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Anonymous on October 10, 2011

I was diagnosed and treated for genital warts, but they came back. What should I do?

About a year and a half ago I noticed something on my penis. I thought nothing of it and it went away by itself. About 18 months later, something appeared again so I went to the sexual health clinic, where they diagnosed several flat warts. I was given ointment to treat the warts and that seemed to help. But then a flat wart came back ⎼ much bigger, 0.5 cm diameter ⎼ and another has become a raised wart, about 0.3 cm diameter. I treated them again with the ointment and they seemed to be going way again...but almost overnight, they have come back. T he raised wart raised and the flat wart is looking pink and healthy. Can you help? Is there another ointment I can get? I do not want to go to the sexual health clinic again if possible.

answered by Lisa Oldson, MD on October 10, 2011

I can understand your concern and I’ll try to help you understand some of your options for treatment of genital warts.

First, I’m happy to hear you’ve already visited a clinic for a diagnosis of your genital warts...as you probably know, genital warts can only be diagnosed at a doctor’s office.

You asked about what can be done for genital warts that come back after treatment...unfortunately, recurring genital warts are very common. According to a study conducted by the Warsaw School of Medicine, between 30-70% of people with treated genital warts get them again within six months.

Although you mentioned that you don’t want to go back to a clinic, I’m afraid that’s exactly the right thing to do. When genital warts come back after treatment, it could mean you simply need a different treatment method. Or, it might mean that you have a different type of condition. 

For example, secondary syphilis infection is known for a type of warts (condyloma lata) that can be mistaken for genital warts. Skin cancer (squamous cell carcinoma) is another possibility...so it’s a good idea to revisit a doctor or clinic to confirm the diagnosis.

As for alternative treatments for genital warts, there are several...but all need to be prescribed or administered at a doctor’s office. One option is for the clinician to administer a type of acid to the warts followed with an ointment applied at home. Or, your warts might just need a different topical cream.

When medication doesn’t work, surgical therapy is also an option. This type of therapy is usually reserved for large warts (those larger than 1-2 cm) but could be used for smaller warts that don’t respond to medication. Cryotherapy (freezing the warts), laser therapy (vaporizing the wart) and excisonal therapy (cutting away the warts) are all possible procedures your doctor can decide upon examining you.

Remember, while you have visible warts, it’s important to discuss your condition with any sexual partner or partners. To protect your partner(s) from also getting genital warts, your best bet is to avoid sexual activity all together...at least until the warts have gone away. 

Why? Because genital warts ⎼ which are caused by some types of human papillomavirus (HPV) ⎼ spread easily through skin-to-skin contact. So once the warts are gone, it’s still a good idea to use protection for sexual activity. That means you should wear a condom when you have vaginal, oral or anal sex.

Now that you know a little more about additional treatments for genital warts, I hope you’ll return to your clinic or visit a doctor for treatment.

I wish you good luck and good health!

Related info:

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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