Dr. Deepti Shukla
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a male in 30s and noticed three skin warts a few months ago but I thought they will go by themselves but they are not going. Though I did not notice much increase in size since I first noticed them but I am feeling some itchiness on these for the last few days. Otherwise, I am feeling fine. First is on the upper right thigh. Second is bottom on the lower abdomen near the beginning of penis. Third which is quite small is on the penis upper side. Pictures attached. I am not sexually active for over a year so I did not think it could be an STD but I had full ayurvedic body massage late last year where it could be that they are using used oils for massage which could have caused some skin infection. Please advise about this skin disease and its treatment as I am worried about it.
Hello,
Welcome to icliniq.com.
First thing, warts can be acquired by non-sexual contact also. As you mentioned about the massage, it is highly possible that you acquired it from this source only. My first advice is do not touch these warts frequently as it can lead to the spread of warts to other body areas also. Now as I saw your photos (attachment removed to protect patient identity), these warts are big in size so it will take time to resolve. The best treatment for you is immunotherapy in which we give injections on warts sites. We give the injection at one or two big warts only and it leads to resolution of the warts but injection is obviously only possible when you see you in person. The next best treatment is the application of Imiquimod cream and one tablet to improve your immunity. I am giving you a prescription but one thing I need to ask that do you have any other disease? Are you taking medicine for any other illness?
Treatment plan
Patient's Query
Thank you doctor,
I do not have any other disease and not taking any medicines. Also, I researched on the net that warts like these in the penis area could be because of HPV. I got a general check up done last year including STDs and all were negative but I think they did not check for HPV. Kindly let me know if it could be cancerous as I am very worried? Is there any test that could tell what is this disease? Can it spread to another person by touch or sharing food? I am single but can it be transferred to another person through sexual intercourse? Please advise me on the best possible creams irrespective of cost that I could put on these and how much time they will take to go away? Can they spread to other areas of my body as I am worried about it? I am taking vitamin supplements such as Vitamin B, C, Zinc etc. Is it fine or can I take any else?
Hello,
Welcome back to icliniq.com.
Yes, genital warts occur due to HPV (human papillomavirus) but warts do not become cancerous. HPV virus per se can cause cancer in older age but that is common in females. So you do not have to worry about it. Yes, it can transfer by sexual contact to your partner and they can spread to other body parts that is why do not touch it and then touch other body parts. It spreads by touching not by sharing food. Now coming to treatment, zinc helps in warts by improving immunity but only zinc will not help. We will have to start antiwart treatment also. I had uploaded the prescription but this app rejected because the medicine I prescribed cannot be advised without video consultation according to telemedicine guidelines. One more thing did you apply anything on warts? Any cream or lotion for warts? Warts are diagnosed clinically only and to confirm usually we do gram stating.
Patient's Query
Thank you doctor,
I did not put anything on these as yet. I found online another cream for warts which is Podophyllin, Podofilox but I am sure if it is available in India. Which is better Podofilox or Imuiquimod? Should I apply it only on warts or entire penis and scrotum so it does not spread further? Does it have any side effects on the penis or testicles in any way? Also, is there any good brand in it and how long it takes to remove them?
Hi,
Welcome back to icliniq.com.
Yes, Imiquimod is better as you have warts on the area other that genitals. Podophyllin is good for genital warts. Instructions: Apply Imiquimod only on the wart with a toothpick. Be careful it should be applied on normal skin as irritation may occur. I am again saying do not apply on normal skin.
Patient's Query
Thank you doctor,
But one wart is on the penis, it is a small one as you can see in the image. So it is fine to put Imiquimod there too or I can try Podophyllin? I read Podophyllin gives faster results. Also, is one-time application daily enough? Approximate time frame in weeks for this treatment? T Zinc acetate is a tablet or cream?
Hello,
Welcome back to icliniq.com.
Zinc acetate is a tablet. Imiquimod works for genital warts also. I personally prefer Imiquimod as it much safer for home applications. Podophyllin I prefer to apply under supervision only as it has more chances of causing skin irritation. It will approximately take four weeks for resolution but it depends patient to patient. Some patients respond fast. Hopefully, you will respond fast.
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