What is Podophyllotoxin?

Podophyllotoxin is a plant-based resinous extract used in the treatment of condylomata acuminate, or genital warts. This extract is obtained from the roots of a native North American plant called podophyllum peltatum, or the mayapple. Native American tribes once used this plant to treat parasitic infections and snake bites and as a laxative and purgative. Podophyllotoxin has been used to treat genital warts since the 1930s and is available internationally under brand names such as Wartec® and Condyline®.

Genital warts are a common sexually transmitted disease caused by the human papilloma virus (HPV). More than one hundred types of HPV are known to exist, more than 40 of which can infect the genital region. Two particular strains of the virus, called HPV6 and HPV11, are the most common causes of genital warts. During an active infection with the virus, warts can grow in the urogenital region of both men and women, on the anus, penis, scrotum, vulva, vagina and cervix.

Podophyllotoxin is an effective treatment for genital warts, because of its activity as an antimitotic. This means that it prevents virally infected wart cells from dividing. The wart virus requires actively growing cells in which to replicate, so by preventing growth of infected cells, the virus is destroyed. Eventually, this treatment causes the death of all virally infected cells and new growth of healthy uninfected cells.

Applying podophyllotoxin is not painful, but as infected cells begin to die off, some local skin irritation can be expected. This generally starts on the second or third day after treatment begins. It is common and normal to experience redness, itching, tenderness and pain at the site of treatment.

This medication also can cause some uncommon and potentially harmful side effects. These include bleeding or burning of the treated skin, headaches, dizziness and vomiting. Medical attention should be sought if any of these side effects occur or if local treatment effects continue to worsen for several days.

This toxin is not specific for infected cells, which means that it has the potential to harm healthy tissue. Because of this, podophyllotoxin should be used carefully and only as directed by the manufacturer or by a doctor. The hands and the infected area should be washed and dried prior to applying the medication, and the hands must be thoroughly washed afterwards. Care should be taken to ensure that the medication is not accidentally applied to healthy skin. This medication should not be used by pregnant or nursing women, because of its potentially harmful effects on a fetus or nursing baby.