Aldara after Cryotherapy?

Quick history: I was diagnosed with a genital wart in April '05. I had four cryotherapy treatments over the spring and summer at intervals of 4-6 weeks. After the 4th treatment in late July, I seemed to be in the clear. Around Oct. 1 I went for a follow-up appointment because I noticed a small, almost pinpont, growth in the general area of the wart in addition to what I believed to be a small scar from the cryo. The nurse practioner said she wasn't sure it was a reoccurance and gave me an Aldara prescription. She said to use it only if the bumps in question got bigger. Two months passed and the pinpoint size bump seemed the same but the scar-like growth did seem a bit larger. Since I wasn't absolutely sure I had a reoccurance, I went back to the nurse practioner who said both looked suspicious enough for a quick blast of the liquid nitrogen. She then said to begin using the Aldara immediately. This had never been recommended to me before. Cryo always seemed to be the course of action. I could see one or the other but both confused me and prescribing the use of Aldara so soon after the cryo didn't quite make sense. A second opinion would be welcomed...

My questions: should I wait to use the Aldara until after the swelling/healing from the cryo treatment goes away or start right in? I know now that HPV lives beneath the skin even if not visible in a wart, so if the cryo works and nothing is visible after healing, should I use the Aldara anyway? The nurse practioner seemed to suggest this because the virus is not visible to the naked eye, but I know Aldara can be quite irritating so why use it if there is no visible wart? And why not wait for the cryo swelling to subside to see if the wart disappears based on that treatment?

Thank you for answering my questions.

[Alan Rockoff, MD]

I think your assessment is quite sensible.  Aldara may well irritate the area and not only delay healing but make it impossible to tell whether any warts are left.  Therefore, I would answer your question, "And why not wait for the cryo swelling to subside to see if the wart disappears based on that treatment?" with a resounding, "Why not indeed?!"

I'd wait.

Dr. Rockoff

[asdfg]

Dr. Rockoff,
Thanks for the quick reply and for reinforcing my inlclination in this matter. Puts me at ease.

And thanks in general for being a voice of calm and reason in this vast, oftentimes worrisome, area.

Happy Holidays to allX!

[Jackqweasd]

A related discussion, Scarring from Genital Wart Treatment - Help Plz was started.