Genital Warts Treatment in Texas (Condylomata Acuminata / HPV Warts)
Texas adult care by secure video visit, self pay option starting at $49, MD-only, insurance is not required.
Genital warts (condylomata acuminata) are the most common visible manifestation of human papillomavirus (HPV) infection, caused primarily by HPV types 6 and 11. For many adults, external anogenital warts that are accessible and visible are appropriate for telehealth evaluation and management with patient-applied prescription topical treatments such as imiquimod 5% cream, podofilox 0.5% solution or gel, or sinecatechins 15% ointment — all recommended regimens per the 2021 CDC STI Treatment Guidelines. TeleDirectMD uses a safety-first approach that screens for red flags including rapidly growing or bleeding lesions, intra-anal or intra-vaginal warts, suspected malignant transformation, large or obstructing warts requiring procedural removal, and immunocompromised status before determining whether a telehealth visit is appropriate. When a video visit is appropriate, the MD can complete a visual assessment by video, prescribe patient-applied topical therapy when clinically indicated, provide evidence-based HPV counseling, and discuss partner notification and STI screening. This page is for adults located in Texas, including Houston, San Antonio, Dallas, Austin, Fort Worth, El Paso, Arlington, Corpus Christi, Plano, Laredo, and surrounding areas.
Quick navigation:
- Self pay option starting at $49
- MD-only care (no mid-levels)
- Insurance is not required
- Licensed telehealth care for patients located in Texas at the time of the visit
Last reviewed on 2026-03-23 by Parth Bhavsar, MD
ICD-10 commonly used: A63.0 (final coding depends on clinical details)
Online MD-Only Genital Warts Care in Texas
- Visual assessment of external anogenital warts by secure video
- Patient-applied topical prescriptions when clinically appropriate (imiquimod, podofilox, sinecatechins)
- Evidence-based HPV counseling, recurrence guidance, and partner notification discussion
- Red-flag screening and clear direction to in-person or ER care when needed
Adults 18+ only. TeleDirectMD is not an emergency service. Seek urgent in-person care immediately for rapidly growing, bleeding, or ulcerated genital lesions, lesions suspected of malignant transformation, large or obstructing warts, or signs of severe systemic illness. TeleDirectMD does not prescribe controlled substances.
Genital Warts Telehealth Eligibility Checklist for Texas
You are likely eligible for a TeleDirectMD video visit if ALL of these are true:
✓ You Are Eligible If
- You are 18 years old or older
- You are physically located in Texas at the time of the visit
- You have visible external anogenital warts (on the penis, scrotum, vulva, perineum, groin, or perianal skin) that are accessible for visual assessment by video
- Your warts are not rapidly growing, bleeding, ulcerated, or otherwise suspicious for a more serious condition
- You do not have intra-anal, intra-vaginal, cervical, or urethral meatus warts requiring procedural treatment or specialist evaluation
- You are not severely immunocompromised with extensive or refractory disease
- Insurance is not required. A self pay option is available.
✗ You Are Not Eligible If
- You are under 18 years old
- You have rapidly growing, bleeding, ulcerated, or darkly pigmented lesions suspicious for malignancy
- You have intra-anal, intra-vaginal, cervical, or urethral meatus warts
- You are severely immunocompromised (active HIV with low CD4, organ transplant recipient, or similar) with extensive or treatment-refractory disease
- You have large or obstructing warts that require cryotherapy, TCA application, excision, or other in-office procedures
- You are pregnant (podofilox and sinecatechins are contraindicated in pregnancy; any treatment in pregnancy should be managed in person)
If you have red-flag symptoms or lesions suspicious for malignancy, seek urgent in-person care or evaluation by a dermatologist, gynecologist, or urology specialist. TeleDirectMD is not an emergency service.
How Online Genital Warts Treatment Works in Texas
Book your visit and prepare for your visual assessment
Insurance is not required. No referral needed. Many visits are available same day, depending on scheduling. Before your visit, note when you first noticed the warts, the number and approximate size of lesions, any prior treatment, your sexual history, any known STI exposures, allergies, and any immune-compromising conditions. Good lighting for video and ability to show the affected area will help the MD complete a thorough visual assessment.
See a Texas licensed MD by video
The MD will complete a visual assessment of the warts by video, review your symptom history, screen for red flags (bleeding, rapid growth, suspicious appearance), assess eligibility for patient-applied topical therapy, and discuss HPV counseling including recurrence, transmission, partner notification, STI co-testing, and HPV vaccination when applicable.
