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Treating Genital Warts and Molluscum Contagiosum: Choosing the Right Option

Genital warts vs. molluscum contagiosum

Genital warts and molluscum contagiosum are both viral skin infections whose lesions can be treated and cleared. They are caused by different viruses, however, so the most suitable treatment differs too. Our doctors always confirm the diagnosis before recommending a treatment.

Comparison Genital warts Molluscum contagiosum
Cause Human papillomavirus (HPV), mostly types 6 and 11 Molluscum contagiosum virus (a poxvirus)
Appearance Skin-coloured or pink growths with a rough, cauliflower-like surface; single or in clusters Smooth, shiny, dome-shaped bumps 2–5 mm across, often with a small dimple in the centre
Common sites Genitals, around the anus, groin In adults: genitals, pubic area, inner thighs. In children: anywhere on the body
How it spreads Sexual contact and genital skin-to-skin contact Direct skin contact, sexual contact, and shared items such as towels
Can it go away on its own? Sometimes, but often slowly and it may spread, so treatment is recommended Usually within 6–12 months (sometimes 2–4 years), but treatment reduces spreading to other areas and other people

Whichever condition you have, avoid picking or scratching the lesions, and do not self-treat with over-the-counter wart removers. This can spread the infection and cause wounds or scarring on delicate skin.

 

Our 4 treatment options

Treatments fall into two groups: topical treatments that gradually make lesions fall off (several weeks, no injections), and in-clinic procedures that remove lesions in one or a few sessions (fast results, but the treated skin needs wound care).

1. Aldara cream (imiquimod 5%)

A cream that stimulates the skin’s local immune response so the body clears the HPV infection itself. You apply it at home.

  • Best for: small to medium external genital warts; people who dislike needles or can’t visit the clinic often
  • How to use: apply a thin layer at bedtime, 3 times a week (e.g. Mon–Wed–Fri). Wash off with soap and water 6–10 hours later. Use for up to 16 weeks, with follow-up visits as your doctor advises
  • Pros: painless treatment you do at home; relatively low recurrence compared with other methods, because your own immune system learns to fight the virus
  • Limitations: slow — results usually appear after 4–8 weeks. The treated skin may become red, sore or raw. Not for use during pregnancy, or inside the vagina, cervix or anus. The cream can weaken condoms
  • For molluscum: not recommended as a main option, as studies show unclear benefit

2. TCA and podophyllin application

The doctor applies the medicine precisely to each wart in the clinic. It destroys the wart tissue, which dries and falls off within a few days.

  • Best for: small genital warts in limited numbers, especially on moist skin
  • Procedure: takes a few minutes, no anaesthetic needed. Repeated every 1–2 weeks; most people need 3–6 sessions
  • TCA (trichloroacetic acid): works immediately with mild stinging during application. Safe in pregnancy, and can be used for some molluscum cases
  • Podophyllin: must be washed off at the time your doctor specifies (about 1–4 hours). Used on limited areas only. Not for use in pregnancy
  • Pros: low cost per session, no injections, no large open wound
  • Limitations: several clinic visits; may irritate or abrade surrounding skin; not suitable for large or numerous warts

3. Electrocautery

Heat from an electrical current destroys the lesions directly.

  • Best for: genital warts and molluscum that are small to medium and not too numerous; people who want lesions removed in one visit
  • Procedure: numbing cream or a local anaesthetic injection, then each lesion is treated. Takes about 15–30 minutes depending on the number of lesions
  • Pros: immediate results, usually done in a single session; can be used during pregnancy at the doctor’s discretion
  • Limitations: wounds heal in 1–3 weeks and must be kept clean; scarring or pigment changes are possible, especially with deep or numerous treatments

4. CO2 laser

A laser beam vaporises the wart tissue precisely, with good control over depth.

  • Best for: numerous, large or clustered warts; hard-to-treat areas (e.g. around the anus or the urethral opening); warts that did not respond to other treatments
  • Procedure: local anaesthetic injection, then the doctor treats each lesion. Takes 15–45 minutes depending on the area
  • Pros: immediate results, can clear many lesions in one session, minimal bleeding, less damage to surrounding skin than electrocautery; can be used during pregnancy at the doctor’s discretion
  • Limitations: higher cost than other options; wounds heal in 2–4 weeks; temporary dark marks or scarring are possible

 

Treating Genital Warts and Molluscum Contagiosum: Choosing the Right Option

 

Comparing the 4 treatments

Creams are gentler but slower. Electrocautery and laser work immediately, but the treated skin needs aftercare.

