Hi. I used Aldara for two weeks and my warts went away. I didn't have to scratch or scrape. I don't think you should puncture them at all. The cream caused some severe skin reactions for me (and it was on my bum :( ) so I stopped using it two weeks in for about a week and then when I went to start applying the cream again the warts were gone.
So, I think horror stories have a time and a place but I wouldn't let them freak you out or cause you to do something drastic like puncture your warts before applying the cream. Believe me, the cream works fine without puncturing them.
Your doctor can help you clear an outbreak of warts with medications or surgical treatments. The underlying virus is never completely eliminated, however, and genital warts may reappear even after treatment.
Genital warts may disappear without treatment, but sometimes eventually develop a fleshy, small raised growth. There is no way to predict whether they will grow or disappear.
Depending on the size and location of the wart, and other factors, a doctor will offer one of several ways to treat them.
* Imiquimod (Aldara) a topical immune response cream, applied to the affected area
* A 20% podophyllin anti-mitotic solution, applied to the affected area and later washed off
* A 0.5% podofilox solution, applied to the affected area but not to be washed off
* A 5% 5-fluorouracil (5-FU) cream
* Trichloroacetic acid (TCA)
* Pulsed dye laser
* Liquid nitrogen cryosurgery
* Electric or laser cauterization
HPV can spread through skin-to-skin contact with any infected part of the body — but using a condom every time you have sex can significantly reduce your risk of contracting HPV.
If warts are visible on your genital area or your partner's, avoid sexual contact until the warts are treated.
It is best to be cautious and you should seek medical advise at the earliest.
Let us know if you need any other information.
Aldara works by stimulating the immune system's toll like receptor number 7 (TLR7) which is a dna sensing receptor that detects a viral infection. From there interferon alpha is produced and the whole innate inflammatory immune response is triggered, causing the immune system to attack the HPV and inactivate it.
There are two issues however. 1) Some people are genetically missing the TLR7 receptor - for them Aldara does absolutely nothing. Not even a rash. 2) Some HPV types, notably HPV-16 and 18 (the two most common) produce a protein that inhibits the TLR7 activation pathway. They have evolved to evade the human immune system in this way to survive. This is why those two genotypes are the most prevalent in the world. So if you are infected with one of those types Aldara is pretty useless as well.