the Use of Phenol in Post-Electrocautery Treatment for Warts

Issues with using Phenol Red after electrocautery?

Hello, I discovered cauliflower-like lesions in the follicular area of my genital region last June, approximately 3-4 lesions.
I immediately went to a major hospital for electrosurgical treatment (at the same time, I also had over ten hemangiomas removed, which had developed over the past year).
After about 9-10 months, in April of this year, I found a particularly unusual lesion, and I suspected it was a "recurrence of the cauliflower." During this time, a few more hemangiomas had appeared.
I went back to the same hospital, got a diagnosis, and underwent electrosurgical treatment again.
The doctor prescribed a medication called "Podophyllotoxin" ointment, instructing me to start applying it after the electrosurgical wounds have healed, with a regimen of three times a day for a month, followed by a follow-up appointment.
I would like to ask the following questions:
1.
The doctor mentioned that normal skin should not react.
If there is discoloration or similar changes, it indicates that there may be latent cauliflower virus in that area.
Is this understanding correct regarding the primary function of Podophyllotoxin to induce and eliminate dormant cauliflower lesions in the skin?
2.
Is it necessary to apply the ointment three times a day? If it is inconvenient to apply it during lunchtime at work, would applying it only twice a day affect the treatment?
3.
If, by the end of the treatment, there is no reaction on the skin, does that mean the cauliflower lesions have been cleared, and I can stop using the medication?
4.
I may have contracted the virus from my girlfriend, who had lesions appear about six months before I first developed mine.
However, it has been about one year and three months since she last had any symptoms.
Does this mean her risk of recurrence has decreased? If she uses Podophyllotoxin, would it be effective for her as well?
Thank you for your response.

Zhaihua, 20~29 year old female. Ask Date: 2019/05/01

Dr. Cai Zhuorong reply Urology

1.
The doctor told me that normal skin should not show any reactions.
If there is discoloration or similar changes, it indicates that there may be latent human papillomavirus (HPV) in that area.
The primary function of Sinecatechins is to induce the clearance of latent HPV in the skin.
Is this understanding correct? A: According to the drug label, the mechanism of action of Sinecatechins ointment in clearing genital and perianal warts remains unknown.
In vitro studies have shown that green tea extract has antioxidant properties; however, the clinical significance of this finding is still unknown.
2.
Do I need to apply it three times a day? If I cannot apply it during my lunch break at work and only apply it twice a day, will it affect the treatment? A: Currently, there are no reports indicating the effectiveness of applying it only twice a day.
If you can only apply it twice a day, you may consider using WARTEX cream.
3.
If my skin shows no reaction by the end of the treatment, does that mean the warts are cleared and I can stop the medication? According to research, after 16 weeks of continuous use of Veregen, the clearance rate of external genital and perianal warts is approximately 50-60% compared to the control group.
4.
I may have been infected by my girlfriend; she had warts about six months before I first developed them.
However, it has been about a year and three months since she last had any symptoms.
Does this mean her risk of recurrence has decreased? A: There are many risk factors for wart recurrence, including overall immune function.
Since she has not had any recurrence of symptoms, her risk may be lower.
If I ask my girlfriend to use Sinecatechins, will it be effective? A: The indication for Sinecatechins is for the treatment of external genital and perianal warts (Condylomata acuminata) in adults aged 18 and older.
Therefore, if there are no visible warts, it is not an appropriate indication for the medication.

Reply Date: 2019/05/01

More Info

Phenol, particularly in the form of topical treatments like "Phenol Clean" (酚瑞淨), is often used in dermatology for various skin conditions, including warts (also known as condylomata acuminata or genital warts). Your situation involves the treatment of warts following electrocautery, and you have several questions regarding the use of this medication.

1. Effectiveness of Phenol: Your doctor’s explanation about the potential for latent HPV (human papillomavirus) to be present in the skin is accurate. Phenol works by inducing a chemical reaction that can help to eliminate warts and potentially target any dormant virus in the skin. The idea is that if there is a reaction (such as redness or irritation), it may indicate that the virus is still present in that area. However, it’s essential to understand that while phenol can help in treating warts, it does not guarantee the complete eradication of the virus, as HPV can remain dormant in the body.

2. Application Frequency: Regarding the application frequency of three times a day, it is generally recommended to adhere to the prescribed regimen for optimal results. However, if your schedule makes it difficult to apply the medication three times a day, applying it twice may still be beneficial, but it could potentially reduce the effectiveness of the treatment. It’s best to discuss any changes in the application schedule with your healthcare provider to ensure that you are still receiving adequate treatment.

3. Stopping Treatment: The absence of a skin reaction does not necessarily mean that the warts are completely cleared or that the HPV is eradicated. It is crucial to follow up with your healthcare provider after completing the treatment course to evaluate the area and determine if further treatment is necessary. Your doctor may perform a physical examination or other assessments to confirm that the warts are gone and that there are no signs of recurrence.

4. Transmission and Recurrence: Regarding your girlfriend, if she has not had any symptoms of warts for over a year, her risk of recurrence may be lower, but it is not eliminated. HPV can remain dormant for long periods, and while she may not currently show symptoms, it is still possible for the virus to reactivate. If she has been diagnosed with HPV in the past, it would be prudent for her to consult with a healthcare provider before starting any treatment like phenol. Using phenol may not be necessary unless she has visible warts or symptoms.

In conclusion, while phenol can be an effective treatment for warts, it is essential to follow your healthcare provider's instructions closely. Regular follow-ups are crucial to monitor the treatment's effectiveness and to manage any potential recurrence of warts. Additionally, discussing any concerns with your healthcare provider will help ensure that both you and your girlfriend are taking the appropriate steps to manage your health effectively.

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