Hi doctor, I am a 19-year-old female. I lost my virginity about 10 months ago with my boyfriend. Now after 10 months has passed I found out that I have two warts inside my vagina. It is white color although, the one on the top started to have a slight pink color. But the second one on the bottom which is much smaller still has completely white color and around the vagina blades, I have a little while dots. Also, there are very tiny warts line along the blades. So, when I went to see the GP near my house he had a look and said that there is nothing to worry it is still small. But in my opinion, I think it is quite big. So the doctor gave me a prescription for Condyline paint which he told me to use for three days only per week and I have to keep using it for three weeks and if it does not get better he told me to see him again. Now I have a few questions. Is this mean I have an HPV virus inside my body? How can I make the virus go away permanently? Will Gardasil injection make it go away? If it does not go away permanently, how can I make sure that I have no HPV viruses and so these warts will not come back again? Is this mean that I have this HPV from my boyfriend? How to use Condyline paint correctly? I wash my vagina blades and use the cotton pads to dry it, then I use start to use the Condyline paint. I only dip the swab once into the reagent and then I open my vagina blades so that I am able to paint the two warts inside my vagina as much as I can. Then I paint it all over the very tiny warts in the vagina blades area. Am I doing it correctly? Now I have been using the Condyline for two days, but the very tiny warts that are around the vagina blades started to grow more. Is this mean anything? Can condoms prevent these HPV viruses? If I break up with my boyfriend, will this help my symptoms and health to become better? I am very scared of whether this can leads to cancer? I do not want this to ever happen to me again, how can I prevent this to happen again? If my warts are gone can I have sex with my boyfriend? Will these symptoms comeback again? If I decided to buy the Gardasil injection and injected it now, then the next after two months, then next after six months, but during this time can I have sex with my boy friend? Will the vaccine still work?
Hello. I have gone through your history and pictures provided. (attachment removed to protect patient identity).  I appreciate that you have consulted the doctor and begun the treatment. As rightly prescribed, Condyline (Podophyllotoxin) paint is very effective in genital warts. The right way of application is by using a cotton swab or brush applicator on the clean and dry visible warts. Wait till the paint dries before putting on garments. Avoid application to surrounding normal skin. Repeat application two to three times a week until there is a substantial shrink in size or disappearance of warts. Genital warts that you have acquired are because of humanpapilloma virus (HPV) infection which you might have got through sexual route. Most of the times even if one has an HPV infection, it will be subclinical. The infected person not necessarily will have warts but may still continue to shed infective virus in secretions. Once infected with HPV, its elimination is not completely possible nor its elimination is measurable. However, you can prevent symptoms of HPV infection by boosting immunity against it. Gardasil is one of the vaccines against HPV types. This is most effective in preventing cervical cancer when taken before the start of sexual activity and before 26 years of age. However, you can still take the vaccine as the strains that cause warts and that may cause cancer are not the same. Thus Gardasil can still provide immunity to a certain extent against cancer causing HPV. The best way to monitor cervical cancer is to get regular cervical smears. HPV can be present in normal looking skin too. So, the disappearance of warts does not mean free from infection. It is important to use barrier methods like condoms during intercourse to prevent re-infection and further spread. Since the warts are intravaginal, some lesions may not be visible to you. It is better you take doctor's help to apply on all visible warts. If your partner also has HPV infection, the chances that warts will reoccur or spread are more. I recommend a dermatological examination for your partner also. And it is advisable to maintain abstinence during the treatment and vaccine period to help achieve good immunity. After the successful treatment of genital warts and vaccination, sexual activity can be resumed. However, the use of barrier methods during intercourse is advantageous in preventing re-infection. Having one sexually transmitted infection predisposes one to acquire another. UTI (urinary tract infection) could be one of the symptoms. I recommend both partners to have a thorough check with the STD (sexually transmitted disease) expert for early intervention if required.