Condyloma: Symptoms, Causes & Treatment

Condyloma refers to wart‑like growths that can appear as smooth, flat lesions or as cauliflower‑like projections. These lesions most often develop in the genital area, including the penis, vagina, cervix, and anus.

Also called genital warts, condyloma is usually caused by human papillomavirus (HPV) or by reactivation of Treponema pallidum. When due to HPV it is called condyloma acuminatum, and when linked to syphilis it is called flat condyloma or condyloma lata.

Condyloma is treatable, and care should be guided by a gynecologist, urologist, or infectious disease specialist. Treatment may include topical medications, antibiotics, or procedures such as cryotherapy or surgery.

Main symptoms

The most common signs and symptoms of condyloma include:

• Smooth, flat lesions or cauliflower-like growths on the skin

• Whitish, pink, purple, or reddish-brown warts

• Single or multiple lesions of different sizes

• Itching, pain, burning, or discomfort in the affected area

• Bleeding in the affected region

• Difficulty urinating or having bowel movements

• Foul-smelling discharge in the affected area

In men, condyloma lesions are usually found on the head of the penis, but they can also affect the shaft and the area around the anus. In women, lesions typically appear on the vulva, perineum, perianal area, vagina, and cervix.

Less commonly, lesions may develop on the mucous membranes of the nose and mouth, in the larynx, or in the conjunctiva.

It is important to note that many people with condyloma may not have any symptoms.

Confirming a diagnosis

Diagnosis is made by a primary care provider, gynecologist, or urologist based on an evaluation of the lesions, reported symptoms, and medical history.

To confirm the type of condyloma, a provider may order additional tests, such as a biopsy, anoscopy, or Pap smear.

Main types

Depending on the underlying cause, condyloma can be classified as:

1. Condyloma acuminatum

Condyloma acuminatum is caused by HPV infection and leads to lesions that often have a cauliflower-like appearance. These lesions may be white, pink, purple, or reddish-brown.

2. Flat condyloma

Flat condyloma, also known as condyloma lata, is caused by reactivation of the bacterium Treponema pallidum and is a manifestation of secondary syphilis.

In this type, the lesions are smooth, soft, and flat, with a grayish-white color. They tend to appear in moist areas of the body, such as the anus, vaginal lips, or penis.

Possible causes

Condyloma is most commonly transmitted through sexual contact, especially when caused by the human papillomavirus (HPV).

It can also be passed from mother to baby during childbirth. In some cases, it may spread through autoinoculation, when a person touches a wart and then touches another part of their own body.

Flat condyloma occurs due to reactivation of Treponema pallidum and is associated with secondary syphilis. This stage typically develops 2 to 8 weeks after the symptoms of primary syphilis improve.

Treatment options

Treatment depends on the cause of the infection and may include:

1. Ointments and creams

Condyloma acuminatum is often treated with topical medications such as imiquimod or podofilox. These medications help stop HPV from multiplying or stimulate the immune system to fight the infection.

Treatment should follow medical guidance and may take several months or longer for the warts to completely go away.

2. Oral and injectable medications

For flat condyloma, treatment usually involves intramuscular injections of benzathine penicillin to treat syphilis and eliminate Treponema pallidum.

According to the CDC Sexually Transmitted Infections Treatment Guidelines, benzathine penicillin G is the recommended regimen for adults with primary and secondary syphilis.

For people who are allergic to penicillin, an oral antibiotic such as doxycycline may be prescribed.

3. Cryotherapy

Cryotherapy uses liquid nitrogen to freeze and destroy the warts. It is commonly recommended for condyloma acuminatum.

4. Electrocauterization

Electrocauterization is a procedure performed by a doctor that uses electrical current to burn and remove warts.

5. Surgery

Surgical options, including excision, curettage, or laser therapy, may be recommended to remove condyloma acuminatum quickly.

Prevention measures

To reduce the risk of condyloma, it is recommended to use condoms during all sexual activity. Avoiding sexual contact with individuals who have visible genital warts is also important.

Another effective prevention method is the HPV vaccine. According to the CDC, HPV vaccination can start at age 9, is routinely recommended at ages 11 to 12, and is recommended through age 26 for people who were not adequately vaccinated earlier.

Some adults ages 27 to 45 may also choose vaccination after discussion with a clinician.