Genital Warts: Treatment Challenges and Concerns

Q: Genital Warts: Treatment Challenges and Concerns

Hello： Treatment for cauliflower ear may not always be straightforward, as some cases can recur frequently and require multiple interventions. <br>It is advisable to discuss this with your physician. <br>Wishing you good health.

Cauliflower (Condylomata Acuminata)

Hello, doctor.
I would like to ask about a condition I discovered in mid-May this year.
I found warts on my genitals, and after testing, I received a negative result for HIV and was diagnosed with HPV type 11.
After my consultation at the end of May, I was prescribed a topical medication called Urecin.
After using it for a week, I noticed that the warts had grown larger.
Two weeks later, they increased in size, and the surrounding skin became red, swollen, and started to bleed.
I was then scheduled for laser treatment.
A week later, I noticed a small, inconspicuous wart nearby.
After another week of using Urecin, a row of small warts appeared around the wound.
I underwent another round of laser treatment, but the inconspicuous wart was not treated and has grown slightly larger.
After a week, I returned for a follow-up, and the doctor prescribed another week of Urecin.
After just one day of application, the inconspicuous wart and an area that previously had no growth increased in size.
The doctor mentioned that my viral load might be very high and that the growth rate is too fast, indicating that I may need a third round of laser treatment.
I have also been taking immune-boosting medication for four weeks.
For the past few months, I have been noticing a foul odor while showering, and I'm unsure if this is due to repeated infections or if the extensive area of infection is causing the rapid growth.
Does the fact that the foreskin covers the area have any relation to this? It seems that every time I apply the medication, the warts grow particularly fast.
Is this normal? Initially, the warts were quite large, approximately 1.5 cm by 0.5 cm.
Is it normal to have undergone nearly three rounds of treatment in less than a month? I am genuinely concerned that I might end up with severe damage.

Xiao Lin, 30~39 year old female. Ask Date: 2021/06/17

Dr. Du Shixi reply Urology

Hello: Treatment for cauliflower ear may not always be straightforward, as some cases can recur frequently and require multiple interventions.
It is advisable to discuss this with your physician.
Wishing you good health.

Reply Date: 2021/06/17

More Info

Genital warts, caused by the human papillomavirus (HPV), can be a challenging condition to manage, particularly when they are persistent or rapidly proliferating. Your experience with the treatment process, including the use of topical medications like Urekin and multiple laser treatments, highlights some common concerns that many individuals face when dealing with HPV-related issues.

Firstly, it’s important to understand that HPV is a very common sexually transmitted infection, and while there are many types of HPV, types 6 and 11 are primarily responsible for the development of genital warts. The fact that you tested negative for HIV is reassuring, as co-infections can complicate treatment and recovery.

From your description, it seems that the warts have been resistant to initial treatments, which can happen for several reasons. The rapid growth of warts, especially in the context of a high viral load, can indicate that the immune response is not adequately controlling the virus. This can be influenced by various factors, including the extent of the infection, individual immune system responses, and possibly even the anatomical location of the warts. For instance, if the warts are covered by the foreskin, this could potentially create a more favorable environment for the virus to thrive, as moisture and warmth can facilitate viral replication.

The odor you mentioned could be a sign of secondary infection or irritation, which is not uncommon when dealing with warts, especially if they are inflamed or if there is any disruption to the skin barrier. It’s crucial to maintain good hygiene and to follow your healthcare provider's recommendations closely to minimize the risk of additional infections.

Regarding the treatment regimen, it’s not unusual for patients to require multiple treatments, especially if the warts are extensive or if they recur after initial treatment. Laser therapy is often effective for larger or more stubborn warts, but it may not always eliminate the virus entirely. The recurrence of warts after treatment can be frustrating, and it may require a combination of therapies, including topical treatments, laser therapy, and possibly immunotherapy to help boost your immune response against the virus.

It’s also worth discussing the psychological impact of dealing with genital warts. The stress and anxiety associated with this condition can affect your overall well-being and may even impact your immune system. Engaging in stress-reducing activities, seeking support from friends or support groups, and maintaining open communication with your healthcare provider can be beneficial.

In terms of your treatment plan, it’s essential to have a candid discussion with your healthcare provider about your concerns regarding the frequency of treatments and the potential for scarring or other complications. They can provide guidance on the best course of action, which may include adjusting your treatment strategy or exploring additional options such as cryotherapy or other antiviral medications.

In conclusion, managing genital warts can be a complex process that requires patience and persistence. It’s crucial to work closely with your healthcare provider to monitor your condition, adjust treatments as necessary, and address any concerns you may have about the impact of the warts on your health and quality of life. Remember, you are not alone in this journey, and there are resources and support available to help you navigate through these challenges.

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