Welcome to Dr. Arani's Clinic web site for Anogenital warts treatment. Upon consultation, we will
evaluate you and will customize your diagnostic and treatment plan. Most of our patients get treated in only 1 session on the same day.
Watch Dr. Arani on Fox News @ 10 PM on rising STDs in the U.Sn on
We Have Evaluated/Treated more than 10,000 Patients to this date
"Treatment of genital and anal warts is challenging art work.
Genital warts are stubborn STD and they don't go away easily. We have treated thousands in the past with a high success rates and excellent outcomes. It demands clinical experience and skill. We take them off your body one after the other."
Dr. Arani, M.D.
Walk in Today for Your Same Day Painless Genital warts Removal TEL 323-231 6000
........ U P D A T E ........
[We have seen numerous cases of patients who were victims of nonperscribed, non-FDA approved marketed
remedies for genital warts. We strongly advice against these applications. You will risk the worsening of your
condition and facing giant grape/cauliflower shape genital warts or an increasing number of them in a short period of time. HPV genital warts and Molluscum are infectious medical conditions and they need to
be treated by an experienced Physician only.]
There is no over the counter FDA approved product (such as freezing devices, adhesives, chemicals)
available for self treatment. