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Aldara for Genital Warts

1. My dermatologist told me to apply the aldara liberally to make sure that even the tiniest warts in the area are treated.  I have read elsewhere to only apply to the warts, but i have also read that aldara seems to respect healthy skin and only attacks unhealthy skin. Which is true and should i continue applying the aldara liberally to the entire areas.
2. The areas that have crusted and flaked are red and raw.  Do i continue putting the aldara on those regions or should i stop? The cream does not bother me and the rawness is by no means unbearable or even that aggravating. I just genuinely don't know when enough is enough.
3.  I have read that the aldara can cause permanent skin discoloration and i was wondering if there is any way i can mitigate the chances of that happening by applying vitamin E oil or neosporin to the affected area.  I have read that warts grow in moist regions so i dont want to be encouraging more wart growth but i would like to treat the pink, raw skin.
4. When do i stop using the aldara? I was proscribed enough for 16 weeks but i am not sure if i should just continue using the cream for the whole 16 weeks even if all the affected areas have started to erode and turn red and raw or if i should discontinue using it and see if any newer warts develop. If i do stop using it on the majority of the affected areas, is it safe to apply some to the new warts that pop up and save the packet for the next use instead of wasting the remaining cream in the packet.
6. What are the chances of Genital warts returning after successfully using aldara.  I have read that since it is an immune booster that it generally has a very lo recurrence rate but i would like to know if my lifestyle has any influence on that. I am a 24 yr old male who stays in very good shape and eats very healthy.  I hardly drink alcohol but i occasionally smoke marijuana and would like to know if that has an adverse effect on my situation.

3 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum.

Your dermatologist has much more experience using imiquimod (Aldara) than I do.  We don't use it as the main warts treatment in our STD clinic and I have personally treated very few patients with it.  Please confirm my replies with your dermatologist.

1) The research studies with imiquimod applied it only to overt, visible warts.  In theory, broader application might eradicate the more widespread HPV infection that usually accompanies warts, but to my knowledge this hasn't been studied.  Please ask your dermatologist how he recommends applying it.

2) My understanding is that treatment should be withheld from overtly inflamed tissue, until it heals.  But this too is something to ask the doc who prescribed it.

3) I can't say whether these or other treatments might prevent discoloration.  My guess is they don't make much difference.

4) This too is for the dermatologist.  I would think it reasonable to apply the medication to the areas that had visible warts for 2-3 treatments after the warts seem to be gone, but probably it isn't necessary to go beyond that.

5) Missing.

6) Because of imiquimod's immunologic mechanism, it is often assumed (hoped might be a better word) that it might be associated with fewer recurrences than other wart treatments, and in its marketing efforts the manufacturer is happy to let people think so. But in fact there is absolutely no data to indicate it's true, and in my experience all wart treatments have more or less equal recurrence rates.  On average, treatment with any particular method is about 70% effective; if treatment doesn't work or if warts recur, we switch to a different form of treatment.  As for your lifestyle and nutrition, I really don't think it's going to make much difference one way or the other.

I hope these comments have helped.  Best wishes--  HHH, MD
Avatar universal
Also i just wanted to add that i am extreme greatful for the information that you have provided about HPV and GW.  I was extremely depressed when i was first diagnosed but after really realizing what i was dealing with and how it is no different than warts appearing anywhere else on your body, i am much more at ease.  I read many of your responses to other questions relating to HPV and they have really helped me put this virus into perspective. Your expertise and the wonderful way in which you deliver your advise and knowledge has been a god send to all of us lacking proper education about HPV.
239123 tn?1267651214
MEDICAL PROFESSIONAL
Thanks for the kind words.  Take care.
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