Treatment Effectiveness for Genital Warts: A Patient's Journey

Inquiry about the condition after using Lede Mei for a while?

Hello doctor, I have been a patient undergoing treatment for genital warts since November 2020.
The warts were located just below the urethral opening.
At that time, the doctor decided to treat it with topical medication instead of electrocautery.
After a month of treatment, I was told it was completed, but two months later, I noticed the same area had warts again, and I underwent another two months of treatment.
Ultimately, I was diagnosed as having no visible warts.
However, I always felt that the warts had not completely disappeared, as there was still a lump in that area, but the doctors diagnosed it as not being warts.
A week later, I felt some swelling and returned for a follow-up, only to find that the warts in the same area had not resolved.
The doctor advised me to continue with the topical treatment.
During this time, I switched doctors once, and both used Imiquimod for treatment.
Currently, I apply the medication every two days, but the surrounding skin often breaks, so I take regular breaks.
Now, after three weeks of treatment, the size of the warts has not changed; they are only red and swollen, appearing inflamed, with no white spots.
I am unsure if the treatment is effective.
I would like to ask the doctor if it is considered effective if the warts are red but not painful and have not decreased in size after using this medication.
It has been nearly a year of treatment, and I still do not see any improvement.

Mo, 20~29 year old female. Ask Date: 2021/07/15

Dr. Huang Yuande reply Obstetrics and Gynecology

If the diagnosis is indeed condyloma, in addition to medication, if the lesions are extensive or the growths are large, electrosurgery and surgical excision may be considered.
This should be discussed with a physician.

Reply Date: 2021/07/15

More Info

Genital warts, caused by certain strains of the human papillomavirus (HPV), can be a challenging condition to manage, particularly when treatment seems ineffective or when symptoms persist. Your experience over the past year highlights some common issues faced by patients undergoing treatment for genital warts, including the effectiveness of topical medications and the potential for recurrence.

From what you've described, it seems you have been treated with a topical medication, likely imiquimod (often referred to by its brand name Aldara) or podofilox, which are commonly prescribed for genital warts. These medications work by stimulating the immune system to fight the virus and promote the destruction of warts. However, the effectiveness of these treatments can vary significantly from person to person.

The fact that you have been applying the medication for several weeks and have observed redness and inflammation without a reduction in the size of the wart can be concerning. Redness and irritation are common side effects of these treatments, indicating that the medication is having some effect on the skin. However, the lack of visible improvement in the size of the wart may suggest that the treatment is not fully effective in your case.

It's important to understand that while topical treatments can be effective, they may not always eliminate the virus completely. HPV can remain dormant in the body, and warts can recur even after successful treatment. The persistence of a "meat-like" growth in the area you mentioned could be due to residual wart tissue or possibly a different condition altogether. It's crucial to have this area evaluated by a healthcare professional, especially if there are changes in size, color, or texture.

If you continue to experience issues with the current treatment, it may be worth discussing alternative options with your healthcare provider. Other treatment modalities for genital warts include cryotherapy (freezing the warts), laser therapy, or surgical excision, which may provide more definitive results, especially if topical treatments have not been effective.

Additionally, it's essential to maintain open communication with your healthcare provider about your concerns and the effectiveness of the treatment. If you feel that your current treatment plan is not yielding results, don't hesitate to seek a second opinion or request a referral to a specialist, such as a dermatologist or a urologist, who may have more experience with persistent genital warts.

In summary, while redness and inflammation can indicate that the medication is working, the lack of size reduction in the wart is concerning. It's crucial to follow up with your healthcare provider to reassess your treatment plan and explore other options if necessary. Remember, managing genital warts can be a process, and persistence in seeking effective treatment is key to achieving a resolution.

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