Get your treatment plan and, if appropriate, a prescription
If patient-applied topical therapy is clinically appropriate, the MD will send an e-prescription to common Texas pharmacies such as CVS Pharmacy, Walgreens, Walmart Pharmacy, H-E-B Pharmacy, Kroger Pharmacy. You will receive clear instructions on how to apply your medication, what side effects to watch for, when warts should respond, and when to seek in-person follow-up.
Texas Telehealth Regulations for Online Genital Warts Care
Texas Occupations Code Chapter 111 and the Texas Medical Board rules govern telemedicine services, permitting licensed providers to deliver care via audio-video and other telecommunications technologies. Senate Bill 1107 eliminated the requirement for a prior in-person visit, allowing the establishment of a physician-patient relationship through telemedicine with the same standard of care as in-person treatment.
Location matters: you must be physically in Texas during the visit. Insurance is not required. TeleDirectMD does not prescribe controlled substances.
TeleDirectMD vs Other Care Options for Genital Warts in Texas
Here is how TeleDirectMD compares to common settings for adult genital warts care in Texas:
| Care option | Typical cost | Wait time | Provider type | Best for |
|---|---|---|---|---|
| TeleDirectMD | Self pay option starting at $49 | Same day, often within hours | Board-certified MD only (no mid-levels) | External anogenital warts appropriate for patient-applied topical therapy, with HPV counseling, red-flag screening, and prescriptions when clinically appropriate |
| Urgent Care | $150 to $300+ (before insurance) | 1 to 3 hours typical | MD, DO, PA, or NP | When an in-person exam is needed and the situation is not a specialist-level concern |
| Emergency Room | $500 to $3,000+ (before insurance) | 2 to 6 hours typical | Emergency medicine MD or DO | Severe systemic illness, rapidly spreading or extensively bleeding lesions, or concern for serious complication |
| Primary Care | $100 to $350+ (varies) | Days to weeks | MD or DO | Ongoing STI screening, follow-up for recurrent warts, and coordination with dermatology or gynecology |
| Dermatology / STI Clinic | $150 to $400+ (varies) | Days to weeks (varies) | Dermatologist or STI specialist | In-office procedures (cryotherapy, TCA, excision), intra-anal or cervical warts, refractory or extensive disease, and biopsy when malignancy is suspected |
Bottom line: TeleDirectMD is a strong fit for external anogenital warts appropriate for patient-applied topical therapy, with direct MD evaluation, HPV counseling, and clear rules for when in-person or specialist care is needed.
Should I Use TeleDirectMD for Genital Warts in Texas? Decision Guide
Do you have any emergency or red-flag symptoms?
- Rapidly growing, bleeding, ulcerated, or darkly pigmented genital lesions
- Lesions suspicious for malignant transformation (irregular pigmentation, non-healing ulcer, dermal infiltration)
- Intra-anal, intra-vaginal, cervical, or urethral warts
- Large or obstructing warts that may require in-office procedural removal
- Severe immunocompromise with extensive or treatment-refractory disease
If yes, seek in-person care with a dermatologist, gynecologist, or STI specialist — or the ER for urgent severe presentations
If no, continue to Step 2
Are you 18+ and currently in Texas?
If yes, continue to Step 3
If no, use in-person care as appropriate
Do you have external anogenital warts appropriate for telehealth assessment?
- Visible warts on the penis, scrotum, vulva, perineum, groin, or perianal (external) skin
- Lesions are not bleeding, ulcerated, or suspicious-appearing
- You are not pregnant
- You are not severely immunocompromised
If yes, continue to Step 4
If no or any red flags are present, in-person evaluation is recommended
You may be appropriate for a TeleDirectMD video visit
TeleDirectMD can complete a visual assessment by video, screen for red flags, prescribe patient-applied topical therapy when clinically appropriate, provide evidence-based HPV counseling, discuss partner notification and STI screening, and give you clear guidance on follow-up and when in-person care is needed.
What Does Online Genital Warts Treatment Cost in Texas?
Transparent options. Insurance is not required.
TeleDirectMD Video Visit
$49
Self pay option. Insurance is not required.
- MD evaluation and red-flag screening
- Visual assessment of external warts by secure video
- Topical prescription when clinically appropriate (imiquimod, podofilox, or sinecatechins)
- Evidence-based HPV counseling, partner notification guidance, and STI co-testing discussion
- Clear follow-up and escalation instructions
Typical Cost Comparison
Common ranges people see before insurance. Actual costs vary.
