Managing HPV: Post-Treatment Care for Genital Warts

Q: Managing HPV: Post-Treatment Care for Genital Warts

Hello, Miss You： After the excision of the warts, if there has also been extensive electrosurgical treatment, then there is no need to use antiviral ointment. <br>However, if the lesions are very small and only excised (because the physician could not confirm it was HPV at that t

Post-treatment of cauliflower?

Hello, two weeks ago I noticed a growth in my vulva that resembled genital warts.
The doctor removed it on-site and sent it for testing, and also checked my vagina for any other lesions, finding none.
Two weeks later, it was confirmed to be genital warts, and there has been no recurrence since.
The doctor prescribed me Aldara (imiquimod) to apply to the area where the warts were removed, but the lesion was very small (the doctor mentioned this as well), and I can no longer find the wound.
Is it necessary to apply the ointment since I'm unsure of the exact location? The doctor also asked if I would be using the medication, which made me question the necessity of treatment, and I am concerned about potential side effects of the ointment.
Does the ointment have any effect on inhibiting the virus from spreading to other areas? Additionally, I was quite shocked and embarrassed at the time, so I didn't ask many questions.
The doctor also did not mention whether I should abstain from sexual intercourse, whether my partner should be tested, or if I need to schedule follow-up appointments.
I currently have a monogamous partner, but I haven't informed him...
I'm worried about the warts reappearing.
What should I do moving forward? Does getting the nine-valent vaccine provide any protective effect now? Thank you.

Yu, 30~39 year old female. Ask Date: 2021/02/04

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello, Miss You: After the excision of the warts, if there has also been extensive electrosurgical treatment, then there is no need to use antiviral ointment.
However, if the lesions are very small and only excised (because the physician could not confirm it was HPV at that time), it is advisable to use antiviral ointment for safety.
If you have a monogamous partner, it is recommended that your boyfriend also get checked by a urologist.
During this period, it is best to refrain from sexual activity to avoid reinfection.
Currently, receiving the nine-valent vaccine can only prevent cervical cancer caused by human papillomavirus (HPV), but since you have already contracted warts, it cannot prevent the occurrence of warts.

Reply Date: 2021/02/04

More Info

Managing HPV, particularly after a diagnosis of genital warts (also known as condylomata acuminata), involves a multifaceted approach that includes treatment, follow-up care, and preventive measures. Here’s a comprehensive overview based on your situation and concerns.

Treatment and Post-Treatment Care
1. Topical Treatments: Your doctor has prescribed a topical medication, likely imiquimod (brand name Aldara) or another similar agent, to apply to the area where the wart was removed. Even if the wart was small and the site is hard to locate, using the medication can still be beneficial. These topical treatments work by stimulating the immune system to fight the HPV virus and can help prevent the recurrence of warts.
2. Application of Medication: It is understandable to feel uncertain about applying the medication if you cannot find the exact spot. However, applying it to the entire area where the wart was located can help ensure that any residual virus is targeted. The medication is generally safe, but like all treatments, it can have side effects, including local irritation or inflammation. If you experience significant discomfort, consult your healthcare provider.

3. Effectiveness Against Transmission: While topical treatments can help reduce the viral load in the treated area, they do not completely eliminate the virus from your body. Therefore, while using the medication may help prevent the development of new warts in the treated area, it does not guarantee that the virus will not spread to other areas or to your partner.

Sexual Health Considerations
1. Sexual Activity: It’s important to discuss sexual health openly with your partner. While you are currently in a monogamous relationship, HPV is highly contagious, and it can be transmitted even when warts are not visible. It may be wise to abstain from sexual activity until you have completed treatment and have a clearer understanding of your HPV status.

2. Partner Testing: Encourage your partner to get tested for HPV, especially if you have not disclosed your diagnosis. This can help both of you understand your sexual health better and take necessary precautions.

3. Follow-Up Appointments: Regular follow-up appointments with your healthcare provider are crucial. They can monitor for any recurrence of warts and assess the effectiveness of the treatment. If new warts appear, further treatment options may be necessary.

Vaccination
1. Gardasil 9 Vaccine: The Gardasil 9 vaccine is effective against several strains of HPV, including those that cause the majority of cervical cancers and genital warts. If you have not yet received the vaccine, it is advisable to discuss this with your healthcare provider. While the vaccine is most effective when given before the onset of sexual activity, it can still provide benefits even after exposure to certain HPV types.

2. Timing of Vaccination: If you decide to get vaccinated, it is typically recommended to wait until after your current treatment is completed. This ensures that your immune system can respond effectively to the vaccine.

Emotional and Psychological Support
Receiving a diagnosis of HPV and genital warts can be overwhelming and may lead to feelings of shame or anxiety. It is important to seek support, whether through counseling, support groups, or discussions with trusted friends or family. Understanding that HPV is a common virus can help alleviate some of the emotional burden.

Conclusion
In summary, managing HPV and genital warts involves careful adherence to treatment, open communication with your partner, and proactive measures like vaccination. Regular follow-ups with your healthcare provider will help ensure that you remain informed about your health and any necessary next steps. Remember, you are not alone in this journey, and support is available.

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