Hi. 34 year old male. I was diagnosed 14 months ago by a Colo-rectal surgeon as having HPV (anal warts) and went through a 8-week somewhat painful application of Veregen, after which the bumps disappeared fully. Oddly they seem to have appeared following irritation from shaving the peri-anal area. Then, 1 month ago, I noticed flatter and more linear/blotchy raised areas appear - this time again, following shaving irritation (I should have learned not to shave this area). Since I am traveling oversees for several months, I self-diagnosed, and bought a 1-month supply of Aldara 5% Cream from an OTC pharmacy, and have been applying that following the directions in the product insert (3x/week, overnight). What seems odd is that the shape of the 'bumps' are flat, only slightly raised, flesh-toned (i.e. matches adjacent skin color), and located in blotchy irregularly shaped areas (rather than individual round bumps or cauliflower shapes usually described), and there is no itching or pain, aside from irritation from the Aldara. I would upload a photo to describe the appearance better, although I understand that this is not permitted.
My questions are:
1. Since it seems to result from shaving irritation, is it possible that this re-occurance is not from HPV, but just scar tissue from the previous treatment or some type of reaction? I ask because the Aldara cream does not seem to have any effect on the bumps themselves after 4 weeks of use, beyond irritating & darkening the adjacent skin where the buttocks meet.
2.Since I am abroad and can visit directly to any specialist (no US health insurance restrictions), which type of practitioner would be the best to diagnose/treat this: Dermatologist, Colo-Rectal Surgeon, or other?
Thank you, I appreciate your recommendations.