Acyclovir for condylomas: instructions for use and contraindications

Acyclovir ointment is an antiviral drug that dermatologists and gynecologists prescribe for the treatment of genital warts. Over the years, the topic of condylomas has become increasingly relevant for many men and women. These growths on the skin and mucous membranes force medical specialists to implement new, more effective drugs to combat HPV. However, ingrained beliefs about obtaining positive results from certain treatments sometimes prevent patients from trying an innovative medicine.

Composition and active substance

The human papillomavirus has become so widespread among the world's population that scientists have developed a lot of medications in various forms, with different bases and active ingredients. Acyclovir has been used for condylomas for more than 30 years. However, its effectiveness in the fight against human papillomavirus is quite controversial. The product is indeed antiviral, but it was developed to combat the herpes virus, and its components cannot affect HPV.

For condylomas that occur in parallel with genital herpes rashes, gynecology often prescribes acyclovir ointment for external use.

The composition of the drug includes:

acyclovir;
poultry fat;
preservative (propylene glycol, methyl parahydroxybenzoate, nipagin);
purified water;
preservative;
emulsifier No. 1;
macrogol.

The active ingredient is acyclovir, an artificially created analogue of the DNA component (purine deoxynucleoside).

Acyclovir for papillomas - reviews

Whether Acyclovir helps with papillomas can be found out from user reviews online. They claim that Acyclovir is effective at the onset of the disease, preventing the spread of the virus.

According to reviews, Acyclovir for papillomas should be used only as part of systemic therapy. At the same time, it is necessary to use surgical methods or chemical agents to remove warts.

Sergey, 47 years old

When many papillomas appeared on my body, I was prescribed Acyclovir. I took it for 2 weeks and at the same time burned out papillomas with Superclean. I forgot about the problem for several months, but then the growths appeared again. You need to maintain your immunity, then nothing will happen.

Olga, 23 years old

My doctor prescribed acyclovir for the treatment of papillomas. But she didn’t recommend any ointment. New growths did not appear, but the old ones did not go away until I began to cauterize them. The product is good, but it doesn’t make warts fall off.

For more information about the treatment of papillomas, watch the video:

How does the drug act on condylomas?

This drug in various forms is prescribed for skin diseases caused by viral infection. Condylomas are manifestations of the action of HPV in the body of an infected man or woman. These growths on the skin and mucous membranes of the genitals and mouth are a sign of weakened immunity. And since the body’s resistance is reduced, genital warts often develop in combination with other diseases, including viral herpes. In such cases, the doctor prescribes Acyclovir, which effectively fights the pathogen itself and its manifestations on the human body.

Condylomas and herpes rashes can manifest themselves with similar symptoms: itching, pain, discomfort in the affected area. But the appearance of genital warts is significantly different from the manifestations of the herpes virus. Condylomas have an oblong shape. They are multiple, forming groups of growths resembling cabbage inflorescences. A herpes rash is distinguished by the formation of blisters with a translucent liquid inside, which is completely uncharacteristic of HPV. Some patients testified that this antiviral agent also affects genital warts in the intimate area. But perhaps the reason for the positive dynamics in the treatment of HPV manifestations were other drugs that are prescribed as part of complex therapy.

The active ingredient of the drug is a synthetic substitute for the natural component of DNA and “works” exclusively in skin cells affected by one of the types of herpes. Acyclovir enters the infected cell, is phosphorylated into acyclovir monophosphate, then it is converted into diphosphate and triphosphate. The latter stops the formation of pathogen DNA in the body.

The destructive effect of this ointment on genital warts is questionable. There are other medications for the external signs of the human papillomavirus, and they are widely used to combat condylomas of various localizations. Viferon is highlighted among them.

Treatment for HPV must be comprehensive. Medicines for external use help get rid of rashes, and internal use of drugs is aimed at fighting the pathogen, strengthening the immune system, and supporting the body with vitamin supplements.

