Thanks for posting your query at DoctorSpring.com
From the description provided, I understand your wife has recurrent genital warts.
Before I come to the treatment part, let me assert that podowart is not for self application. It should be applied by a doctor only as its an antimitotic drug with high systemic toxicity if used in amounts larger than 0.4 to 0.5 ml . So please dont use it on your own.
For genital warts,I go with these therapies
1)Podowart application or Trichloroacetic acid application, cryotherapy, electrocautery( all these done by doctor)
2)Imiquimod cream or fluorouracil cream application( Self application)
3)Intralesional vaccine- given for multiple wart, recurrent and refractory wart.
Usually multiple sittings are required in wart treatment.
Now coming specifically to your wife's case, had she been my patient initially I would have gone with therapies mentioned in points 1 and 2 and if warts would have been refractory to treatment or recurrent then I would have gone with Intralesional vaccine therapy. Here we use MMR vaccine and inject 0.3 ml in biggest wart or the first wart. Maximum of five injections are given three week apart. This induces local immunity preventing recurrence of the wart and would treat existing wart too.
Cervarix or gardasil Anti HPV vaccines are meant for prevention and have no role once wart develops. There is no age for giving vaccines. You can give it any time. These vaccines have a preventive role in cervical cancer and warts.
As you have tried multiple therapies, I would advise that you talk to your doctor regarding Intralesional MMR vaccine.
Hope this helped. Should there be any query, please write back.
Patient replied :
Thanks Doctor for the reply.. Couple of things to Clarify:
1. We are in Touch with a senior Dermotoligist and the doctor only applies Podiwart.
2. Initially there were only 2-3 warts and Post Podowart treatment and bringing the Size down..Doctor suggested for cryotherphy of 3 sessions - But our badluck post Cryo, warts got multipled and Doctor Stopped Cryo and continued with Podoward to bring it down.
3. Now, all the warts are allmost gone 95% ( No visible ) and doctor Suggested for Imiquad . which my wife is applying for last 1 month every alternative days. allthough everything is gone, but she says where the 1st wart had come, there is a small recurrence.
4. Our Worry is, Since its being persistant for almost 1 yr.. will it spread inside her cervix and cause cancer.
I think i have explained in detail doctor, pls help us with a permamnent cure. we got married just 2 yrs back and planning to have a baby post her cure.
5. Does MMR have any side effects and will it be effective.
Thanks for providing all the details.
As just a single wart has occured, dont count it as recurrence and dont be worried. As I had mentioned earlier, warts take time. Continue with imiquimod right now. It will help in treating all existing warts. I would advise that you start zinc supplement of your wife. Zinc has a good role in improving as well as modulating immunity. If residing in India, start tab ascazin one tablet thrice in a day. Continue it for two to three months. It is just a supplement and totally safe.
Ask her to continue imiquimod till all warts are gone, then she can discontinue topical therapy ie all creams etc to see if she is completely cured or still having recurrence. But zinc should be continued till three months.
If possible send a pic of your wife's affected area as it would help me in ascertaining the severity and number of warts. Also let me assure that this consultation is totally private, the images and names are not visible to anyone except the doctor and the patient.
Hope this helped.