Comparative efficacy of topical garlic extract and 20% podophyllin solution in the treatment of female genital warts: a triple-blind randomized clinical trial.

Background: Genital warts caused by human papillomavirus are common sexually transmitted infections, with no single therapy providing consistent clearance. Garlic extract has antiviral and antiproliferative properties and may offer a low-cost treatment.

Objective: To compare the efficacy and safety of topical 5% garlic extract with 20% podophyllin solution in women with genital warts.

Methods: Seventy-four women were randomized to 5% garlic extract (n = 37) or 20% podophyllin (n = 37), applied weekly for four weeks. Wart size and count were assessed using marginal models (generalized estimating equations). The primary outcome was change in mean wart size and the secondary outcome was change in wart count.

Results: Mean wart size decreased from 1.61 ± 0.81 to 0.60 ± 0.82 mm with garlic extract and from 2.96 ± 7.99 to 0.62 ± 0.73 mm with podophyllin. The between-group p-value at final assessment was 0.756; group × time interaction p values were 0.329 for wart size and 0.583 for count. Among 35 and 37 participants analyzed, complete response occurred in 18 (51.4%) and 19 (51.4%), respectively; complete or partial response occurred in 23 (65.7%) and 25 (67.6%). Itching and burning occurred in 8 (21.6%) garlic-treated participants each.

Conclusion: Both treatments reduced wart size and count, with similar response rates. Four-week follow-up precluded assessment of durability and recurrence.