Boys and young men, however, don’t get the same free coverage under the law, even though the human papillomavirus (HPV) vaccine is also approved for the prevention of genital warts in males.

Why the difference? “Genital warts aren’t life threatening,” says Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society.

Merck, which manufactures one of the two FDA-approved HPV vaccines, is conducting research to see if the vaccine prevents genital cancers in men, says Saslow. In the meantime, though, the vaccine has already been shown to prevent cervical, vaginal and vulvar cancers in women. “It’s a matter of cost-effectiveness,” says Saslow.

The vaccine is pricey, requiring three shots over a six-month period, at about $130 each.

The human papillomavirus, which is transmitted through sexual contact, is extremely common, accounting for an estimated 500,000 cases of genital warts every year. “It’s the common cold of the genital tract,” says Saslow.

There are several treatments to eliminate genital warts. And, the body can rid of the virus, although it’s possible to get re-infected.

The health law requires that immunizations that are recommended by the Advisory Committee on Immunization Practices be provided without charge to patients in new health plans starting this fall. ACIP is a group of 15 experts appointed by the Secretary of Health and Human Services.

While the HPV vaccine is recommended for all girls and young women between 9 and 26, the committee made a “permissive” recommendation for boys and men in the same age range, says Lance Rodewald, director of the immunization services division for the Centers for Disease Control and Prevention. Basically, that means it’s OK to vaccinate males for genital warts, but it’s not essential.

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Patient-Applied:

Podofilox 0.5% solution or gel. Patients should apply podofilox solution with a cotton swab, or podofilox gel with a finger, to visible genital warts twice a day for three days, followed by 4 days of no therapy. This cycle may be repeated, as necessary, for up to four cycles. The total wart area treated should not exceed 10 cm2, and the total volume of podofilox should be limited to 0.5 mL per day. If possible, the health-care provider should apply the initial medicine to demonstrate the proper application technique and identify which warts should be treated. The safety of podofilox during pregnancy has not been established.
OR
Imiquimod 5% cream. Patients should apply imiquimod cream once daily at bedtime, three times a week for up to 16 weeks. The treatment area should be washed with soap and water 6-10 hours after the application. The safety of imiquimod during pregnancy has not been established.

Provider-Administered:

Cryotherapy with liquid nitrogen or cryoprobe. Repeat applications every 1-2 weeks.
OR
Podophyllin resin 10%-25% in a compound tincture of benzoin. A touch should be applied to each wart and allowed to air dry. The treatment may be repeated weekly, if necessary. To avoid the possibility of complications associated with systemic absorption and toxicity, two important guidelines should be followed: 1) application should be limited to <0.5 mL of podo-phyllin or an area of <10 cm2 of warts per session, and 2) no open lesions or wounds should exist in the area to which treatment is administered. Some specialists suggest that the preparation should be thoroughly washed off 1-4 hours after application to reduce local irritation. The safety of podophyllin during pregnancy has not been established.
OR
Trichloroacetic acid (TCA) or Bichloroacetic acid (BCA) 80%-90%. A small amount should be applied only to the warts and allowed to dry, at which time a white “frosting” develops. If an excess amount of acid is applied, the treated area should be powdered with talc, sodium bicarbonate (i.e., baking soda), or liquid soap preparations to get rid of unreacted acid. This treatment can be repeated weekly, if necessary.
OR
Surgical removal either by tangential scissor excision, tangential shave excision, curettage, or electrosurgery

Alternative Regimens

Intralesional interferon
OR
Laser surgery

Podofilox 0.5% solution or gel, an antimitotic drug that destroys warts, is relatively inexpensive, easy to use, safe, and self-applied by patients. The majority of patients experience mild-to-moderate pain or local irritation after treatment. Imiquimod is a topically active immune enhancer that stimulates production of interferon and other cytokines. Local inflammatory reactions are common with the use of imiquimod; these reactions include redness and irritation and are usually mild to moderate. Traditionally, follow-up visits are not required for patients using self-administered therapy. However, follow-up might be useful several weeks into therapy to determine the appropriateness of medication use and the response to treatment.