Prescription costs are separate and vary by medication and pharmacy. Topical treatments for genital warts (imiquimod, podofilox, sinecatechins) can vary widely in cost; ask your pharmacist about generic availability and pricing.
No hidden fees. If medication is not clinically appropriate or in-person care is needed, you still receive a complete evaluation, guidance, and clear instructions on what level of care you need next.
What Are Genital Warts?
Genital warts (condylomata acuminata) are soft, flesh-colored growths that appear on the skin or mucous membranes of the anogenital area. They are caused by certain strains of human papillomavirus (HPV) — most commonly HPV types 6 and 11, which together account for approximately 90% of all genital wart cases. These HPV types are considered low-oncogenic-risk types, meaning they are associated with warts rather than cervical or anal cancer. However, genital warts can be cosmetically distressing, emotionally challenging, and are a sign of an underlying sexually transmitted HPV infection that can be passed to partners even when warts are not visible.
HPV is one of the most common sexually transmitted infections in the United States, with the CDC estimating approximately 13 million new infections diagnosed annually and over 42 million Americans already infected. About 1% of sexually active adults have clinically visible genital warts at any given time, with the peak age group being 20 to 24 years old. Warts can appear on the penis, scrotum, vulva, perineum, groin, perianal skin, and occasionally inside the vagina, on the cervix, in the anal canal, or at the urethral meatus — the last four sites requiring in-person evaluation and specialist management. Genital warts can resolve spontaneously (about 30% clear within 4 months and about 65% within 2 years), remain unchanged, or increase in size or number if left untreated. Immunosuppressed patients, including those with HIV, are more likely to have larger, more numerous, and more treatment-resistant warts.
TeleDirectMD focuses on external anogenital warts in immunocompetent adults that are accessible for visual assessment by secure video and appropriate for patient-applied topical prescription therapy. The 2021 CDC STI Treatment Guidelines recommend three patient-applied regimens for external anogenital warts: imiquimod cream, podofilox solution or gel, and sinecatechins ointment. A telehealth visit can allow the MD to assess the appearance and location of warts by video, determine appropriateness for topical therapy, prescribe the appropriate treatment, and provide evidence-based HPV counseling — all without an in-person visit for select cases. Cases involving intra-anal, intra-vaginal, cervical, or urethral warts, warts suspicious for malignancy, large or obstructing lesions requiring procedures, or extensive disease in immunocompromised patients require in-person specialist evaluation.
Causes and Risk Factors for Genital Warts
Genital warts are caused by human papillomavirus (HPV), a DNA virus transmitted primarily through direct skin-to-skin sexual contact. Understanding the risk factors helps identify who is most likely to benefit from telehealth evaluation versus who needs in-person care.
- HPV types 6 and 11: These two low-oncogenic-risk HPV types cause approximately 90% of all genital warts. They are transmitted through genital-to-genital, oral-to-genital, or anal sexual contact and can be passed even when warts are not visible.
- Multiple sexual partners: Having multiple partners increases the risk of HPV acquisition. Approximately 3 out of 4 unaffected partners of patients with genital warts will develop warts within 8 months of contact with the affected individual.
- Immunosuppression: People with HIV infection, organ transplants, or other causes of immune compromise are more likely to develop genital warts, more likely to have extensive or hard-to-treat disease, and more likely to experience recurrence after treatment.
- Lack of HPV vaccination: Gardasil 9 vaccine protects against HPV types 6 and 11 (which cause warts) and several high-risk types. Vaccination prior to sexual debut is highly effective at preventing genital warts; it does not treat existing HPV infection or existing warts.
- Age: Genital warts are most common between ages 17 and 33, with peak incidence at ages 20 to 24. The immune system often clears HPV over time, with median clearance of about 6 months in young men and 90% clearance within 2 years in women.
- Cigarette smoking and local factors: Smoking and local moisture or skin trauma in the anogenital area may increase susceptibility to HPV infection or wart development.
Treatment of genital warts aims to remove visible lesions and relieve symptoms or cosmetic concerns but does not eradicate the underlying HPV virus. Warts frequently recur, especially in the first 3 months after treatment. HPV can still be transmitted to partners even after warts resolve. Partner notification, consistent condom use, STI screening, and discussion of HPV vaccination are all important parts of a complete management plan.
