Managing Wart Treatment Duration and Recurrence in Urology

Treatment duration for cauliflower lesions?

Hello Dr.
Hsu, I learned about my condition of genital warts around December last year.
When I visited the STD prevention clinic for treatment, the lesions were relatively small.
I purchased a topical treatment called Warticon (or similar) for my regimen (there are about six lesions located in the pubic area and near the testicles).
After approximately two and a half months of treatment (until mid-February), I have noticed two types of changes in the lesions: 1.
The first type has fallen off and feels flat without any raised texture.
2.
The second type, despite ongoing treatment, seems not to have completely shed and remains in a small stage.
I would like to ask the doctor if I should consider changing my treatment approach (perhaps switching to electrosurgery?).
Additionally, regarding the first type of lesion that has shed, shortly after it fell off, I noticed small raised bumps appearing again.
Is this a recurrence? Should I continue applying the topical treatment to these new bumps? If this is a recurring issue, could you please advise on how to reduce the recurrence rate? Due to the nature of my work as a computer engineer, I sometimes experience higher stress levels and irregular sleep patterns.
Thank you.

Xiao Hua, 30~39 year old female. Ask Date: 2010/02/14

Dr. Xu Weikai reply Urology

Generally, we treat the condition with medication, and once it flattens, it usually falls off on its own.
If there are doubts about the effectiveness, one can seek treatment at a medical facility for electrosurgery or cryotherapy with liquid nitrogen, both of which tend to have better outcomes but can be more painful.
Regarding what you mentioned about recurrence, from a medical perspective, minimizing exposure to the infectious agent can effectively reduce the chances of recurrence.
Additionally, in medical terminology, recurrence is typically not used for this type of condition; it is more akin to a cold, where one would not say their cold has recurred, but rather that they have a new infection.
Developing a habit of frequent handwashing is important, and in public places, washing hands before using the restroom can significantly reduce the risk of reinfection.
If you have any further questions or if anything is unclear, feel free to ask again for further discussion and research.
Sincerely, Dr.
Hsu Wei-Kai, Department of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2010/02/14

More Info

Managing warts, particularly genital warts caused by the human papillomavirus (HPV), can be a challenging process, especially when considering treatment duration and recurrence. Your situation, where you have been treating warts with a topical medication for about two and a half months, is not uncommon. It’s important to understand that the treatment of warts can vary significantly based on individual circumstances, including the size, location, and number of warts, as well as the patient's overall health and immune response.

Firstly, the two types of responses you are observing in your warts are typical. The first type, where the wart has fallen off and feels smooth, suggests that the treatment may have been effective in removing that particular wart. However, the second type, where the wart remains small and has not completely resolved, indicates that the treatment may not be fully effective for that lesion.
In terms of treatment options, if the current topical treatment is not yielding satisfactory results, it may be worth considering alternative methods. Electrosurgery (or electrocautery) is one option that can be effective for removing warts, especially if they are persistent or larger in size. Other options include cryotherapy (freezing the wart), laser therapy, or surgical excision. Each of these methods has its own benefits and risks, and the choice of treatment should be made in consultation with your healthcare provider.

Regarding the recurrence of warts, it is essential to understand that HPV can remain dormant in the body, and even after successful treatment, new warts can develop. The appearance of new growths shortly after treatment could indeed indicate a recurrence. It is advisable to continue monitoring the area and to apply the topical treatment as directed. If new warts appear, you should consult your healthcare provider to discuss the best course of action.

To reduce the recurrence rate of warts, consider the following strategies:
1. Boost Your Immune System: A strong immune system can help your body fight off HPV. Ensure you are eating a balanced diet rich in vitamins and minerals, getting regular exercise, and managing stress levels. Chronic stress can weaken your immune response, so finding ways to manage stress through relaxation techniques, exercise, or hobbies can be beneficial.

2. Avoid Irritation: Avoid any activities that may irritate the area where the warts are located. This includes avoiding tight clothing and practicing good hygiene.

3. Follow Up with Your Healthcare Provider: Regular follow-ups can help monitor the situation and allow for timely intervention if new warts appear. Your provider may suggest a different treatment approach if the current one is not effective.

4. Consider HPV Vaccination: If you have not already been vaccinated against HPV, discuss this option with your healthcare provider. The HPV vaccine can help protect against the strains of the virus that cause most genital warts and some cancers.

5. Practice Safe Sex: Using condoms can help reduce the risk of transmitting HPV, although they do not provide complete protection since the virus can be present in areas not covered by a condom.

In conclusion, managing genital warts requires a tailored approach based on individual circumstances. If your current treatment is not effective, consider discussing alternative treatments with your healthcare provider. Additionally, focusing on immune health and preventive measures can help reduce the likelihood of recurrence. Regular communication with your healthcare provider is key to effectively managing this condition.

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