the Growth of Genital Warts During Treatment: FAQs

Is it normal for the lesions to continue growing despite using LedaMed for treating genital warts (condylomata acuminata)?

Hello Doctor: I recently had a diagnosis of genital warts and have already visited a clinic where the physician prescribed me Aldara cream to apply.
Currently, there is only one lesion on my foreskin, and I have been applying the cream regularly.
However, I have noticed that this lesion continues to grow; it has changed from a small bump to a more pronounced wart-like appearance.
Is this progression normal? (It has been about 3 weeks since I started applying the cream.) Additionally, I would like to ask if it is safe to masturbate during this treatment period.
Is it permissible to engage in sexual intercourse? If there is a need for sexual activity, aside from using condoms, what other precautions should I take?

Kunrao de nanzi, 10~19 year old female. Ask Date: 2019/01/22

Dr. Cai Zhuorong reply Urology

Some cases of genital warts (commonly known as "cauliflower") may not respond well to Aldara cream, and further treatment options should be considered.
Genital warts can also infect areas of skin outside the penis, which means there is still a possibility of transmission through contact, as condoms do not provide complete protection.

Reply Date: 2019/01/22

More Info

Genital warts, also known as condylomata acuminata, are caused by certain strains of the human papillomavirus (HPV). When undergoing treatment, such as with the medication you mentioned (likely imiquimod or another topical agent), it is not uncommon for the warts to appear to grow or change in appearance before they start to resolve. This can be concerning for patients, but it is important to understand the treatment process and what to expect.

1. Growth During Treatment: It is not unusual for genital warts to initially appear to grow or become more pronounced during the early stages of treatment. This can happen for several reasons:
- Inflammatory Response: The topical treatment can cause an inflammatory response, which may make the warts appear larger or more irritated before they start to shrink.

- Treatment Timeline: It typically takes several weeks for the treatment to effectively reduce the size of the warts. In your case, three weeks is still relatively early in the treatment process. It is essential to continue applying the medication as prescribed and to follow up with your healthcare provider for further evaluation.

- Individual Variation: Each person’s body responds differently to treatment, and some may experience a slower resolution of warts than others.

2. Sexual Activity During Treatment: Regarding sexual activity during treatment, it is generally advisable to avoid sexual intercourse until the warts have been fully treated and resolved. Engaging in sexual activity can:
- Spread the Virus: HPV is highly contagious, and having sexual contact can transmit the virus to partners, even if warts are not visible.

- Irritation and Complications: Sexual activity may irritate the treated area, potentially worsening the condition or delaying healing.

If you feel that sexual activity is necessary, using condoms can reduce the risk of transmission, but it is important to note that condoms do not provide complete protection against HPV, as the virus can be present on areas not covered by the condom.

3. Self-Care and Monitoring: During treatment, it is crucial to monitor the warts and any changes in your body. If you notice significant changes, increased pain, or if the warts continue to grow despite treatment, you should contact your healthcare provider. They may consider alternative treatments, such as cryotherapy, laser therapy, or surgical removal, depending on the severity and persistence of the warts.

4. Follow-Up Care: Regular follow-ups with your healthcare provider are essential to ensure that the treatment is effective and to monitor for any potential recurrence of warts. HPV can remain dormant in the body, and while treatment can remove visible warts, it does not eliminate the virus entirely.

In summary, while it can be concerning to see genital warts grow during treatment, this can be a normal part of the healing process. It is essential to continue treatment as prescribed and to maintain open communication with your healthcare provider. Avoiding sexual activity during treatment is advisable to prevent transmission and irritation. If you have any further concerns or questions, do not hesitate to reach out to your healthcare provider for personalized advice and support.

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