Treatment Options for Anal Warts

[JohnBoston]

   I am a 38 year old, HIV negative man.  I've had anal warts for six months-- mostly on the outside, but two inside. I have received five treatments with Podophyllin and the warts are definitely much smaller but have not completely cleared.  My doctor is suggesting laser sugery, although he is willing to do more treatments with Podophyllin if I want to.  I have heard that laser surgery is extremely painful and that the warts may still come back anyway.  My questions:



   1.  Should I try laser surgery?



   2.  Should I keep doing Podophyllin treatments?



   3.  Are there any other treatment options? I've read about Imiquod and heat shock proteins.



   I've also read that dysplasia may be a risk and I am wondering whether and how this should be taken into consideration.



   Thank you.

[Alan Rockoff, MD]

Because warts are viral, cutting, burning, or lasering them often fails to get rid of them or prevent recurrences.  Other less invasive but destructive methods include cryosurgery (freezing), burning them with electricity, or applying acid.  This often requires many treatments.  Home-applied therapies include imiquimod, an immune stimulator, and podophyllotoxin, a purified form of podophyllin.  My own bias is to be less aggressive, because the warts come back if they want to, no matter how powerfully you blast them away.



Dysplasia is an uncommon risk.  Regular checkups should head off problems along those lines.



Best.



Dr. Rockoff

[Delia9]

A related discussion, Ms was started.