Cryotherapy destroys warts by thermal-induced cytolysis. Health-care providers must be trained on the proper use of this therapy because over- and undertreatment might lead to complications or low efficacy. Pain after application of the liquid nitrogen, followed by necrosis and sometimes blistering, is common. Local anesthesia (topical or injected) might facilitate therapy if warts are present in many areas or if the area of warts is large.

Podophyllin resin, which contains several compounds, including antimitotic podophyllin lignans, is another treatment option. The resin is most frequently compounded at 10%-25% in a tincture of benzoin. However, podophyllin resin preparations differ in the concentration of active components and contaminants. The shelf life and stability of podophyllin preparations are unknown. A thin layer of podophyllin resin must be applied to the warts and allowed to air dry before the treated area comes into contact with clothing; overapplication or failure to air dry can result in local irritation caused by spread of the compound to adjacent areas.

Both TCA and BCA are caustic agents that destroy warts by chemical coagulation of proteins. Although these preparations are widely used, they have not been investigated thoroughly. TCA solutions have a low viscosity comparable with that of water and can spread rapidly if applied excessively; therefore, they can damage adjacent tissues. Both TCA and BCA should be applied sparingly and allowed to dry before the patient sits or stands. If pain is intense, the acid can be neutralized with soap or sodium bicarbonate.

Surgical therapy has the good thing about usually eliminating warts at just one visit. However, such therapy requires substantial clinical training, additional equipment, and a longer office visit. After local anesthesia is applied, the visible genital warts can be physically destroyed by electrocautery, in which case no additional hemostasis is required. Care must be taken to control the depth of electrocautery to prevent scarring. Alternatively, the warts can be removed either by tangential excision with a pair of fine scissors or a scalpel or by curettage. Because the majority of warts are exophytic, this procedure can be accomplished with a resulting wound that only extends into the upper dermis. Hemostasis can be achieved with an electrocautery unit or a chemical styptic (e.g., an aluminum chloride solution). Suturing is neither required nor indicated in the majority of cases if surgical removal is performed properly. Surgical therapy is most beneficial for patients who have a large number or area of genital warts. Carbon dioxide laser and surgery might be useful in the management of extensive warts or intraurethral warts, particularly for those patients who have not responded to other treatments.

Interferons, both natural or recombinant, have been used for the treatment of genital warts. They have been administered systemically (i.e., subcutaneously at a distant site or IM) and intralesionally (i.e., injected into the warts). Systemic interferon is not effective. The efficacy and recurrence rates of intralesional interferon are comparable to other treatment modalities. Administration of intralesional interferon is associated with stinging, burning, and pain at the injection site. Interferon is probably effective because of its antiviral and/or immunostimulating effects. Interferon therapy is not recommended as a primary modality because of inconvenient routes of administration, frequent office visits, and the association between its use and a high frequency of systemic adverse effects.

Because of the shortcomings associated with all available treatments, some clinics employ combination therapy (i.e., the simultaneous use of two or more modalities on the same wart at the same time). No data support the use of more than one therapy at a time to improve efficacy of treatment, and some specialists believe that combining modalities might increase complications.
Recommended Regimens for Cervical Warts

For women who have exophytic cervical warts, high-grade SIL must be excluded before treatment is initiated. Management of exophytic cervical warts should include consultation with a specialist.

Recommended Regimens for Vaginal Warts

Cryotherapy with liquid nitrogen. The use of a cryo-probe in the vagina is not recommended because of the risk for vaginal perforation and fistula formation.
OR
TCA or BCA 80%-90% applied to warts. A small amount should be applied only to warts and allowed to dry, at which time a white “frosting” develops. If an excess amount of acid is applied, the treated area should be powdered with talc, sodium bicarbonate, or liquid soap preparations to remove unreacted acid. This treatment can be repeated weekly, if necessary.

