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CDC Recommends Boys Receive HPV Vaccine

WarOnWarts — Thu, 27 Oct 2011 18:41:45 +0000

Coverage of the decision by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) to expand its recommendation for the HPV vaccine to boys and young men aged 11-21 was widespread, appearing on the three network newscasts, and in national newspapers. The story took up over ten percent of news time. ABC World News (10/25, story 3, 0:30, Sawyer) reported that the committee “recommended boys ages 11 and 12 and young men 13 to 21 be vaccinated. Not just girls, who, as we know, are at risk for cervical cancer.”

On NBC Nightly News (10/25, lead story, 3:00, Williams), NBC’s Chief Medical Editor Dr. Nancy Snyderman said that “One of the reasons the parents have backed away from this vaccine in the past is that because it combines three shots spaced out over several months, and sometimes that means compliance is not so good, and insurance companies have backed away from covering it, but the hope today is that the CDC has recommended it, it will be one step forward getting our kids inoculated and having insurance coverage so parents don’t have to bear the cost.”

The CBS Evening News (10/25, story 6, 2:15, Pelley) reported that “experts argue that kids should get” the vaccine early, “before sexual activity and before they develop these diseases like cancer and genital warts. Now for the future, another important thing is that the earlier this vaccine is given, the better the protection, the better the immune response and the better they’re going to be protected against these diseases in the future.”

Cryotherapy is one effective treatment for warts

WarOnWarts — Sat, 30 Oct 2010 13:05:53 +0000

Cryotherapy with liquid nitrogen to remove common warts may be more effective than salicylic acid or a wait-and-see approach, according to the results of a randomized controlled trial reported online September 13 in the Canadian Medical Association Journal.

“Cryotherapy is widely used for the treatment of cutaneous warts in primary care,” write Sjoerd C. Bruggink, MD, from Leiden University Medical Center in Leiden, the Netherlands, and colleagues. “However, evidence favours salicylic acid application. We compared the effectiveness of these treatments as well as a wait-and-see approach.”

This is a great treatment for warts – but not the only one. Many more options exist than were tested by this study – so be sure to review all of your options for treating warts with your doctor.

Anal Warts in Men

WarOnWarts — Tue, 12 Oct 2010 18:19:14 +0000

What are anal warts?

Anal warts (also called “condyloma acuminata”) are a condition that affects the area around and inside the anus. They may also affect the skin of the genital area. They first appear as tiny spots or growths, perhaps as small as the head of a pin, and may grow larger than the size of a pea. Usually, they do not cause pain or discomfort to afflicted individuals. As a result, patients may be unaware that the warts are present. Some patients will experience symptoms such as itching, bleeding, mucus discharge and/or a feeling of a lump or mass in the anal area.

Anal warts, thought to be caused by the human papilloma virus, can grow larger and spread if not removed.

It is important to know that Anal warts can be found both heterosexuals and in men who have sex with men. Either way, it is nothing to be ashamed of – and it is something that you SHOULD SEEK TREATMENT FOR.

What causes these warts?

They are thought to be caused by the human papilloma virus (HPV) which is transmitted from person to person by direct contact. HPV is considered a sexually transmitted disease. You do not have to have anal intercourse to develop anal condyloma.

Do these warts always need to be removed?

Yes. If they are not removed, the warts usually grow larger and multiply. If left untreated, the warts may lead to an increased risk of cancer in the affected area. This is similar to the risks of cervical cancer in women.

What treatments are available?

If warts are very small and are located only on the skin around the anus, they may be treated with a topical medication. They may also be treated by a physician by freezing the warts with liquid nitrogen. Warts may also be removed surgically. Surgery provides immediate results but must be performed using either a local anesthetic – such as novocaine – or a general or spinal anesthetic, depending on the number and exact location of warts being treated. Warts inside the anal canal usually are not suitable for treatment by medications, and in most cases need to be treated surgically.

Must I be hospitalized for surgical treatment?

No. Surgical treatment of anal warts is usually performed as outpatient surgery.

How much time will I lose from work after surgical treatment?

Most people are moderately uncomfortable for a few days after treatment, and pain medication may be prescribed. Depending on the extent of the disease, most people return to work the next day.

How long is treatment usually continued?

Follow-up visits are necessary at frequent intervals for several months after the last wart is observed to be certain that no new warts occur.

What can be done to avoid getting these warts again?