Symptoms and Red Flags for Genital Warts in Texas
Use this table to understand which presentations are appropriate for telehealth evaluation and which require urgent in-person care.
| Symptom or situation | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Soft, flesh-colored or pink raised bumps on the external genitalia, perineum, or perianal skin | Classic external anogenital warts (condylomata acuminata) appropriate for topical therapy | Often yes | If bleeding, ulcerated, or rapidly growing |
| Flat or cauliflower-shaped lesions on the vulva, penile shaft, or scrotum without bleeding | External genital warts amenable to patient-applied topical treatment | Often yes | If irregular pigmentation, dark coloration, or non-healing ulceration |
| Anal or perianal warts visible on external skin | External perianal warts may be treatable with topical therapy; intra-anal warts require specialist evaluation | Sometimes — external only | Intra-anal warts always require in-person evaluation with colorectal specialist |
| Warts inside the vagina, on the cervix, or at the urethral meatus | Internal warts require in-person evaluation and procedures (cryotherapy, TCA, or excision) | No | Requires in-person specialist evaluation; not appropriate for telehealth |
| Rapidly growing, bleeding, or ulcerated anogenital lesion | Possible malignant transformation or high-grade HPV-related lesion; biopsy indicated | No | Urgent in-person evaluation — possible squamous cell carcinoma or high-grade intraepithelial neoplasia |
| Darkly pigmented, irregular, or non-healing genital lesion | Suspicious for malignancy (penile, vulvar, or anal cancer); biopsy needed | No | Urgent in-person evaluation with dermatology or surgical specialist |
| Known HIV or other significant immunosuppression with extensive or treatment-refractory warts | Immunocompromised patients have more aggressive disease and lower treatment response; in-person specialist management preferred | No | In-person evaluation; sinecatechins are contraindicated in this group |
Differential Diagnosis: Genital Warts vs Other Conditions
Several conditions can resemble genital warts. Careful visual assessment and clinical history help distinguish classic condylomata acuminata from other diagnoses. TeleDirectMD will conduct a thorough visual assessment by video and direct cases that cannot be confidently differentiated from more serious conditions to appropriate in-person care.
Sometimes Appropriate for Telehealth Guidance
- Classic external anogenital warts with a typical soft, raised, flesh-colored appearance and confirmed sexual exposure history
- Pearly penile papules — small, smooth, dome-shaped papules arranged in rows around the corona of the penis that are a normal anatomic variant requiring no treatment
- Skin tags (acrochordons) — soft, pedunculated growths in skin folds without HPV-related features; telehealth can help assess and reassure
- Discussion of HPV recurrence, partner notification, and STI co-screening in a known case of genital warts
- Follow-up after completed topical treatment course to assess response and guide next steps
Often Requires In-Person Evaluation
- Condylomata lata (secondary syphilis) — flat, broad, moist papules in the anogenital area caused by Treponema pallidum; requires serologic syphilis testing (RPR/VDRL, treponemal antibody) and in-person examination
- Molluscum contagiosum — smooth, umbilicated, dome-shaped papules caused by a poxvirus; may be difficult to distinguish from small warts by video alone and benefits from in-person confirmation
- Seborrheic keratosis — non-sexually-transmitted benign skin growth; evaluation may require in-person dermatologic examination to confirm benign nature
- Squamous cell carcinoma or high-grade intraepithelial neoplasia — any ulcerated, bleeding, pigmented, or non-healing genital lesion requires urgent biopsy and in-person specialist evaluation
- Intra-anal or intra-vaginal warts requiring procedural treatment (cryotherapy, TCA, or surgical excision)
- Herpes simplex virus (HSV) with painful vesicles or ulcers — requires STI testing and targeted antiviral management
Genital Warts vs Condylomata Lata (Syphilis)
Genital warts are raised, soft, flesh-colored or cauliflower-like growths caused by HPV types 6 or 11 and are not painful. Condylomata lata are flat, broad, moist, whitish-gray papules or plaques caused by secondary syphilis (Treponema pallidum). They may look superficially similar but require a completely different workup and treatment. Any atypical flat moist genital lesion should prompt in-person evaluation and serologic syphilis testing.
Genital Warts vs Molluscum Contagiosum
Molluscum contagiosum presents as small, smooth, round, dome-shaped papules with a characteristic central umbilication (dimple). Genital warts tend to be more irregular, rougher, and may have a cauliflower-like surface. Both are sexually transmissible in adults. Distinguishing the two by video alone can be difficult for small lesions, and in-person confirmation may be preferred.
