Managing Genital Warts: Treatment Options and Expert Advice

I would like to inquire about the treatment issues related to cauliflower?

Hello, I was diagnosed with genital warts in April or May and subsequently began a long treatment process at the Kunming branch of the United Hospital (formerly the STD Prevention Institute).
As of August, there has been no improvement; I return weekly for check-ups and medication.
I previously purchased Wartrol and have applied it, but I still have three warts.
I later switched to Aldara.
During the treatment, there were some signs of improvement, but the warts fell off and then grew back.
It seems like the condition may be spreading, possibly due to irritation and infection of normal skin from the medication.
I've been trying to take care of myself by reducing late nights, avoiding alcohol and spicy food, and committing to exercise at least three times a week to boost my immune system, but there still hasn't been any improvement.
My overall health is not great.
I discussed the possibility of electrosurgery with my doctor, but they seem quite opposed, emphasizing that electrosurgery can lead to recurrence, is painful, and may leave scars.
The healing process for electrosurgery wounds also takes a long time, which makes me anxious.
However, since my treatment has been prolonged, the doctor mentioned that if I decide to go for electrosurgery, I would need to wait until the current wounds have healed.

Should I consider switching to a larger hospital to request electrosurgery? I've heard that laser treatment may leave fewer scars and have a quicker recovery time, so should I opt for that instead? Can you recommend a hospital that would be suitable for my treatment? If I do decide to have surgery, should I stop going to my current hospital for check-ups and medication, and just apply antibiotic ointment to allow the wounds to heal before moving to another hospital for electrosurgery?
In my daily life, how can I prevent the condition from spreading further? I'm really worried.
Additionally, when I first discovered my condition, I had an HIV test, which came back normal.
After completing treatment, if there are no recurrences, should I get tested again? Also, if I receive the HPV vaccine at a gynecology clinic during this treatment period, will it help boost my immune system? If I get vaccinated while symptomatic, will the pre-vaccination blood tests show any abnormalities? I'm concerned about my family finding out about my genital warts.
Thank you for your thoughtful response!

Chen, 20~29 year old female. Ask Date: 2008/08/03

Dr. Yan Dawei reply Urology

The treatment for cauliflower (condyloma) is primarily through electrosurgery as a second-line treatment, and you can undergo electrosurgical procedures at another major hospital.

Reply Date: 2008/08/03

More Info

Genital warts, caused by certain strains of the human papillomavirus (HPV), can be a challenging condition to manage. The treatment options available vary in effectiveness and may depend on the extent of the warts, the patient's overall health, and personal preferences.

Treatment Options
1. Topical Treatments:
- Podophyllin and Podofilox: These are plant-derived compounds that can be applied directly to the warts. They work by destroying wart tissue.

- Imiquimod (Aldara): This is an immune response modifier that helps the body fight the virus. It is applied directly to the warts and can stimulate the immune system to clear the warts.

- Sinecatechins (Veregen): This is a green tea extract that can also be applied topically to treat external genital warts.

2. Cryotherapy: This involves freezing the warts with liquid nitrogen. It is a common and effective method but may require multiple sessions.

3. Electrosurgery: This method uses electrical currents to burn off the warts. While effective, it can be painful and may leave scars.

4. Laser Treatment: This is typically reserved for larger warts or those that do not respond to other treatments. It is effective but can also be more expensive and may require anesthesia.

5. Surgical Removal: In some cases, warts may need to be surgically excised, especially if they are large or persistent.

Expert Advice
Given your situation, where you have been undergoing treatment for several months without significant improvement, it may be worth considering a consultation with a specialist, such as a dermatologist or a gynecologist who specializes in HPV-related conditions. They can provide a more tailored treatment plan and discuss the possibility of more aggressive treatments like electrosurgery or laser therapy.

If you are considering switching to a larger hospital or clinic for treatment, ensure that the facility has a good reputation for treating HPV-related conditions. It’s important to communicate openly with your healthcare provider about your concerns and treatment preferences.

Managing Symptoms and Preventing Spread
While undergoing treatment, it is crucial to maintain good hygiene and avoid any activities that could irritate the affected area. Here are some tips:
- Avoid Irritants: Steer clear of harsh soaps, scented products, and tight clothing that could irritate the area.

- Healthy Lifestyle: Continue your efforts to boost your immune system through regular exercise, a balanced diet, and adequate sleep. Avoiding smoking and excessive alcohol can also help.

- Safe Practices: Use condoms to reduce the risk of transmitting HPV to partners, even if warts are not visible.

Vaccination and Follow-Up
Regarding the HPV vaccine, it is generally recommended for individuals who have not been previously infected with the strains covered by the vaccine. If you are currently experiencing an outbreak, it may be best to wait until the warts have resolved before getting vaccinated. The vaccine can help prevent future infections with other strains of HPV, which may reduce the risk of developing new warts.

As for HIV testing, if you tested negative previously and have not engaged in high-risk behaviors since then, it may not be necessary to retest immediately after treatment for genital warts. However, regular screenings are advisable based on your risk factors.

In summary, managing genital warts can be a lengthy process, but with the right treatment and lifestyle adjustments, you can improve your condition. If your current treatment is not effective, consider seeking a second opinion or exploring other treatment options. Always communicate openly with your healthcare provider about your concerns and treatment goals.

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