Several conversations with friends have brought to my attention a seemingly notorious ignorance about how to best treat genital and anal warts. In large part, this may be due to the fact that official information sources about STIs like the CDC have some significant holes in their fact sheet about HPV and men.

For example, the CDC website states, "Genital warts can be treated with medicine, removed (surgery), or frozen off. Some of these treatments involve a visit to the doctor. Others can be done at home by the patient himself. No one treatment is better than another."

No. According to my sources - a friend who is a physician's assistant as well as the colon & rectal surgeon that treated me for anal warts - certain forms of treatment are significantly more effective than others. Removal by fulguration (burning) greatly reduces wart recidivism compared to cryotherapy (freezing). This information is not readily available. A simple Google search using the terms "HPV gay men" is unhelpful. The results are either vague or couched in wishy-washy medical jargon full of caveats and disclaimers.

Unfortunately, I don't have access to a study that demonstrates the superiority of fulguration to cryotherapy. Apparently, neither do most MDs. This means that when gay men visit the doctor, they need to pose some essential questions that are most likely not part of the doctor or PA's routine examination:

1) If you bottom, request that your doctor examine your anus with a flashlight. This way, they will be able to visually identify any extant warts.
2) Request an examination with an anal scope. Warts can potentially grow 2-3" inside the rectum and cannot be located by flashlight alone.
3) If warts are present, request a referral to a surgeon that can perform fulguration, not cryo.

--Scott