Recommended Regimens for Urethral Meatus Warts

Cryotherapy with liquid nitrogen
OR
Podophyllin 10%-25% in compound tincture of benzoin. The treatment area must be dry before contact with normal mucosa. This treatment can be repeated weekly, if necessary. The safety of podophyllin during pregnancy has not been established.

Although data evaluating the use of podofilox and imiquimod for the treatment of distal meatal warts are limited, some specialists recommend their use in some patients.
Recommended Regimens for Anal Warts

Cryotherapy with liquid nitrogen
OR
TCA or BCA 80%-90% applied to warts. A small amount should be applied only to warts and allowed to dry, at which time a white “frosting” develops. If an excess amount of acid is applied, the treated area should be powdered with talc, sodium bicarbonate, or liquid soap preparations to remove unreacted acid. This treatment can be repeated weekly, if necessary.
OR
Surgical removal

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The best mode of treating the none vascular wart is  by excision. Whatever substitute is tried, the surgeon most commonly resorts to this at last. The ligature is quite as painful, or more so, and certainly much less efficient. Whether excision or the ligature be adopted, the surface that is exposed should be touched with caustic. With this precaution, the wart very often re-appears —without it, we may generally count on its doing so. When discharges co-exist with wart, proper means for arresting them should always be employed. Improvement of the secretions is desirable also–and for this, aperients, with the warm bath, and regulated diet are of service. When warts of the glans, or of the inner prepuce its angle, have occasioned phymosis, or those other can- sequences to which I have fully alluded, it becomes indispensable to divide the prepuce, or even to remove it. Indeed, if a patient with a prepuce naturally long, evinces a disposition to warts, which is not effectually prevented by cleanliness and the constant application of lint, I should strongly recommend the operation of division of the prepuce, or even that for the removal of some portion of it. I have performed both several times on this account, and the warts have subquentty ceased to appear. When adhesion’s have occurred between the inner prepuce and the warts, and ulcerated openings have formed in various parts of the prepuce, removal of a portion.

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How are genital warts treated?

Because genital warts often recur and are so easily spread, eradicating them can be frustrating. Part of the treatment
involves evaluating the woman’s partner as well as discussing techniques to prevent the spread of the warts, since obviously it is pointless to remove warts in a woman who continues to have sexual contact with an infected partner. For small warts, self-treatment with the prescription cream imiquimod (Aldara) is sometimes successful, although it can irritate surrounding skin. The cream is applied 3 times a week until the warts dissolve. Larger or persistent warts can be dissolved with a topical agent such as podophyllin or trichloracetic acid applied directly. Because these medicines (especially podophyllin) can cause chemical burns if used incorrectly, women should not try to apply them at home. Podophyllin must be removed several hours after it is applied and usually needs to be reapplied several times at weekly intervals. It should not be used by women who are pregnant because it can cause birth defects. A topical cream, podofilox, which a woman can apply herself for 3 days a week up to 3 weeks, is also available by prescription and is effective. If warts persist or return after this treatment, the clinician will make sure they are not cancerous by doing a biopsy, if necessary using a topical or local anesthetic. Once cancer has been ruled out, the clinician may try burning or freezing off the warts using electrocautery (see entry) or liquid nitrogen (see cryosurgery). These techniques are sometimes used instead of topical agents when warts are extensive or occur in particularly sensitive locations. Some investigators have also had success removing a small number of warts by injecting them with alpha interferon several times a week for about 3 weeks. Though less likely to cause pain and scarring than other treatments, alpha interferon makes some women feel as though they have the flu and is not safe for use during pregnancy. Injection of Interferon B into the muscle of the arm or buttocks appears to be an effective and less painful treatment, but it is not yet available in the United States. There is some psychological research to suggest that warts may respond to hypnosis in some individuals for whom medical treatments fall, as a last resort for extensive or persistent infections, laser surgery may be used. Though quite effective in eradicating warts, laser surgery usually requires regional or general anesthesia, and many women experience incapacitating pain in the perineum (the skin between the vulva and the anus) after surgery, as well as persistent vulvar pain. Because it is hard to tell it all warts have been removed, a woman should be rechecked by her clinician after about 6 months. Sometimes additional treatment may be necessary. Th make sure no cancerous changes have occurred, a Pap test every 6 months thereafter for at least a few years is a good idea.

