Once a patient has had condylomata, the skin always sheds virus to some degree.  As such, barrier contraception (e.g. condoms) is recommended unless a couple is actually trying to conceive.  The question of who gave the virus to whom is not a useful one.  The virus may have been shed asymptomatically by either partner for quite some time before lesions develop.  

The goal is to make your patient free of visible warts for as long as possible.  Eradication of the virus from the skin is impossible.  Destructive modalities delivered with precision such as liquid nitrogen, Trichloroacetic acid, electrosurgery, and podophyllin are helpful.

Podophyllin resin in tincture of benzoin has long been a mainstay of therapy.  Apply it to external lesions (do not apply to vaginal or cervical warts in women or use during pregnancy) and wash off with soap and water after 4 - 6 hours.  Re-evaluate your patient 1 week after treatment to determine whether additional therapy is necessary.

A new form of podophyllin (Condylox) is commercially available and should only be considered for emotionally mature, dexterous, and reliable patients.  The active ingredient is podofilox, a purified and standardized form of podophyllin toxin suitable for self-application by a patient.

Podofilox is meant only for external condylomata and should not be used on mucous membrane lesions or during pregnancy in females.  Follow the PDR recommendations carefully because over treatment will result in considerable irritation.   This should be applied only to lesional skin.  This medication is also quite expensive.  It is not meant for everyone.

Other pharmacologic means to treat condylomata include biologic response modifiers such as topical imiquimod cream (Aldara) and intralesional interferon.  These modalities are very costly and are only considered appropriate for treatment when prescribed by Dermatologists.