Modern methods of treating genital warts

Genital warts (synonyms: condylomata acuminate, viral condylomas, genital warts, genital warts) are diseases caused by the human papillomavirus (HPV). Diseases caused by HPV are among the most common contagious viral infections in humans. HPV is a small, round, double-stranded DNA virus with a diameter of 50 to 55 nm. To date, more than 80 types of HPV have been described (Table 1). Infections caused by HPV are highly specific to the epidermis, since HPV has a tropism for epithelial cells of the skin and mucous membranes.

Genital warts are highly contagious. Infection occurs through contact, most often sexually. The virus can survive for a long time on infected objects. Small abrasions, cracks or abrasions serve as entry points for the virus. The virus can also spread by autoinoculation. Lack of personal hygiene, wearing tight underwear, maceration of folds in obese people, as well as immunodeficiency conditions contribute to the development of lesions over a large area of the skin.

Over the past 20 years, there has been an increase in the incidence of genital warts. In the United States, genital warts (or genital warts) are one of the most common sexually transmitted diseases. The incidence of genital warts exceeds 106.5 cases per 100 thousand US population, which is about 0.1% of the entire population [1]. Close attention to this disease is explained by the fact that some of the types of HPV that cause genital warts can lead to malignancy of the process. The most potentially dangerous are types 16 and 18. It is no coincidence that it is important to promptly diagnose and treat genital warts. Recurrence of genital warts is not always associated with re-infection, but can be caused by reactivation of the virus.

Clinical picture. The incubation period lasts from 3 weeks to 6 months and averages about 2.8 months. Men and women are equally susceptible to this disease. The average age of patients ranges from 22 to 25 years.

Typically, genital warts are localized on the genitals and in the perianal area. In HIV-infected patients, genital warts may appear in unusual places, such as the face, eyelids, and ears. In men, the most common locations are the penis, urethra, scrotum, perianal, anal and rectal areas [2]. The elements of the rash are flesh-colored, can be represented by smooth papules the size of a pinhead, and in the initial stages of development are not always noticeable on the penis. To identify them, a test is carried out with 5% acetic acid. After treatment of the skin, the color of the papules becomes whitish. Subsequently, the papules grow and take on a warty or thread-like shape, resembling cauliflower or cockscomb. As a rule, genital warts are multiple and located in groups.

In women, the clinical picture of genital warts can be varied. Classic exophytic lesions on the external genitalia are common and easily detected during examination, but they can also be accidental findings during colposcopy or sigmoidoscopy. On the labia minora and on the vestibule of the vagina, condylomas are moist, velvety or multiple finger-like growths and occupy a significant area. Condylomas in the cervical canal are found in 20% of women infected with HPV and with genital warts localized on the external genitalia. Localization of genital warts on the cervix or in the cervical canal is considered an unfavorable factor, as it can contribute to the development of cervical cancer [3].

Even with timely and rational treatment, genital warts often recur. This is due to the fact that the virus can remain in an inactivated state for a long time in apparently healthy areas of the skin and mucous membranes.

Differential diagnosis of genital warts is carried out with secondary syphilis (condylomas lata), molluscum contagiosum, bowenoid papulosis, lichen planus, lichen planus, angiokeratomas, angiofibromas on the coronal sulcus of the glans penis, folliculitis, soft fibroma, pilar cyst (Table 2).

Diagnosis of genital warts is usually not clinically difficult. Additionally, in some cases, a test is carried out with 5% acetic acid. To do this, a medical napkin moistened with a solution is placed in the area of the expected localization of genital warts for 5–10 minutes, after which the rash acquires a whitish tint [4].

When diagnosing genital warts, it is necessary to conduct testing for syphilis and HIV infection.

A biopsy is indicated for those patients who suspect precancerous lesions or squamous cell carcinoma. Removing genital warts does not reduce the risk of developing cervical cancer. Therefore, all women who have a history of genital warts should undergo an annual cytological examination of cervical smears in order to timely detect the oncological process.

