Genital Warts: Treatment Questions and Concerns - Urology

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Genital warts, also known as condylomata acuminata, are caused by certain strains of the human papillomavirus (HPV). They can appear as small, flesh-colored or gray growths in the genital area, including the penis, vulva, and around the anus. In your case, the white spots you described on the glans (head) of the penis may be indicative of early-stage genital warts, but it is essential to have a proper diagnosis from a qualified healthcare provider.

1. Appearance of Genital Warts: Initially, genital warts may appear as small, flat, or slightly raised bumps. They can be smooth or have a cauliflower-like appearance. In some cases, they may not be very prominent, which could explain why they are sometimes difficult to see or feel. The fact that you have noticed changes in their visibility with different states of erection is not uncommon, as blood flow can affect the appearance of the skin.

2. Cryotherapy Effectiveness: Cryotherapy, or freezing treatment, is a common method for removing genital warts. After one session, the wart may not fall off immediately; it can take several days to weeks for the treated area to heal and for the wart to slough off. It is possible that the doctor could not find the warts during your follow-up visit because the treatment was already taking effect, or the warts were not prominent enough to be detected at that time.

3. Effect of Topical Treatments: Topical treatments like imiquimod (often referred to as Aldara) or podofilox (often referred to as Condylox) can help in treating genital warts. However, these treatments typically require consistent application over several weeks to see results. It is important to follow the instructions provided by your healthcare provider regarding the frequency and method of application.

4. Continuing Treatment with Aldara: If you are experiencing irritation or redness in the area where you applied the medication, it is crucial to consult with your healthcare provider. They can assess whether the irritation is a normal side effect or if it indicates an adverse reaction. If the area is becoming increasingly red and uncomfortable, it may be advisable to pause treatment until you can get further guidance.

5. Potential Damage to Normal Tissue: When applying topical treatments, it is essential to follow the instructions carefully to avoid damaging healthy skin. These medications can cause irritation and should not be applied to areas that are not affected by warts. If you are concerned about the effects on normal tissue, it is best to limit application to the affected areas only and consult your doctor for specific advice.

6. Applying Treatment on Ulcerated Areas: If you have developed ulcers or open sores, it is generally recommended to avoid applying topical treatments directly to these areas until they have healed. Applying medication to broken skin can lead to increased irritation and discomfort. Discuss with your healthcare provider whether you should continue treatment in this situation.

In summary, it is crucial to maintain open communication with your healthcare provider regarding your symptoms and treatment. If you have concerns about the effectiveness of your treatment or the appearance of your skin, do not hesitate to seek a second opinion or further evaluation. Genital warts can be managed effectively with the right treatment plan, and your healthcare provider can help guide you through this process.