Managing Skin Conditions: Concerns with Phenol and Genital Warts

Q: Managing Skin Conditions: Concerns with Phenol and Genital Warts

Hello： For a detailed introduction to Phenylephrine, you can refer to Dr. <br>Lin Cheng-Hsien's article at https：//www.dr-skin.com.tw/health/view/63. <br>If your skin condition does not improve or worsens, it is recommended to consult a nearby dermatologist for diagnosis and trea

Conditions associated with the use of phenylephrine?

Hello Doctor, I discovered some rash-like bumps on my genitals in February.
I visited both a clinic and a hospital, and the doctors visually assessed that it didn't look like genital warts (since they were too small for the doctors to biopsy).
Later, I went to a laboratory where they scraped some skin and confirmed it was genital warts, with a viral load of 5+.
During the consultation, the doctor mentioned it didn't look like warts, but suggested that if I was concerned, I could use Aldara.
However, I have experienced ulceration from Aldara, so I researched and bought Fenofibrate instead.
Initially, I thought the lesions would respond, but instead, other areas have developed more white crusts (flat, with a black dot in the center, showing no signs of falling off, about one centimeter in diameter).
Should I continue using Fenofibrate, or should I stop the treatment? The affected area has already spread to about one-third of my entire genital region (including the perineal area).

Xiao Wu, 20~29 year old female. Ask Date: 2023/06/22

Dr. Li Yufen reply Dermatology

Hello: For a detailed introduction to Phenylephrine, you can refer to Dr.
Lin Cheng-Hsien's article at https://www.dr-skin.com.tw/health/view/63.
If your skin condition does not improve or worsens, it is recommended to consult a nearby dermatologist for diagnosis and treatment at http://www.derma.org.tw/user_finddoctor.php.
Thank you!

Reply Date: 2023/06/22

More Info

When managing skin conditions, particularly concerning genital warts (also known as condylomata acuminata), it is essential to approach treatment with caution and informed guidance. Based on your description, it seems you have been diagnosed with genital warts, and you are currently using a topical treatment, likely containing phenol, which is known for its caustic properties and can cause irritation or ulceration in sensitive areas.

Firstly, it is crucial to understand that genital warts are caused by certain strains of the human papillomavirus (HPV). While some strains can lead to warts, others are associated with a higher risk of cervical and other genital cancers. Therefore, regular follow-ups with a healthcare provider are essential for monitoring and managing your condition effectively.

You mentioned that you initially used a product called "樂得美" (likely referring to Imiquimod), which caused ulceration, leading you to switch to a phenol-based treatment. It is not uncommon for patients to experience irritation or adverse reactions to topical treatments, especially in sensitive areas like the genital region. The appearance of new lesions or worsening of existing ones can be concerning, and it may indicate that the treatment is not working as intended or that the condition is progressing.

Regarding your question about whether to continue using the phenol-based treatment, here are some considerations:
1. Consult Your Healthcare Provider: It is imperative to consult with your dermatologist or healthcare provider before making any changes to your treatment regimen. They can assess the current state of your skin and determine the best course of action.

2. Monitor for Side Effects: If you are experiencing significant irritation, increased lesions, or any other concerning symptoms, it may be wise to discontinue the treatment until you can consult with a healthcare professional. The genital area is particularly sensitive, and aggressive treatments can sometimes exacerbate the condition.

3. Alternative Treatments: There are various treatment options for genital warts, including cryotherapy (freezing the warts), laser therapy, and other topical treatments such as podophyllin or trichloroacetic acid (TCA). Your healthcare provider can discuss these alternatives with you, especially if the current treatment is not yielding positive results.

4. Follow-Up Care: Regular follow-ups are crucial in managing HPV-related conditions. Even if the warts are not causing discomfort, monitoring their progression and any changes in your skin is essential for effective management.

5. Avoid Self-Treatment: While it may be tempting to try different over-the-counter treatments, self-treating without professional guidance can lead to complications. Always seek advice from a healthcare provider before starting or stopping any treatment.

In summary, while phenol-based treatments can be effective for some skin conditions, they can also cause irritation, especially in sensitive areas. Given your situation, it is best to consult with your healthcare provider to evaluate your current treatment plan and explore alternative options if necessary. Managing genital warts requires a tailored approach, and professional guidance is key to achieving the best outcomes while minimizing discomfort and complications.

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