Treatment and prevention

Using condoms reduces the risk of infecting sexual partners. It is impossible to completely remove HPV; you can only remove genital warts, easing the patient’s condition and reducing the risk of infecting a sexual partner. There are several treatment methods for genital warts. They all have certain disadvantages.

Cryodestruction is one of the most commonly used treatment methods. The affected surface is treated with liquid nitrogen using a cotton swab or spray. The treatment is repeated every 1–2 weeks until all condylomas are completely removed. The method rarely leads to scarring and is low cost. Cryodestruction can cause severe pain. It is not always possible to treat the entire affected surface at once. In some cases, hyperpigmentation or hypopigmentation may develop after cryodestruction.

Diathermocoagulation is a painful method of treatment and leaves behind permanent scars, therefore it is used only for the removal of single condylomas.

Laser removal is carried out using carbon dioxide and neodymium YAG lasers (yttrium aluminum garnet lasers). Scars may remain after removal.

Drug treatment methods. Condilin (podophyllotoxin) - 0.5% solution in 3.5 ml bottles with an applicator. The component of Condilin, podophyllotoxin, is the most active in the composition of the plant extract of podophyllin; when applied topically, it leads to necrosis and destruction of genital warts. The advantage of this treatment method is that the patient can independently treat the affected areas of the skin in accessible areas. Using a plastic applicator, the drug is applied to the condyloma; All condylomas are gradually wetted, but no more than 50 pieces at a time (in area no more than 10 cm2). The drug should be applied with caution, avoiding healthy areas of the skin. The first time the treatment is carried out by a doctor or nurse, teaching the patient how to apply the drug correctly. After treatment, the preparation must dry to avoid irritation of the surrounding skin or ulceration. Condilin is applied 2 times a day for 3 days, and then take a 4-day break. The duration of treatment should not exceed 5 weeks. Contraindications for the use of the drug are pregnancy, lactation, childhood, and the use of other drugs containing podophyllin.

Solcoderm is a mixture of acids: 65% nitric, 98% acetic, as well as lactic and oxalic acid and copper nitrate; Available in the form of a solution (ampoules of 0.2 ml). After it is applied to the surface of the skin, it turns yellow, after which mummification of the treated tissue occurs. Treatment must be carried out by medical personnel. The drug is applied to the surface using a glass capillary or applicator, after which the drug must dry. It is allowed to treat an area of no more than 4–5 cm2 at a time. If necessary, treatment can be repeated after 4 weeks. Application of the drug may be accompanied by severe burning and pain, in some cases hyperpigmentation and scarring may occur.

Interferon preparations are injected directly into genital warts. The procedure is painful and requires repeated treatment.

Trichloroacetic acid in a concentration of 80–90% is applied directly to the condylomas. Its remains are removed with talc or sodium bicarbonate. If necessary, treatment is repeated at intervals of 1 week. If after 6-fold treatment genital warts remain, then it is necessary to change the treatment method.

Literature

KR Beutner, TM Becker, KM Stone. Epidemiology of HPV infections // J. Am. Acad. Dermatol. 1988; 18: 169–172.
S. M. Syrjanen et al. Anal condylomas in men // Genitour. Med. 65: 1989; 216–224.
MJ Campion. Clinical manifestations and natural history of genital human papillomavirus infection // Obstet. Gynecol. Clin. North. Am. 1987; 14: 363–388.
D. E. Fitzpatrick, D. L. Eling. Secrets of dermatology // M.: ZAO Publishing House BINOM, 1999. 511 p.