External Genital Warts vs Malignant Lesion
Classic genital warts are soft, flesh-colored, and benign. Red flags suggesting possible malignancy or high-grade intraepithelial neoplasia include rapid growth, ulceration, bleeding, irregular pigmentation (dark, mottled, or black coloration), a non-healing appearance, or palpable firmness. Any lesion with these features requires urgent in-person biopsy and specialist evaluation. TeleDirectMD will direct such cases to in-person care.
If the clinical presentation is atypical, the lesion is suspicious for malignancy, or the diagnosis cannot be confirmed by visual assessment, TeleDirectMD will direct you to appropriate in-person care. We do not prescribe topical therapy for lesions that appear potentially malignant, intra-anal, intra-vaginal, or cervical.
When Is a Video Visit Appropriate for Genital Warts?
When a Video Visit Is Appropriate
- Visible external anogenital warts on the penis, scrotum, vulva, perineum, groin, or perianal (external) skin
- Warts appear typical — soft, raised, flesh-colored, cauliflower-shaped, without bleeding, ulceration, or suspicious pigmentation
- Immunocompetent adult without extensive or refractory disease
- No intra-anal, intra-vaginal, cervical, or urethral meatus warts
- Not pregnant
- No prior topical treatment failure requiring escalation to procedural care
- Located in Texas at time of visit
Red Flags Requiring In-Person or Specialist Care
- Rapidly growing, bleeding, ulcerated, or darkly pigmented genital lesion
- Lesion suspicious for malignancy (non-healing ulcer, irregular pigmentation, dermally infiltrated)
- Intra-anal, intra-vaginal, cervical, or urethral meatus warts
- Severe immunosuppression with extensive or treatment-refractory disease
- Large or obstructing warts requiring cryotherapy, TCA, excision, or electrosurgery
- Pregnancy (podofilox and sinecatechins are contraindicated; imiquimod safety in pregnancy is insufficient)
If any red-flag features are present, seek in-person evaluation with a dermatologist, gynecologist, or STI specialist. TeleDirectMD is not appropriate for these presentations.
Treatment Options for Genital Warts
The 2021 CDC STI Treatment Guidelines classify genital wart treatments as either patient-applied or provider-administered (procedural) modalities. TeleDirectMD focuses exclusively on the patient-applied topical regimens that can be prescribed via telehealth for eligible external anogenital warts. No single treatment is superior for all patients or all warts — the MD will choose based on wart location, size, patient history, pregnancy status, immune status, allergies, and cost considerations.
Patient-applied topical therapy (telehealth-prescribable)
Three CDC-recommended patient-applied regimens are appropriate for external anogenital warts and can be prescribed via telehealth when clinically appropriate. Imiquimod 5% cream is an immune-response modifier applied at bedtime three times per week for up to 16 weeks; the area is washed off 6 to 10 hours after application. Podofilox 0.5% solution or gel is an antimitotic agent applied twice daily for 3 days, followed by 4 days off, for up to four cycles; total treatment area should not exceed 10 cm² per day. Sinecatechins 15% ointment, derived from green tea extract, is applied three times daily (a 0.5 cm strand per wart) for up to 16 weeks; it is not washed off and should not be used in immunocompromised patients or during pregnancy. Warts located on moist surfaces tend to respond best to topical treatments.
HPV counseling and partner management
HPV counseling is a core component of genital warts management and is well-suited to telehealth. Key counseling points include: treatment removes warts but does not eradicate the underlying HPV virus; warts frequently recur, especially in the first 3 months after treatment; HPV can be transmitted to partners even after warts resolve; partners should be counseled that they may already have HPV even without visible warts; condoms reduce but do not eliminate HPV transmission risk; STI co-testing (chlamydia, gonorrhea, syphilis, HIV) is recommended; and Gardasil 9 vaccine prevents HPV types 6 and 11 in those not yet exposed but does not treat existing infection.
Observation without treatment
Because genital warts may resolve spontaneously — approximately 30% clear within 4 months and about 65% within 2 years — observation without immediate treatment is an acceptable option for some patients with small, asymptomatic warts who prefer to avoid topical therapy. The MD can discuss the natural history and help the patient make an informed decision about treatment timing.
STI co-screening
The CDC recommends that all persons with genital warts be offered testing for other STIs, including chlamydia, gonorrhea, syphilis, and HIV. TeleDirectMD can order STI lab testing and discuss how to access local or mail-in STI testing in Texas.
