genital warts treated at the same time. The cost is on a sessional basis. Further treatment will incur an additional cost.

You can reach us by calling (02) 9411 4880 or by SMS to 0433 284 880 to schedule an appointment to see our doctor.