How can genital warts be prevented?
Preventing the spread of genital warts involves the same safer sex practices required to prevent the spread of any sexually transmitted disease. Because abstinence from sexual activity while the warts are contagious is often impractical, condom use is important until all warts have been eradicated. Male condoms, however, do not provide total protection, since a mans scrotum can harbor the wart virus.

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1. It is conducive to diseases using immune enhancer, such as poly-muscle cell, interferon, transfer factor etc., to improve the body’s immunity along with local treatment.

2.Wartrol can be used along with local treatment to make warts off, which can play a role in preventing relapse of genital warts.

3. If suffering from redundant prepuce, male should do circumcision; and if having vaginitis, cervicitis, or other inflammations, women should also treat them actively along with local treatment of genital warts.

4. To strike a proper balance between work and leisure, to intensify nutritional support and to take exercise so as to improve the body’s immunity.

5. If Sexual partners have some discomfort, they should also be checked. If they were found in both male and female in couples, such as erythemas, nodules, proliferators, ulcers, increased secretions, inflammations and so on, it is immediately to go to hospital for treatment.

6. Keeping optimistic and healthy can adjust the body’s internal system, and it is conducive to cure the disease.

7. During treatment, it should be banned that drinking, smoking, eating seafood products (fish, crabs, shrimp, etc.), spicy food, beef, mutton, “Sukiyaki”,  ”Shabu-Shabu” and so on.

8. During treatment, the absolute prohibition of sex life is necessary. It must be done to wash hands before and after using the toilet and before meals. Separate articles for daily use with other people, do not to abuse other people’s daily necessities, and pay attention to disinfection and isolation.

9. Some edible mushrooms, which contain large amounts of polysaccharide materials and can effectively improve the patient’s cellular immune function, should be eat so as to reducing the recurrence rate of genital warts.

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3
On the third day after using wartrol.
The following night, according to the doctor’s statement, I soaked my penis in warm water for 20 minutes at first, and then absorbed water on the penis with medical cotton bud. I found that genital warts had gone! All the skin around genital warts had became white, except for the area connected to the genital warts, such as a grain size, it was a shallow red, and maybe it’s the new skin.
This morning, I continued to use wartrol. At first, I still soaked my penis in warm water for 20 minutes, then, I found that white things increased more. What made me feel confused was why white things around the wound were more than the area connected the genital warts.
Today I wipe the drug wartrol into large areas of the skin according to the doctor’s statement. Three days passed, and all genital warts were off.

4
On the fourth day after using wartrol
Today is the fourth day. The feeling is painful.
Last night when back home, I soaked my penis in warm water for 15 minutes. A small amount of white substance dissolved in the water. And then I washed it with water for ten minutes, after that wiped the drug wartrol into penis.
In the night, the penis always erected, and the wound was painful in waves.
This morning, I wanted to wipe wartrol, but it’s too painful to turn up the foreskin. Finally, I turned it up at one fling, it’s really too painful. I soaked it in warm water for a while, absorbed water on the penis with medical cotton bud, and then wiped wartrol into penis.