What TeleDirectMD Does Not Manage
- In-office procedures for genital warts — cryotherapy with liquid nitrogen, trichloroacetic acid (TCA) or bichloroacetic acid (BCA) application, electrosurgery, laser, or surgical excision
- Intra-anal, intra-vaginal, cervical, or urethral meatus warts requiring specialist evaluation or procedural management
- Suspected malignant transformation, high-grade intraepithelial neoplasia, or biopsy-indicated lesions
- Large or obstructing warts in pregnancy requiring in-office evaluation and management
- Extensive or treatment-refractory disease in severely immunocompromised patients needing specialist care
Common Medication Options for Genital Warts
These are the three CDC-recommended patient-applied topical regimens for external anogenital warts. The actual medication, dosing schedule, and duration are determined by the MD after reviewing your wart location, number, size, immune status, pregnancy status, allergies, and ability to apply medication at home. All are examples only.
| Medication | Typical regimen | Duration | Key considerations |
|---|---|---|---|
| Imiquimod 5% cream (Aldara) | Apply a thin layer to external warts at bedtime 3 times per week (e.g., Mon, Wed, Fri); wash off with soap and water 6 to 10 hours after application | Up to 16 weeks | Immune response modifier; local reactions (redness, erosion, itching) are common and can indicate response; avoid with active inflammatory skin disease (psoriasis, vitiligo); data on pregnancy are insufficient — avoid during pregnancy; not for internal warts |
| Imiquimod 3.75% cream (Zyclara) | Apply a thin layer to external warts at bedtime every night; wash off with soap and water 6 to 10 hours after application | Up to 8 weeks | Lower concentration than 5% cream; may have similar efficacy with potentially fewer local side effects; same contraindications as 5% formulation; brand and generic availability varies by pharmacy |
| Podofilox 0.5% solution or gel (Condylox) | Apply to warts twice daily for 3 consecutive days, then 4 days off; repeat up to 4 cycles; total area treated should not exceed 10 cm² per day; total volume limited to 0.5 mL per day | Up to 4 weekly cycles (4 weeks total) | Antimitotic (causes wart necrosis); local pain and irritation common; contraindicated in pregnancy; not for internal warts; MD will identify which lesions to treat and demonstrate proper application technique |
| Sinecatechins 15% ointment (Veregen) | Apply a 0.5 cm strand to each external wart 3 times per day; do not wash off; avoid genital, anal, and oral sexual contact while ointment is on skin | Until complete wart clearance or up to 16 weeks | Green tea catechin extract with anti-proliferative and immunostimulatory properties; do NOT use in HIV-positive or otherwise immunocompromised patients; do NOT use in pregnancy (safety unknown); local reactions include erythema, pruritus, ulceration, and vesicular rash |
Important: Example regimens only. The actual medication, dosing schedule, and duration are determined by the MD after reviewing your clinical situation including wart location, size, immune status, pregnancy status, allergies, and ability to apply medication. TeleDirectMD does not prescribe controlled substances. These medications are prescription-only; do not use over-the-counter wart treatments (such as salicylic acid) on genital warts.
Home Care, Prevention, and Follow-up for Genital Warts
What to Do Now
- Apply your prescribed topical medication exactly as directed — proper application technique and adherence are critical to treatment success
- Avoid sexual contact with the affected area while using podofilox or while sinecatechins ointment is on the skin; discuss safe practices with your partner
- Notify sexual partners so they can seek evaluation; partners may already have HPV even without visible warts
- Seek STI co-testing for chlamydia, gonorrhea, syphilis, and HIV if not recently tested, as the CDC recommends co-testing in all persons with genital warts
- Discuss HPV vaccination (Gardasil 9) with your doctor if you have not been vaccinated and are under 45 years old — it does not treat existing warts but may reduce risk of future HPV infection with other types
What to Watch For During and After Treatment
- Local skin reactions (redness, itching, burning, mild erosion) during topical therapy are common and expected; they generally indicate the treatment is working
- Severe pain, deep ulceration, or blistering beyond the treatment site warrants stopping treatment and contacting your provider
- Most warts should show a response (shrinking or clearing) within 3 months of therapy; lack of improvement after a full course may require a different treatment modality
- New warts appearing during or after treatment are common due to HPV recurrence; wart recurrence most often occurs within the first 3 months after completing treatment
- Any new lesion with rapid growth, bleeding, ulceration, or dark pigmentation should prompt in-person evaluation promptly — these are not typical features of benign recurrence
Prevention and Follow-up
- Use condoms consistently and correctly — they reduce but do not eliminate the risk of HPV transmission, as HPV can infect skin not covered by a condom
- Routine STI screening including HIV testing is recommended for sexually active adults at risk; your treatment visit is a good opportunity to discuss your screening schedule
- Gardasil 9 vaccine is recommended for adults through age 26 and can be considered through age 45 in some individuals after discussion with a provider; it is effective against the HPV types that cause most genital warts
- If warts recur after completing a course of topical therapy, follow-up is recommended to discuss alternative treatment modalities or in-person procedures
- If symptoms suggesting internal warts develop (rectal discomfort, bleeding, or vaginal/cervical concerns), in-person evaluation with a gynecologist, colorectal specialist, or dermatologist is appropriate
When Not to Use TeleDirectMD for Genital Warts in Texas
TeleDirectMD is designed for selected external anogenital wart cases appropriate for patient-applied topical therapy. We are direct about when telehealth is not appropriate.
