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Question:
I have skin-colored bumps in my anal area and red bumps on my buttocks that alternate between itching and burning for the past 10 weeks. Sometimes they bleed and there is pain upon bowel movements. A sigmoidoscopy was done 8 weeks ago and the GI doc said the bumps were nothing and everything was ok internally. A few weeks later my HIV doc said I had a dermatitis and treated it with an anti-fungal. A few weeks after that a dermatologist said it was HPV. I am starting treatment with Aldara next week. She said it was safe to use it perianally and intranally (however the maker of the drug say ONLY to use it externally). Is this true? Do genital warts usually have these symptoms? The itching/burning can become intense at times.

Answer:
by Georgan Gregg:
()
Diagnosis of genital warts (condylomata acuminata, human papilloma virus-HPV, condyloma) can be difficult. Warts usually do not cause itching or burning. An HIV-knowledgeable dermatologist is the right specialist for any skin problems you have, including HPV. Talk with her again about treatment of the internal warts, as Aldara is a topical treatment to be applied directly on external warts. Genital warts are one of the most common STD, with dozens of virus under the broad name HPV, but only certain types resulting in warts. The appearance of these warts varies. Warts are usually tested before your doctor can offer a diagnosis. Generally, warts caused by HPV are a small problem. Treatment will be determined by considering the size, location and number of warts, changes in the warts, your preference, cost of treatment, convenience, adverse effects, and your physician’s experience with the treatments. Imiquimod or Aldara is used for external genital and perianal warts. Applied as a cream, it is an immune response modifier that stimulates the immune system to fight HPV. This cream is applied at home over the course of several months. Compared to other topical treatments for genital & perianal warts Aldara usually produces less burning & skin irritation. But because 3-4 months of therapy is needed, you must stick with it for it to work. A site I recommend for you to learn more about HPV is American Social Health Association. Keep asking your doctors questions. It’s one of the most important ways you have to maintain your health. Check back with us anytime.

Reviewed by: Patricia Fawver Ph.D. in Sexology

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