In some cases, warts may recur repeatedly after successful removal, since the virus that causes the warts often persists in a dormant state in body tissues. Discuss with you physician how often you should be evaluated for recurrent warts. Abstain from sexual contact with individuals who have anal (or genital) warts. Since many individuals may be unaware that they suffer from this condition, sexual abstinence, condom protection or limiting sexual contact to single partner will reduce your potential exposure to the contagious virus that causes these warts. As a precaution, sexual partners ought to be checked, even if they have no symptoms.

Can I get rid of penile pearly papules?

Dr. A — Wed, 29 Jul 2009 20:33:12 +0000

Pearly penile papules are small raised nodules (bumps), usually 1-2 mm in size, which are located around the rim of the penis head in the form of string of pearls. Usually developing during adolescence, they have been reported in up to 35% of males. Uncircumcised men are more likely to have pearly penile papules. Very often these lesions are confused with genital warts, although there is no known link between warts and pearly penile papules.

Pearly penile papules are NOT cancer and are NOT spread via contact or sex. Most men with penile papules do not seek medical treatment.

Men do not need to have them removed but some men feel uncomfortable having spots or dots on the penis. Some men are worried that a partner my not have sex with them because they look like warts or other sexually transmitted bumps such as herpes.

Many treatment methods have been tried, including circumcision and freezing. But these methods had proven to be either ineffective or have side effects.

Until recently,burning and carbon dioxide laser were considered the most effective treatment options.

Radiofrequency surgery was introduced into dermatology, it became a great option to remove unwanted papules effectively, safely, and with no scarring or bleeding. Originally used to remove papules on the nose or other small bumps radiofrequency removal is an effect technique. Because radiofrequency uses radio waves and not electricity, there is less damage to surrounding tissue and its small and light hand-piece allows for more precise and complete removal.

Usually one treatment is enough to remove all penile papules.

Treatment area is numbed with lidocaine cream making the area not sense pain or heat. The skin takes a week to ten days to heal. Patients can resume daily work activities that same day but we encourage no sexual relations until the healing process is finished

Not all penis bumps are warts (part II)

WarOnWarts — Thu, 04 Jun 2009 20:10:34 +0000

In a previous post, we discussed penile pearly papules.

Lichen planus can also cause bumps on the penis. This condition is an inflammatory condition - NOT an STD.

Classical lichen planus is characterized by shiny, flat-topped, firm papules (bumps) varying from pin point size (‘guttate’) to larger than a centimetre. They are a purple colour and often are crossed by fine white lines (called ‘Wickham’s striae’). They may be close together or widespread, or grouped in lines (linear lichen planus) or rings (annular lichen planus). Linear lichen planus can be the result of scratching or injuring the skin. Although sometimes there are no symptoms, it is often very itchy.

Lichen planus may affect any area, but is most often seen on the front of the wrists, lower back, and ankles. They are also commonly found on the penis.

Sometimes it may be necessary to take a skin biopsy to confirm the diagnosis. One of the best treatments for lichen planus on the penis are injections with cortisone.

Does the doctor need to get a biopsy before freezing my penile warts?

Dr. A — Fri, 29 May 2009 13:14:02 +0000

Penile warts are diagnosis that a trained doctor can make without a biopsy. If patients have many warts or ones that look suspicious for other lesions like cancer I often biopsy a representative sample and freeze (with liquid nitrogen) or burn (electrocautery) or laser (C02 or YAG) the rest. If a patient has warts on the foreskin and wants a circumcision I sent the tissue for biopsy.

If your doctor didn’t send a biopsy and it didn’t come back that’s fine. If it keeps coming back and there was never a biopsy ask your doctor to sent a piece to the lab or make sure they are convinced its not cancer.

I hope this post is helpful. Go to our find a physician tab if you need an evaluation

Thanks,

Dr. A.

Perianal Warts Need Treatment!

WarOnWarts — Mon, 26 Jan 2009 15:01:40 +0000

Peri-anal warts are a serious condition – with multiple treatment options. There is a significant risk of developing anal cancer if these are not treated. In fact, this risk may be greater than the risk of developing cervical cancer (which is what PAP smears check for.) Though we typically do not test for the presence of HPV on the penis, it is very important to check for HPV in and around the anus in patients at risk (ie: those who have had anal sex).

Since it is difficult to examine yourself in this area, it is most important for you to get examined by a physician if you feel any growth, bump, roughness, or experience any bleeding from the area.

Treating Warts: A True Balancing Act.

Dr. S — Mon, 29 Dec 2008 18:16:47 +0000

Treating penile warts presents several problems to the patient and to the treating physician. The ideal treatment would be non-invasive, non disfiguring, quick, painless and it would eliminate the risk of any wart recurrence.

The ideal treatment does not exist.

Most treatments offer some sort of balance between expedience, invasiveness, and recurrence. The correct treatment really depends on patient preferences, patient medical history, and the doctor’s experience.