You Should Not Use TeleDirectMD If
- You have a rapidly growing, bleeding, ulcerated, or darkly pigmented genital lesion — this requires urgent in-person evaluation
- You have intra-anal, intra-vaginal, cervical, or urethral meatus warts — these require in-person procedures and specialist management
- You are pregnant — topical wart treatments are contraindicated or insufficiently studied in pregnancy
- You are severely immunocompromised (HIV with low CD4, active immunosuppressive therapy, organ transplant) with extensive or refractory disease
- You have large or obstructing warts that require cryotherapy, TCA, electrosurgery, or surgical excision
- Your lesion has not been previously diagnosed as a wart and has features suspicious for malignancy
- You are under 18 years old
- You are not physically in Texas at the time of visit
Alternative Care Options
- Emergency room: for rapidly spreading lesions, signs of severe systemic illness, or urgent concern about malignancy
- Dermatologist or STI clinic: for in-office procedures (cryotherapy, TCA, excision), biopsy of suspicious lesions, intra-anal or cervical warts, and extensive or refractory disease
- Gynecologist: for cervical, vaginal, or vulvar warts, cervical cancer screening coordination, and management during pregnancy
- Primary care: for ongoing STI screening, HPV vaccination, and referral coordination for complex wart management
Genital Warts Treatment FAQs for Texas
Can I get genital warts treatment online in Texas?
Yes, if you are an adult 18+ located in Texas and your external anogenital warts are appropriate for telehealth after red-flag screening. TeleDirectMD can complete a visual assessment by video, prescribe patient-applied topical therapy (imiquimod, podofilox, or sinecatechins) when clinically appropriate, and provide HPV counseling and partner notification guidance. Cases with intra-anal, intra-vaginal, or cervical warts, or lesions suspicious for malignancy, are not appropriate for telehealth and will be directed to in-person care.
How much does an online genital warts visit cost in Texas?
TeleDirectMD offers a transparent self pay option starting at $49 for an adult video visit in Texas. Insurance is not required. Prescription costs for topical treatments (imiquimod, podofilox, sinecatechins) are separate and vary by medication, pharmacy, and insurance coverage. Ask your pharmacist about generic options.
Does Texas allow telemedicine for this kind of visit?
Yes. Texas allows licensed professionals to provide telemedicine within their scope when appropriate and according to accepted standards of care.
What topical medications can be prescribed for genital warts online?
The three CDC-recommended patient-applied topical treatments for external genital warts are: imiquimod 5% cream (applied at bedtime 3 times per week for up to 16 weeks), podofilox 0.5% solution or gel (applied twice daily for 3 days on, 4 days off, for up to 4 cycles), and sinecatechins 15% ointment (applied 3 times per day for up to 16 weeks). The appropriate choice depends on wart location, your immune status, pregnancy status, allergies, and ability to apply medication at home.
Can genital warts be diagnosed without an in-person exam?
For classic external anogenital warts with a typical appearance and a consistent sexual exposure history, visual assessment by video is often sufficient to identify the condition and recommend treatment. However, atypical lesions, lesions suspicious for malignancy, or internal warts require in-person evaluation. The MD will assess whether a visual diagnosis by video is appropriate or whether in-person confirmation is needed.
Will treatment cure genital warts?
Treatment removes visible warts but does not eliminate the underlying HPV virus from your body. Warts frequently recur, especially in the first 3 months after completing treatment. HPV may remain in the skin and can still be transmitted to partners even after warts have cleared. Most immunocompetent adults will eventually clear HPV on their own over time, but this can take months to years.
Are genital warts dangerous or can they cause cancer?
