Recurring Genital Warts: Causes, Treatment, and Prevention

Q: Recurring Genital Warts: Causes, Treatment, and Prevention

Hello： If you look online, you can find that there are over 100 types of warts. <br>Some are prone to recurrence, while others may be treated successfully with one session. <br>However, some may reappear after a few months. <br>Currently, the options are to remove them through bu

The cauliflower has not been improving?

Hello, doctor.
My husband was infected with genital warts (the lesions were located at the lower edge of the penile coronal sulcus) in June 2018.
Since the infection was very localized, he underwent laser treatment to remove the lesions and applied Aldara cream for about a month (I immediately went for a gynecological check-up, which resulted in a negative finding).
In late January 2019, he experienced a recurrence (at the same location) and I also had a check-up that was negative.
Because the lesions were small (two pointed protrusions), the doctor recommended continuing with Aldara cream, but after three months of no improvement, surgery was scheduled for early April to excise the lesions.
However, after the surgery, the doctor did not perform proper suturing, resulting in a protrusion resembling granulation tissue on the glans.
Upon closer inspection today, the skin on the granulation tissue looks different from other areas, with many tiny tubes (arranged in pointed protrusions).
Additionally, a very small protrusion has developed nearby.

I would like to ask the doctor, is it true that genital warts cannot be completely cured? Why does my husband keep experiencing recurrences? I have tested negative; how did he contract genital warts? He is very frustrated about how he got it (excluding the possibility of infidelity).
My husband is quite reserved and only, about ten years ago in college, was persuaded by friends to visit a prostitute (with a condom), and since then, he has not had any other sexual encounters.
Is it possible he contracted it back then? Also, could his poor immune system be the reason for the recurrent genital warts? How can we boost his immune system? Is it possible that an HIV infection could lead to a weakened immune system, causing him to keep getting genital warts? What would be the best treatment for him? Are there any recommended doctors in Taipei for treating genital warts?

Ren, 30~39 year old female. Ask Date: 2019/05/08

Dr. Du Shixi reply Urology

Hello: If you look online, you can find that there are over 100 types of warts.
Some are prone to recurrence, while others may be treated successfully with one session.
However, some may reappear after a few months.
Currently, the options are to remove them through burning or to use topical ointments, but there is no definitive cure, with success rates generally around 50-70%.
Having a good immune system certainly helps, so paying attention to nutrition, exercise, and sleep is beneficial.
Physicians at medical centers can manage these cases, and there is no need to seek out special treatments.
In my personal clinical experience, the effectiveness of various treatments is quite similar.
Wishing you good health.

Reply Date: 2019/05/08

More Info

Understanding recurring genital warts, also known as condylomata acuminata, involves a comprehensive look at their causes, treatment options, and preventive measures. Genital warts are caused by certain strains of the human papillomavirus (HPV), particularly types 6 and 11, which are considered low-risk for cancer but can lead to the development of warts in the genital area.

Causes of Recurring Genital Warts
The primary mode of transmission for HPV is through direct skin-to-skin contact during sexual activity, which includes vaginal, anal, and oral sex. It is important to note that HPV can be transmitted even when an infected person does not have visible warts. In your husband's case, it is possible that he contracted the virus during a past encounter, as HPV can remain dormant in the body for years before symptoms appear.
The recurrence of genital warts can be attributed to several factors:
1. Immune Response: The body’s immune system plays a crucial role in controlling HPV. If the immune response is weakened, the virus can reactivate, leading to the formation of warts.

2. Incomplete Treatment: If the initial treatment does not completely eliminate the warts, they may return. This can happen if the warts are not fully excised or if topical treatments are not applied correctly or for a sufficient duration.

3. Stress and Health: Factors such as stress, poor nutrition, and other health issues can weaken the immune system, making it more difficult for the body to suppress the virus.

Treatment Options
Treatment for genital warts can vary based on the size, location, and number of warts. Common treatment methods include:
1. Topical Treatments: Medications like imiquimod (Aldara) and podofilox (Condylox) can be applied directly to the warts. These treatments stimulate the immune system or destroy the wart tissue.

2. Surgical Options: If topical treatments are ineffective, surgical removal may be necessary. This can include cryotherapy (freezing the warts), laser therapy, or excision.

3. Follow-Up Care: After treatment, it is essential to have regular follow-ups with a healthcare provider to monitor for recurrence and manage any new warts that may develop.

Prevention
Preventing the spread of HPV and the recurrence of genital warts involves several strategies:
1. Vaccination: The HPV vaccine (Gardasil or Gardasil 9) can protect against the most common cancer-causing and wart-causing strains of the virus. It is recommended for preteens but can be given up to age 45.

2. Safe Sex Practices: Using condoms can reduce the risk of HPV transmission, although they do not provide complete protection since HPV can infect areas not covered by a condom.

3. Regular Check-Ups: Regular visits to a healthcare provider for screenings and check-ups can help in early detection and management of HPV-related issues.

Immune System and Health Considerations
Regarding your concerns about your husband's immune system, it is true that a weakened immune system can contribute to the recurrence of genital warts. To strengthen the immune system, consider the following:
- Healthy Diet: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support immune function.

- Regular Exercise: Physical activity can boost overall health and immune response.

- Stress Management: Techniques such as mindfulness, yoga, and adequate sleep can help reduce stress, which in turn can improve immune function.

HIV and Immune Function
While HPV and HIV are both sexually transmitted infections, having HPV does not mean that one has HIV. However, individuals with HIV may have a compromised immune system, which can lead to more severe manifestations of HPV, including more frequent recurrences of genital warts. If there are concerns about HIV, it is advisable for your husband to get tested.

Conclusion
In summary, genital warts can be a frustrating condition due to their potential for recurrence. It is essential to work closely with a healthcare provider to determine the most effective treatment plan and to explore preventive measures. If you are looking for a specialist in Taipei, consider seeking out a dermatologist or a urologist with experience in treating HPV-related conditions. Regular follow-ups and open communication with your healthcare provider will be key in managing this condition effectively.

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