Do I Still Need Treatment for a Stable Genital Wart After a Year?

If the cauliflower has not grown for over a year, does it still need treatment?

Hello Doctor, this is my first time asking a question online.
On May 21, 2016 (when I was 18 years old), I was diagnosed with a wart at the junction of the vaginal opening and the anus.
After treatment with Podophyllin (which recurred three times, and I was treated three times), there has been no recurrence so far.
On December 15, 2016, I discovered another wart above the anal opening (in the groin area), which was treated twice with Podophyllin, and there has also been no recurrence to date.
However, in September 2016, the doctor mentioned a small wart inside the vaginal opening, which I also felt.
I have applied medication several times without success (I used Podophyllin four times).
I initially planned to undergo electrocautery treatment when I turn 20 in November this year.
Strangely, it has been a year, and that small wart has neither grown nor multiplied; it remains stable at my vaginal opening.
Since I am overweight and often stay up late playing on my phone, which has led to floaters, along with having depression and autonomic nervous system dysregulation (the warts have caused me a lot of distress), my immune system should be quite poor, and I would expect frequent recurrences.
However, there have been no signs of recurrence or growth so far.
I am wondering if, as long as it does not grow or multiply, I can forgo treatment? Thank you, Doctor, for reading my lengthy message.
This question has been on my mind for a long time.
BY Sanba Ahua (by the way, I have undergone colposcopy several times, and there has been no new wart growth, and the skin in other areas is also clear.
This has been a comforting reassurance amidst the significant mental stress over the past two years.)

San Ba A Hua, 20~29 year old female. Ask Date: 2017/09/12

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On May 21, 2016 (at the age of 18), a wart was diagnosed at the junction of the vaginal opening and the anus.
After treatment with Condylox (three applications due to recurrence three times), there has been no recurrence to date.
On December 15, 2016, another wart was found above the anal opening (in the groin area), which was treated with Condylox twice, and there has also been no recurrence so far.
However, in early September 2016, a doctor noted a small wart inside the vaginal opening, which I also felt.
Several treatments with Condylox (four applications) were ineffective.
I initially planned to undergo electrosurgery when I turned 20 in November this year.
Interestingly, a year has passed, and that small wart has neither grown nor multiplied; it remains stable at my vaginal opening.
Given that I am overweight, often stay up late playing on my phone (which has led to floaters), and also suffer from depression and autonomic nervous system dysregulation (the warts have caused me distress), my immune system should be quite poor, and I would expect frequent recurrences.
However, to date, there have been no signs of recurrence or growth.
I am wondering if, since it has not grown or multiplied, treatment is still necessary? Answer: Electrosurgery would be a better option.

Reply Date: 2017/09/12

More Info

It's great that you're reaching out for information regarding your health, especially concerning genital warts. Based on your description, it seems that you have been managing your condition for several years now, and you have not experienced any new growths or recurrences since your last treatments. This is a positive sign, but let's delve deeper into your concerns and the implications of your situation.

Genital warts, caused by certain strains of the human papillomavirus (HPV), can sometimes resolve on their own, especially if your immune system is functioning well. The fact that you have not seen any new growths or changes in the existing wart for over a year is encouraging. It suggests that your body may be keeping the virus in check, which is a good indication of your immune response.

1. Do You Still Need Treatment?
Given that the existing wart has not changed in size or number over the past year, and considering that you have had multiple checks with no new growths, it may not be necessary to pursue aggressive treatment at this time. However, it is essential to continue monitoring the situation. If the wart remains stable and does not cause discomfort or other issues, some healthcare providers may recommend a "watchful waiting" approach. Nonetheless, it is crucial to have regular check-ups with your healthcare provider to ensure that no new warts develop and that the existing one remains stable.

2. Understanding HPV and Your Immune System:
HPV can remain dormant in the body, and many individuals may carry the virus without any symptoms. The immune system plays a significant role in controlling the virus. Factors such as stress, sleep, and overall health can impact your immune function. Since you mentioned experiencing stress and other health issues, it's vital to focus on improving your overall well-being. This includes managing stress, getting adequate sleep, and maintaining a healthy lifestyle, which can help bolster your immune system.

3. When to Seek Treatment:
If you notice any changes in the wart, such as growth, bleeding, or discomfort, it would be wise to seek treatment promptly. Additionally, if you experience any new symptoms or if the wart starts to cause psychological distress, discussing treatment options with your healthcare provider would be beneficial.
4. Psychological Impact:
It's understandable that dealing with genital warts can lead to feelings of anxiety and depression. It’s essential to address these feelings, as mental health is just as important as physical health. Consider speaking with a mental health professional who can help you manage your anxiety and depression, especially since you mentioned having a history of these issues.

5. Future Considerations:
If you decide to pursue treatment in the future, options include topical treatments, cryotherapy, or laser therapy. Each option has its benefits and potential side effects, so discussing these with your healthcare provider will help you make an informed decision.

In conclusion, while it seems that you may not need immediate treatment for your stable genital wart, ongoing monitoring and regular check-ups are essential. Focus on your overall health and well-being, and don’t hesitate to seek support for any mental health concerns. If you have any further questions or if your situation changes, please reach out to your healthcare provider for personalized advice.

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