The HPV types that cause genital warts (types 6 and 11) are considered low-oncogenic-risk types — they cause warts, not cervical or anal cancer. The HPV types associated with cancer (types 16, 18, and others) are different strains. However, it is possible to have more than one HPV type, and all persons with genital warts should be up to date on cervical cancer screening (for those with a cervix) and should discuss HPV vaccination and STI co-screening with their provider.
Do I need to tell my partner I have genital warts?
Yes. The CDC recommends that current partners be informed about genital warts, as the HPV types that cause warts can be passed to partners. Partners should be counseled that they may already have HPV even without visible warts; HPV testing of sex partners is not routinely recommended. Condoms reduce but do not eliminate HPV transmission risk. TeleDirectMD will provide evidence-based guidance on partner notification during your visit.
When should I go to the ER for genital warts?
Most genital warts do not require emergency care. However, go to the ER or seek urgent in-person evaluation if you have rapidly growing or extensive lesions causing bleeding or obstruction, signs of severe systemic illness, or a genital lesion that is ulcerated, bleeding, or otherwise suspicious for cancer. TeleDirectMD will redirect you to appropriate care if any of these features are identified during your video assessment.
Can TeleDirectMD treat genital warts in other states?
Yes. TeleDirectMD offers adult evaluations via video visits across multiple states where our physicians are licensed. You must be physically located in the state where you are requesting care at the time of your video visit.
Can TeleDirectMD treat children or teens with genital warts?
No. TeleDirectMD treats adults 18+ only. Patients under 18 with genital warts should be evaluated by a pediatrician or appropriate specialist in person.
Can I use my insurance for a TeleDirectMD visit?
Insurance is not required. If your plan is eligible, you may be able to use insurance. A self pay option is also available.
Can sinecatechins or podofilox be used during pregnancy?
No. Podofilox and sinecatechins are both contraindicated in pregnancy. Imiquimod data in pregnancy are insufficient and its use is generally avoided. Pregnant patients with genital warts should be evaluated in person — TeleDirectMD is not the appropriate setting for wart management during pregnancy.
What is the difference between genital warts and herpes?
Genital warts are soft, raised, flesh-colored, painless or mildly uncomfortable growths caused by HPV types 6 or 11. Genital herpes causes painful vesicles (blisters) that progress to ulcers, often with tingling, burning, or flu-like symptoms, and is caused by herpes simplex virus (HSV). They are different viruses requiring different treatments. TeleDirectMD can help evaluate which is more likely based on your symptom history.
Need help today?
Insurance is not required. Adult-only video visits. MD-only care. Safety-first visual assessment, red-flag screening, topical prescriptions when appropriate, and clear next steps.
References
- CDC STI Treatment Guidelines 2021 — Anogenital Warts (Human Papillomavirus Infection)
- Sexually Transmitted Infections Treatment Guidelines, 2021 — MMWR Recommendations and Reports (CDC)
- Condylomata Acuminata (Genital Warts) — StatPearls, NCBI Bookshelf (Leslie SW et al., updated 2025)
- Genital Warts: Diagnosis and Treatment — American Academy of Dermatology (AAD)
- Genital Warts: Overview — American Academy of Dermatology (AAD)
- Management of External Genital Warts — American Academy of Family Physicians (AAFP), American Family Physician, 2014
TeleDirectMD Telehealth Disclaimer
TeleDirectMD provides MD-only virtual urgent care for adults (18+) in Texas using secure video visits to evaluate external anogenital wart symptoms, conduct visual assessment, provide evidence-based HPV counseling, and prescribe patient-applied topical treatments (imiquimod, podofilox, sinecatechins) when clinically appropriate per the 2021 CDC STI Treatment Guidelines. Insurance is not required. You must be physically located in Texas at the time of your video visit. TeleDirectMD does not prescribe controlled substances.
TeleDirectMD is not an emergency service and is not a replacement for urgent in-person care. This service is intended only for external anogenital warts in immunocompetent adults that are appropriate for patient-applied topical therapy. TeleDirectMD does not perform or prescribe in-office procedures (cryotherapy, TCA, excision), does not manage intra-anal, intra-vaginal, cervical, or urethral meatus warts, does not manage suspected malignant lesions, and does not manage extensive disease in severely immunocompromised patients — all of which require in-person specialist evaluation.
Online genital warts treatment in Texas. HPV wart prescription online. Imiquimod prescription telehealth. Podofilox prescription online. Genital wart treatment by video visit in Texas.
Get Genital Warts Treatment Treatment in Other States
TeleDirectMD treats genital warts treatment via telehealth in 41 states. If you are traveling, relocating, or helping a family member in another state, select below to find this treatment near them.