STDs Expert Forum
treatment
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The STD Forum 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.

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treatment

I am a 42yr old female in excellent health. MY HIV and herpes test are negative.Recent pap normal.  Two month ago i was dx with genital wart--anogenital wart(mainly around the anus), under went several treatments--exsion and hyfercation, once under local anesthesia treated by a colorectal surgeon, but they keep reoccurring every 1-2wks. I am healthy, do not smoke, exercise and live a healthy life style. After the first treament I got the garadasil injection the first one just in case, but they are reoccurring at a fast rate. I just got put on Aldara and will start treatment tonight, but I want to know what is the best treament modalitiy, what else can i do?  when will it be under control, I just want to know is there anything else to do. In addition could taking the gardasil increase the likelihood of reoccurrence and why are they coming up so frequently?
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Welcome to the STD forum.  Unfortunately, however, I cannot help very much.  STD specialists are highly expert in recognizing warts, understanding of HPV transmission and prevention, and initial treatment.  However, persistent/recurrent warts are primarily the domain of dermatologists.

When we have patients like you in my STD clinic, i.e. recurrent or persistent warts after 2-3 rounds of routine treatment, we generally try a second approach -- for example, if we started with podphyllin or freezing with liquid nitrogen, we might switch to the opposite, or might try Aldara.  If the problem continues, we then refer to dermatologists.

What I can do, however, is reassure you on two points.  First, eventually the warts clear up, and when that happens, usually they do not recur.  Second, this does not usually mean there is any immune system abnormality, i.e. there are no implications for your general health.

So from my limited expertise in this arena, I suspect you'll do fine on Aldara.  If not, continue to follow up with your provider; or if s/he is not a dermatologist, consider seeing one for a second opinion and advice.  But don't be too worried over the long run.

A final comment is that the HPV vaccine (Gardasil) has no effect at all on established warts.  I hope you and your provider were not expecting it to help your current warts problem; it will not do so.  However, Gardasil will protect you from future HPV infections with any of the 4 HPV types that it covers.

Best wishes--   HHH, MD
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H. Hunter Handsfield, M.D.Blank
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