How to treat vestibular papillomatosis?

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I have seen the pictures. (attachment removed to protect patient identity).

It is vestibular papillomatosis. But tell me the answers to some questions. Since when it is present? Is it painful or not? Is it also present in areas other than mentioned in the photo? If it is since childhood, not painful, and not present anywhere else then, it is vestibular papillomatosis. There are many thoughts on the condition and some also believe that it can be caused by HPV (human papillomavirus). It is a debatable issue. So if you are confused with two or three opinions then you can go for biopsy for confirmatory diagnosis. But as I said it is vestibular papillomatosis on the first look, with symmetrical spread only on labia.

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If you do not know since when it is present, but if it present for a long period then it is vestibular papillomatosis.

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Pap (papanicolaou test) smear and HPV both are different things. Your pap's smear is normal and negative for any changes of cervical cells. Now HPV is human papilloma virus which can affect the skin or mucosal membrane like cervix, vagina, vulva, and mouth. When it is in the cervix then some HPV can change the structure of cervical cells. There are 100s of types of HPV virus out of which only two or four types can affect the cervix more badly and can convert to cervical cancer also. So we are doing pap smear screening test and see for early changes of cervical cells. As soon as we find some cells then we can do a confirmatory test for HPV and looks for the type. Your test looks normal means there are no cervical changes that are harmful. There can be HPV or not. Sometimes HPV virus remains asymptomatic for the whole life. And this test only sees cervical cells. It does not cover vulval cells.