Treatment options include:

Imiquimod: This is a form of immunotherapy. Is not invasive and non-disfiguring but requires 16 weeks of therapy. Dermatologists seem to like to use it, but urologists like Dr Schoor, who have had extensive experience with imiquimod, have not found it useful for his male wart patients.
Podophylin: This is another form of immunotherapy. Like imiquimod, it is non-invasive and non-scar producing. Podophylin takes approximately 4 weeks to work and is very effective on penile condylomas. Recurrence rates are low with this approach.
Cryo therapy: This means freezing off the warts, usually with liquid nitrogen. This is a great treatment that effectively gets rid of the lesions without scar formation or marks and has very low recurrence rates. It is painful and requires at least 3 to 4 applications over a 6 to 8 week period. Dermatologists like this form of treatment for their patients. Urologists don’t too so much of it, however.
Cautery: Effective though invasive and scar producing. It does require that the doctor give a local aneshtetic prior to the procedure. Recurrence rates are higher than for the other treatments, but the results are immediate. Perhaps the worst aspect of this approach is that the cautery smoke may contain vaprized though live viral particles that can be inhaled by patient and staff alike. To prevent this occurrence, special masks may be worn.
Excision: 100% effective but 50% or greater recurrence risks when used alone. It does leave a scar but the result is immediate, which most men want. Another advantage is that it allows for pathologic confirmation of the lesion, which on rare occasion can be a penile veru
Using crythherapy to treat disease

cous cancer. Recurrence risks can be minimized by cauterizing or freezing the base after the excision or by having the patient apply podophylin or imiquimod after the wart has been removed.
Laser therapy: This procedure is done in the OR with a CO2 laser. It is very effective over the short and long term, non-scar forming, and immediate. It is very expensive and best reserved for patients with extensive disease, such as in the immunoscompromised population.

We hope readers find this useful.

Myths and Misconceptions of Genital Warts

WarOnWarts — Sat, 06 Dec 2008 14:46:30 +0000

Genital Warts are among the most prevalent sexually transmitted diseases, but people lack the right information to help prevent or treat this condition. Clear, correct, updated information regarding human papillomavirus (HPV) and genital warts is difficult to find. The result is that a lot of myths and misconceptions regarding genital warts abound. In some cases, these mistaken beliefs may even do harm. Inaccurate information may have several physical and emotional ramifications on the sufferer. For instance, he/she may suffer from severe anxiety over his/her condition, doubt the faithfulness of his/her partner, undergo an expensive and painful treatment that could otherwise have been avoided, or worst of all, neglect having his/her condition treated and risk his/her health.

This article tackles the most common misconceptions and busts these myths in order to make more people understand genital warts and HPV better.

Myth: Only women can carry HPV and have genital warts.

Fact: The chances of men and women having HPV and genital warts are more or less equal. However, the symptoms of genital warts appear more on women because their anatomy provides a better breeding ground for the virus. The warm and moist environment of the vagina makes it an attractive location for the virus to reside in and multiply.

Myth: I can only get genital warts by having unprotected sex.

Fact: It is no doubt that having unprotected sex increases your chances of getting HPV. HPV can also be transmitted by direct skin contact. Thus, some forms of protection like condoms won’t guard you against some STDs because they don’t cover the entire genital area. It can also be passed on through oral sex, resulting in warts in the mouth and throat. Moreover, some studies have shown that HPV can be spread through contact with infected objects such as contaminated medical equipment and bath towels.

Myth: If I don’t see genital warts, it means that I don’t have HPV.

Fact: HPV, when passed on, can be in a latent or incubation phase that can last for a few weeks to even several years. Thus, symptoms of genital warts won’t manifest right away. A carrier may never know that he/she has the virus. In fact, experts estimate that only around 1 percent of all Americans who are sexually active have visible warts.

Myth: Genital warts appear only on the head of the penis.

Fact: Genital warts can appear anywhere – on the head, shaft, scrotum, or even the thighs or lower abdomen. Here are some warts on the shaft.

Not all penis bumps are warts

Dr. A — Wed, 19 Nov 2008 15:12:06 +0000

Penile pearly papules are tiny bumps on the rim of the glans or head of the penis. It is common for young men to be concerned about the dots because they look like warts or other growths. They are usually very small a couple of millimeters in diameter and are clear or pearly in appearance. If you have these don’t be alarmed. A note of caution just because you have pearly papules doesn’t mean you can ignore other bumps or lesions on your penis. Everyone who is not practicing safe sex and notices lesions that are suspicious should seek medical attention.