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Dermatology  (Expert Forum)
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Genital warts, completly lost...
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.

Genital warts, completly lost...

by method414141, Dec 27, 2006 12:00AM
Hello, I am a 24 year old male about 7 weeks ago I was diagnosed with genital warts, I have about 15 mostly really small. My dermatologist used cryotherapy and perscribed aldara. I got a second opinion and this doctor thought that microsurgery and then electrocaultry to burn the wart at its root was the best treatment option.

So far I have used the aldara (5 weeks) as perscribed from the time of the cryotherapy from my dermatologist, this seems to have irritated the areas where the cryotherapy occurred but hasnt done a thing to a the warts I found after cryo:

1)Is it possible to be getting results from Aldara without seeing any irritation to the warts that were not treated with cryo? Is it normal to use cryo and aldara together? What is the normal process of aldara because my penis is not red all over like the "during treament" on the aldara website?

2) There is some painful blistering on my scrotum from the aldara (not that I had visible warts there it is just where my penis lay after I put on the aldara)...is this normal? Is it more likely fighting the infection there or just a side effect?

3)Is there a good way to tell what is a wart and what isnt, I asked my dematologist three times (bi-weekly check-ups) and he tells me that it doesnt matter the aldara should take care of it (I do not like this answer because aldara does not seem to work that well on men or me for that matter)... Is there any way to really tell which bumps are warts or get a good idea?

It is fustrating that every doctor tells me it is not a big deal when HPV is all i think about...

4)Do you endorse a specific treatment option?

Thanks for the help doc, Im really lost...

by Alan Rockoff, MD, Dec 27, 2006 12:00AM
Aldara can work without irritation.  Blistering from Aldara, however, is normal.  You can't tell what little bump is a wart and what isn't, so don't even try.  Even your dermatologist will have a tough time until all the irritation goes away.  There is no one best treatment option (and warts don't need microsurgery and don't have "roots.")

You really should be asking these questions of your dermatologist, not a distant person on the internet.  (Specifically, whether a certain bump is a wart or not.)  I advise letting the dust settle from Aldara-induced irritation and cryosurgical blisters, and then assessing what, if anything, is left.

HPV should be taken seriously and treated, of course, but once the warts are gone--and they may be already--then you should be prepared to move on.  Letting HPV take over your mental life is not warranted.

Take care.

Dr. Rockoff
Member Comments (5)

by method414141, Dec 28, 2006 12:00AM
Thanks for the help, I was under the impression that if there is no irritation the aldara is not working, and my dermatologist was telling me that the irritation is what tells you it is working, thanks again!

by ?uestlove, Dec 31, 2006 12:00AM
To: method414141
what did these "warts" look like if u dont mind me asking

by method414141, Dec 31, 2006 12:00AM
Some of then are very small and clear (no idean if these ones are warts. A few of them were a little bigger and either skin colored or brownish. None of them are really that big though i would have to say the largest is just over the size of head of a pin. Any advice? I have am still pretty clueless on this stuff and my dermatologist is nto being that helpful? Most of them have gone away with the aldara or cryo but there are still 6-7 that are around and are not responding to aldara (havent been frozen)...and the ones that did repond to aldara were only the ones that were frozen before the aldara was applied so it might have just responed because it was an open sore already...

by now more scarred than before, Aug 11, 2007 11:39PM
To: derm md
my doctor prescribed cyro and the warts became all black and dark - now even easier to notice than in their native state before 'therapy'.  Is there something I can do to avoid the discoloration (i'm brown skinned and the cryo made a dark blackish spot).  Now I have a cauliflower patch that is black.  does aldara scar also?  can i add something to the scar (just got cryo one day ago), like a lotion, to help reduce the discoloration.  If I go back for a second treatment ( since I still see bumps) will the scar get worse and even more dark?  To be honest I will not go back for more cryo. I'd rather have bumps the same color as my flesh than a black cancerous looking sore on my penis.  Its better to have warts, now I am even more embarassed!
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