L. P. Kotrekhova, Candidate of Medical Sciences, Associate Professor K. I. Raznatovsky, Doctor of Medical Sciences, Professor of St. Petersburg Medical Academy of Postgraduate Education, Moscow

Directions for use and overdose

If condylomas in the intimate area are accompanied by herpes rashes, then Acyclovir should be applied to the affected areas 5 or more times a day with an interval of one hour. It is very important to start treatment in the prodromal period or at the initial stage of the disease. The application of liniment should not be stopped until the blisters on the skin have completely healed. The rash should be covered with a thick crust. Then its arbitrary detachment occurs. And only after healthy skin appears you can stop using the medicine. The duration of therapy should not exceed 10 days.

When treating with the injection and tablet form of the drug, cases of overdose were observed, which were accompanied by nausea, stomach pain, diarrhea, headache, drowsiness, and general malaise. Allergic reactions may also occur in the form of skin rashes.

There is no data on an overdose of liniment.

Acyclovir analogs

If the results of treatment of papillomas with Acyclovir are negative, you can replace the drug with more effective analogues. They exist for each of the forms of release of the drug and have an antiviral effect.

Analogues of Acyclovir ointment:

Viferon ointment . The product contains interferon, a protein that activates the human immune system. To achieve a positive effect, apply the drug to warts 3-4 times a day for a week.
Gel Panavir . The medicine contains a plant extract that blocks the growth of bacteria and viruses. The natural component strengthens the human immune system. Apply the product to papillomas 2 times a day for a week.
Aldara ointment . The medicine contains imiquimod. It has a complex antiviral effect and activates the immune system. Apply the ointment 3 times a week and leave for 6-10 hours.

The tablets have other analogues with an antiviral effect:

Isoprinosine . An antiviral drug with an immunomodulatory effect. Take the medicine 2 tablets 3 times a day for 2-4 weeks. Papillomas disappear due to the restoration of the functions of lymphocytes and the activation of interferon production in the body.
Groprinosin . An analogue of the previous medicine with the active substance inosine. The medication has a gentle effect on the body and can be used even by older people with angina pectoris. The maximum daily dose of the drug is 8 tablets. Take them for 1-2 weeks. If necessary, the medication can be extended up to six months.
Cycloferon . The drug stimulates the production of interferon. The medicine is addictive, so do not take it for more than 1-2 weeks. To eliminate papillomas, take up to 4 tablets per day.
Galavit . A drug with anti-inflammatory and immunostimulating effects. To eliminate warts, take 4 tablets a day. To achieve a positive effect, procedures to remove papillomas are simultaneously prescribed. The course of treatment is 1-2 weeks.
Lycopid . Another immunostimulant that needs to be taken 1 tablet per day for 10 days. The drug relieves inflammation well and heals the skin.

Contraindications and side effects

This medication should be used with caution in patients with acute renal failure. Injections with Acyclovir are contraindicated for pregnant and breastfeeding women.

You should not use the medicine if you are sensitive to certain components of the product.

The following side effects were noted: nausea, vomiting, skin rashes, headache, insomnia, kidney problems, malaise, changes in test results, hallucinations.

Treatment of condylomas, in addition to external effects on neoplasms, should be carried out in combination with antiviral drugs, immunomodulators and vitamin supplements.
Using the medicine exclusively topically will not give the desired effect. You should not self-medicate: all medications should be prescribed by a doctor, depending on the course, stage of the disease and its possible addition to other infections. The article has been verified by the editors

Method of using Acyclovir for warts and side effects

If you have warts, apply Acyclovir ointment or cream every 4 hours. When Acyclovir is prescribed orally, the dosage is 4 tablets of 200 mg per day. A package of 20 pieces is enough for 5 days. This is exactly what the course of treatment consists of. In case of a complex course of the disease, taking Acyclovir can be extended to 10 days. You cannot take the pills for longer, even if during this time recovery and getting rid of warts have not occurred. Along with Acyclovir for warts, you need to take immunomodulatory drugs and vitamins: Supradin, Immunal, Neurovitan, Anaferon, Lykopid, folic and ascorbic acid. External use of Acyclovir for warts causes virtually no side effects.

Rice. 4. Acyclovir tablets are taken orally for multiple warts.