5
On the seventh day after using wartrol
There’re seven days since I used the drug wartrol. During these days there was a stop about two days.
Last night, when I got home, the first thing was soaking my penis in warm water for 20 minutes. I found some white substance floating on the water. Foreskin and the glans were still attached together. So I washed it with flowing water for 10 minutes, at that time about 40% of white things was off, and pink new skin had grown up. Waited it dry then wiped wartrol. I found there’re some white things on Medical Hand Sets. After rubbing wartrol, I didn’t take the foreskin back, yet lay on the bed and watched it for a while. About three minutes later, I found some liquid permeated out from pink new skin, oh, that’s lymph according to doctor’s statement. Half an hour later, I took the foreskin back, there’s a little pain.
In the night, the penis still erected always, and the wound wasn’t painful, but an itch feeling.
In the morning, I didn’t use wartrol. I soaked my penis in warm water for only five minutes because of the time, then waited it dry and wiped Erythromycin ointment. Daytime, some liquid permeated out from the penis, and soiled my underwear.

6.
On the eighth day after using wartrol.
Last night when back home, I soaked my penis in warm water for 20 minutes. A small amount of white substance dissolved in the water. And then I washed it with water for 10 minutes. A lot of white things were off, and red skin was exposed.
This morning when I got up, I flipped the foreskin to have a look, and felt a little drier than yesterday. Then wiped wartrol after soaking my penis in warm water for 5 minutes.
The feeling of the eighth day after using wartrol:
I felt nothing special but cool after using the drug. Put glans penis in the air for about an hour. There was a little hurt when taking the foreskin back.

7
On the 9th day after using wartrol
Yesterday, I continued to use wartrol as usual. White things were any more.
This morning, wiped Erythromycin ointment.

8
On the 10th day after using wartrol
There’re ten days since I used the drug wartrol. In the past few days, I wiped the drugs when it’s time to the drugs, and worked when on the work. The only thing I didn’t do was to eat Korean food. Of course, I did not drink.
Last night when back home, I continued to soak my penis into warm water for 20 minutes, then took a bath, and washed it for 10 minutes by the way. Waited it dry and wiped wartrol. The first feeling was cool also. Half an hour later, I took it back. However, it was worth mentioning that the itch feeling of the penis in an hour and the itch feeling lasted to this morning. Maybe, it was the feeling in new skin’s growth process.
This morning, after bathing penis in warm water, I didn’t use Erythromycin ointment or other any drug but took it back directly as the doctor’s statement.

male genital warts

9
On the 11th day after using wartrol
Last night when I got home, I continued to soak my penis into warm water for 20 minutes, and then wiped the drug wartrol. I found a blister which looked like a bean on it at the process of rubbing wartrol. It’s complication of herpes according to this symptoms and the instruction of wartrol. And I should terminate using wartrol for two days to watch following the statement of the instruction.
As the same of the previous few days, I felt nothing special but cool after using the drug. There was an itch feeling after taking the foreskin back. Now, it’s not hurt when the penis erect, except for touching the blister every times.
This morning, after getting up, I continued to soak my penis into warm water for 10 minutes. The blister found yesterday had gone, and didn’t find lymph any more. I didn’t wipe wartrol, but Erythromycin ointment, because of wanting to watch about two days.

remove genital warts

10
On the 12th day after using wartrol.
Last night, the blister found on the 11th day was broken, and red new skin was exposed. There’s no pain. When bathing penis in warm water for 20 minutes, lot’s of white things were off.

11
On the 13th day after using wartrol
Yesterday, after shopping all day I was tuckered out when got home. I found a pinpoint-sized lump beside when washing my penis. I continued to use wartrol and didn’t pay attention to blister’s place. There’s nothing special feeling but itch once in a while.
This morning when I wake up, I found that three places whose size like a grain of rice had turn white.

male genital warts picture

male genital warts picture

12
On the 14th day after using wartrol.

male genital warts picture

male genital warts picture

male genital warts picture

13
On the 15th day after using wartrol.
Last night when I got home, after bathing penis in warm water for 10 minutes, I waited it dry. I didn’t use wartrol but Erythromycin ointment as the doctor’s statement. Then took it back and felt nothing.
This morning, I didn’t pay attention but go to work directly.

