Methods of Treatment
Final elimination of warts with CO2 Laser treatment.
WARTS DO NOT REMAIN FOREVER
REALITY: Warts go away if thorough treatment is performed and followed by frequent re-examination.
As it is generally true for all viral infections, so is the case for an infection from HPV strains that cause warts
Why is it crucial to treat warts?
Although warts are attributed to low-risk HPV strains (i.e. non oncogenic), high-risk HPV strains (i.e. oncogenic) may coexist in the same lesion. If thorough detection and treatment are not performed, continuous reinfection between sexual partners is inevitable. Therefore, chances are high that viral transmission from the external to the internal genitals occurs, which poses a threat for malformation and cancer.
Oncogenic HPV strains are highly responsible for cervical cancer (almost 100%), anal (95%), vaginal (65%), vulvar (50%) and penile (35%) cancer.
How to react when warts appear on the skin
As soon as lesions are manifested on the skin, complete and thorough examination, using bright focused light, high-resolution magnifying lenses and other equipment used in dermatology, such as a dermatoscope, should be performed by a dermatologist-venereologist.
This is the only way to detect and treat thoroughly all lesions at a given moment, even the subclinical lesions (those that are not visible to the naked eye). It is of vital importance to eliminate the subclinical lesions too, so that they won’t become a cause of relapses and a source of transmission to the surrounding areas or to a sexual partner in the future.
Thorough treatment with Laser
Thorough treatment can be performed with laser, which has two additional advantages:
Thorough treatment should be followed by frequent medical supervision for 8-9 months, so that any possible new lesions are treated in a timely manner, before producing new daughter lesions.
If a complete and thorough treatment is not performed, then lesions that carry significant viral load remain in the area, and the virus eventually manages to prevail over the immune system when the latter is weakened. Weakening of the immune system may be a result of another disease, stress, smoking or alcohol abuse, lack of sleep, poor nutrition habits, etc. If such is the case, it is only a matter of time for new lesions to occur.
Given the setting of a fully equipped and organised dermatology practice and the appropriate expertise in the treatment of genital warts, the effective and safe handling to follow is thorough detection and elimination of all lesions.
In our dermatology practice, ultrapulse CO2 laser is used along with special magnifying lenses with enhanced light beam. In certain cases, identification of HPV strains by HPV genotyping is recommended.
Following the vaporisation of the lesions using ultrapulse CO2 laser, abrasion is applied to achieve complete elimination of the skin lesion. Shortly afterwards, the immediate repeat application of ultrapulse CO2 laser, even in the broader area within a few millimetres around the lesion, ensures complete and effective elimination of genital warts.
CO2 Laser therapy
In any case, patients should examine themselves frequently, so that possible new lesions are identified and eliminated promptly. These might be residual lesions or lesions previously incubated. Since incubation time ranges from 1 to 8 months, the absence of lesions for 8 months serves as the criterion for cure.
However, a monthly dermatologic examination is important, as well as a more frequent patient self-examination for the following 8 months, so as to identify potential daughter lesions, which may have been “implanted” before the elimination. For this reason, each new lesion should be immediately removed, before producing daughter lesions.