Treatment Aldara cream TCA / Podophyllin Electrocautery CO2 laser
Who applies it You, at home Doctor, in clinic Doctor, in clinic Doctor, in clinic
Number of sessions Continuous use for 4–16 weeks 3–6 sessions, 1–2 weeks apart Usually 1 Usually 1
Speed of results Slow Moderate Immediate Immediate
Anaesthetic Not needed Not needed Needed Needed
How it feels Stinging or irritation during the treatment period Mild stinging during application Painless during the procedure; mild soreness afterwards Painless during the procedure; mild soreness afterwards
Recovery No open wound Minor surface irritation 1–3 weeks 2–4 weeks
Lesion size / number Small–medium Small, few Small–medium, not too many Any size, including many lesions
Molluscum Not recommended TCA in some cases Suitable Suitable
Pregnancy Not used TCA: yes / Podophyllin: no At doctor’s discretion At doctor’s discretion
Approximate cost [price] [price per session] [price] [price]

 

Which option suits you?

Find the situation closest to yours, then let our doctor confirm. In many cases two methods are combined — for example, cautery or laser first, followed by Aldara to lower the chance of recurrence.

If you… Options to consider
Want fast results in a single visit Electrocautery or CO2 laser
Have many or large warts, or warts around the anus CO2 laser
Have a few small genital warts and want to avoid wounds TCA / Podophyllin or Aldara
Are afraid of needles Aldara or TCA / Podophyllin
Can’t visit the clinic often Aldara (at home), or electrocautery / CO2 laser (one visit)
Have had warts come back after treatment CO2 laser combined with Aldara
Have molluscum contagiosum Electrocautery or CO2 laser
Are pregnant or planning pregnancy TCA, electrocautery or CO2 laser (avoid Aldara and podophyllin)

See a doctor promptly if lesions grow quickly, bleed, become non-healing sores or change colour, or if you have a weakened immune system (e.g. HIV or immunosuppressive medication), as further tests may be needed.

 

Aftercare and prevention

  • Keep the treated area clean and dry, and apply any medication as prescribed
  • Avoid sexual contact until the skin has fully healed (or as your doctor advises)
  • Don’t pick scabs, and don’t share towels or personal items
  • Attend follow-up visits so any new lesions can be checked
  • Use condoms every time. They reduce the risk but don’t protect 100%, as the virus can spread through skin not covered by a condom
  • Your partner(s) should also be examined
  • HPV vaccination helps prevent genital warts and HPV-related cancers. Ask our doctor whether it’s right for you

Frequently asked questions

How are genital warts different from molluscum contagiosum?

Genital warts are caused by HPV. Molluscum contagiosum is caused by a different virus and often appears as smooth bumps with a central dimple. Other conditions can also cause genital bumps, so have a doctor confirm the diagnosis before treatment. Do not rely on photos or use over-the-counter wart removers on genital skin.

Which wart treatments does GLOVE CLINIC offer, and how is one chosen?

Your doctor considers the diagnosis, number, size and location of lesions, as well as your health and preferences. Options for genital warts may include prescription creams, clinician-applied chemical treatment, electrocautery or CO2 laser. Molluscum requires a separate assessment because treatments used for genital warts are not suitable for every case.

Does cautery or laser treatment hurt, and how many sessions will I need?

Local anaesthetic may be used for electrocautery or CO2 laser to reduce discomfort. You may feel stinging during the injection or soreness afterwards. The number of sessions depends on the lesions, their location and your response. Your doctor will discuss treatment and follow-up; complete clearance in one visit cannot be guaranteed.

Can the bumps return after treatment?

Yes. Removing genital warts does not necessarily clear HPV, so warts can recur. With molluscum, new bumps or reinfection can occur. Attend follow-up visits and have new lesions checked. HPV vaccination helps prevent infection with certain HPV types; it does not treat existing warts or protect against molluscum contagiosum.

How should I care for the treated area, and when can I have sex again?

Follow your doctor's wound-care and medication instructions. Avoid picking, scratching or rubbing the treated area, and do not share towels. Avoid sex while lesions or wounds remain, and ask your doctor when it is appropriate to resume. Condoms reduce risk but do not cover every area of skin that may transmit infection.

Can I be treated if I am pregnant or have a weakened immune system?

A doctor can assess treatment options, but medicines and procedures must suit your health circumstances. Mention pregnancy, possible pregnancy, HIV or immunosuppressive medicines before treatment. Do not start topical medication yourself, especially during pregnancy. Rapidly growing, bleeding or non-healing lesions need further medical assessment.