Hi,
Welcome to icliniq.com.
I understand your concern. As per the history and images provided from your end (attachment removed to protect the patient's identity), they may be genital warts which are a viral infection caused by human papillomavirus (HPV) which are considered to be appearing due to multiple factors, including changes in immunity, may be sexually transmitted or may form through direct skin contact with an infected person or sharing of belongings with an infected person. They present in multiple patterns, including skin tags like small lesions to cauliflower-shaped larger lesions to flat-topped hyperpigmented or skin-colored lesions to a lesion with finger-like filiform appearance. Genital warts may take weeks but sometimes even months or years to appear and may remain asymptomatic. They are not dangerous; however, they may spread fast and increase in size with symptoms like discomfort, itching, pain, and bleeding. They may also keep appearing on and off over months or years, which is also manageable with treatments. On inspection of the image, apart from warts, there are DPN (dermatosis papulosa nigra) or skin tags and moles (also called nevus) present as well, which are on the same level as your skin. Be it DPN, moles, or genital warts, all three are not dangerous and may be managed except for moles which appear due to the clustering of melanocytes that gives the skin pigment on the localized areas which may be present since birth or may appear later on in life and is a completely normal phenomenon. Do not worry, as none of them are dangerous or life-threatening. I would suggest the following. Take Tablet Zinc Acetate 50 mg twice daily in the morning and night after food for one month. Electrocautery is an outpatient procedure done by a dermatologist where the lesions are gently burned and later healed. For this procedure, or for cryotherapy, where the lesions are frozen and eventually it falls off and heals, you may need to consult a dermatologist in person. Avoid unprotected sex, notify your sexual partner, if any, about the same, and advise them to get treated in case of any lesions. Kindly consult a doctor in person for HPV (human papillomavirus) vaccination to prevent reinfections with a different strain. Aldara 5 percent (Imiquimod) cream may also be used. This cream is very strong and may cause skin irritation and is therefore avoided in the skin, which is too sensitive. However, when using this medication, apply vaseline around the lesions to prevent the cream from touching the unaffected skin areas. Apply the cream in the smallest quantity possible on the lesion alone at night three times a week. They may cause stinging, irritation, and redness. In the morning, wash the area well. Make sure to wear gloves during application. This medication is not recommended in case of warts appearing too close to mucosal areas of genital parts or near sensitive areas. Genital warts may be recurrent and therefore taking adequate precautions is important. In case of unprotected sexual activities with high-risk groups in the past or recently, it is advised to undergo STI (sexually transmitted infections) panel testing annually, which is unrelated to the present condition but is always adviced to rule out possible infections and prompt intervention for the same. Kindly revert for more queries. Thank you.