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STDs (Expert Forum)
circumcision to limit wart outbreaks?
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
circumcision to limit wart outbreaks?
by Firefly99, Oct 11, 2006 12:00AM
BACKGROUND: I have had genital wart outbreaks for 10 months now. I am uncircumcised and the warts generally appear on the shaft of the penis, underneath the foreskin. On some occasions, the warts will appear on the head of the penis. I have never experienced outbreaks on the outside part of the foreskin or on any other part of my genitals.
TREATMENT: I do not use Aldara to treat the outbreaks as I suffer bad reactions from it. Instead, my doctor applies podophyllin (generally multiple applications) or burns the warts with a laser.
QUESTION: Since most of the outbreaks occur on the shaft, my dermatologist suggested that I might want to consider circumscision to remove the infected skin and thus limit the outbreaks. My urologist didn't think it was a good idea. Given my description of my experience with warts, is circumcision something you would recommend in order to limit future outbreaks?
Thanks in advance.
TREATMENT: I do not use Aldara to treat the outbreaks as I suffer bad reactions from it. Instead, my doctor applies podophyllin (generally multiple applications) or burns the warts with a laser.
QUESTION: Since most of the outbreaks occur on the shaft, my dermatologist suggested that I might want to consider circumscision to remove the infected skin and thus limit the outbreaks. My urologist didn't think it was a good idea. Given my description of my experience with warts, is circumcision something you would recommend in order to limit future outbreaks?
Thanks in advance.
Doctor's Answer
by H. Hunter Handsfield, M.D., Oct 11, 2006 12:00AM
, Oct 11, 2006 12:00AM
I have never heard of circumcision to treat or prevent HPV or genital warts. Most likely your warts will stop recurring one of these days.
A comment about imiquimod (Aldara): Your wording implies you somehow have come to believe that imiquimod is the treatment of choice. You aren't alone; lots of MedHelp user seem to have that impression. Music to the manufacturer's ears, and a testament to their marketing strategy, but just plain wrong. Imiqimod is no more effective than any other wart treatment, either in terms of speed of response, completeness of response, or recurrence rate. Podophyllin, podofilox (Condylox), tri- or bichloroacetic acid, freezing, or laser cautery all work about equally (about 70% of the time) in the long run none is better than the others. If anything, imiquimod is less good than most (certainly less good than freezing or cautery) because it takes a lot longer and is expensive. If warts persist or recur with one method, you have to try something else.
Good luck-- HHH, MD
A comment about imiquimod (Aldara): Your wording implies you somehow have come to believe that imiquimod is the treatment of choice. You aren't alone; lots of MedHelp user seem to have that impression. Music to the manufacturer's ears, and a testament to their marketing strategy, but just plain wrong. Imiqimod is no more effective than any other wart treatment, either in terms of speed of response, completeness of response, or recurrence rate. Podophyllin, podofilox (Condylox), tri- or bichloroacetic acid, freezing, or laser cautery all work about equally (about 70% of the time) in the long run none is better than the others. If anything, imiquimod is less good than most (certainly less good than freezing or cautery) because it takes a lot longer and is expensive. If warts persist or recur with one method, you have to try something else.
Good luck-- HHH, MD
Aldara would not/and is not that effective. It is indeed a marketing tactic used by most dermatologists.