[Question #5157] Genital Warts

23 months ago
Hello, A few weeks ago I was diagnosed with genital warts. The clinician at the facility I visited gave me a few treatment options. I chose Aldara since it appeared to be the least invasive and helps strengthen the immune system in response to the virus. I used Aldara for a week with one day on, one day off, as instructed. I found that the day after I used it my skin was very tender and almost felt inflamed, so I stopped using it for a few days (this could have something to do with the location of the warts- they are small clusters on the inside of my inner labia- both sides). 

Naturally, this issue has been extremely distressing so I sought out advice from a gynecologist. She confirmed by visual examination that I did have genital warts, and that I need to keep using Aldara. I asked her if there were other options and she said my only other option besides Aldara was to get labiaplasty. This is contrary to what I was told at the clinic- the clinician there told me that the warts can be treated with an acid, frozen, or removed with a laser treatment should I decide that I didn't want to wait weeks to see the affects of the topical treatment.   

This whole experience has been metally/emotionally exhausting. Not that it matters since it's irrelevant to the way by which the disease can be transmitted, but I've only had two intimate partners and i'm not sure how I was infected because both of them exhibited no symptoms (no warts). Regardless, I have it now and I've accepted that, but I'm having a difficult time wrapping my head around the fact that a cosmetic procedure might be the only way to clear the warts. I'm not concerned with the appearance of my labia- I just want the warts to clear so I can feel like I'm in my own body again. 

I know each case is different, but up until this doctors visit today I thought the warts were getting smaller. Now I'm just thinking about how I'm going to pay for a cosmetic procedure that I don't even want just to be wart free. Can anyone s
Edward W. Hook M.D.
Edward W. Hook M.D.
23 months ago
Welcome to our Forum.  I'll be glad to comment and am sorry to hear of the conflicting advice you have received.  Several comments:

1.  Aldara works by causing inflammation which, in turn stimulates the immune system to fight HPV.  Clinical studies suggest that recurrent rates following successful treatment may be slightly lower than with other treatment.  Inflammation at the site of Aldara application is an expected side effect of treatment which may be severe in some persons, compromising their ability to use this form of treatment.
2.  I have not had the opportunity to examine you but it would be most unusual for treatment of genital warts to require labiaplasty.  As you were told earlier, dermatologists have a variety of other treatments which are widely used including topical application of mild acids, freezing with liquid nitrogen or laser ablation.  All are effective.  The location and number of warts may impact the choice of therapy.  I recommend that you see a dermatologist who has experience in treating genital warts to discuss your treatment options.
3.  Acquisition of HPV infection/warts is quite common in sexually active persons.  I would suggest that, in addition to seeking treatment of your warts, you also seek the HPV vaccine which is highly effective for prevention of future infections (the vaccine will not impact your current warts but will help prevent future infection with the most common HPV types).

I hope these comments are helpful to you.  EWH
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23 months ago
Thank you for your response, Dr. Hook.  I will be looking for a dermatologist who has experience treating my condition. 
Edward W. Hook M.D.
Edward W. Hook M.D.
23 months ago
Great, glad I could help.  EWH---