14
16 ~ 17 days of the medication
The 16th day, when got home, I found the place of the glans peeling had not been fully cured, so I continued to use Erythromycin ointment.
Last night I soaked in warm water for 10 minutes, and found the place of the glans peeling was much better. Waited it dry then use wartrol. There’s nothing special feeling in the night but a little itch in the daytime. I think it should be in recovery now. In the past two weeks, during using the wartrol, the white matter gradually reduced, but it can also increase.

15
On the 18th day after using wartrol
Last night when got home, I continued to use wartrol and felt more better. There’s nothing but white things.
This morning when I wake up, I felt a little itch. However, there had been this feeling when I did the laser surgery.
16
On the 20th day after using wartrol
There’re 20 days since I used the drug wartrol. There was a lot of white matter, but they shed a lot.
Today and yesterday, the glans was hurt when there’s a collision on it. I thought that was peeling but it was completely normal! There was a lot of white matter every day, but they shed a lot when soaking in night.

17
On the 21th day after using wartrol.
There’re 21 days since I used the drug wartrol. Repeat soaking with warm water, drying, and wiping wartrol. Last night, the penis always erected, and it was painful in waves.
Yesterday was the fourth day for consecutive wiping wartrol in large-scale skin, and I didn’t find any white substance appearing, only on the both sides of the frenulum appeared a large amount of white material every day.

18
On the 22th day after using wartrol
There’re 22 days since I used the drug wartrol. Repeat soaking with warm water, drying, and wiping wartrol. A large amount of white material still appeared on the both sides of the frenulum. Last night, I found some skin lesions on the penis but it was not very serious. In the night, it always erected as usual but was no longer painful.

19
On the 23th day after using wartrol.
Last night after soaking with warm water, I found more skin lesions as the same as the last time. I waited it dry and then wiped Erythromycin ointment.

20
On the 25th day after using wartrol.
Last night, the skin lesions were a little better than before. After stopped about two days to use wartrol, I continued using wartrol again. Repeat soaking with warm water, drying, and wiping. The skin color of lesions were not red as few days ago but normal. I put glans penis in the air for about half an hour after using wartrol, and then I took it back. An hour later, I flipped the foreskin to have a look, and found some liquid permeated out from the skin lesions. I didn’t pay attention but took it back.

21
On the 26th day after using wartrol
There’re 26 days since I began to use the drug wartrol.
Last night I continued to use wartrol. the skin lesions were much more better than before. The wartrol do have the anti-inflammatory effect and play a psarcogenic role in curing genital warts.
A lot of white substance was off, dissolved in the water. I am very happy that all are recovering.

22
On the 27th day after using wartrol.
Yesterday, I went traveling with several friends, from early morning until 12:00 o’clock at midnight. After got home, I used wartrol according to the method before. I felt much better today. The white matter obviously reduced and gone with the water, but there was a skin lesion.
Every time I soaked for 10 minutes first and then washed it with the shower.
Now the situation is like the normal case, I only feel a little itch during the day; it should be the local lesions are healing.

23
On the 30th day after using wartrol.
I am very glad today. Now glans penis does not have any uncomfortable feeling, the same as normal. Glans penis no longer hurt, by the way I always want to make love with my girlfriend in the night, however, I can control.
Continue to use wartrol.

24
On the 40th day after using wartrol
In any case, I still insist using wartrol. There are still local lesions, but I do not care. And there are still white matter but gone a lot.

25
42~ 43days of the medication
Yesterday was the 42th day of using wartrol. When soaking in warm water, I found that skin lesions were severe, and even bleeding. After drying it, smeared some erythromycin ointment.
This evening, when soaking penis, I found local skin lesions were much better than before. I wanted to smear some of erythromycin ointment, but I thought the skin lesions was not very severe, so I used wartrol instead of .
26
On the 45th day after using wartrol

genital warts cured

I treated Genital warts, and now 6 months gone, genital warts did not come back again.
If you get genital warts try wartrol now!

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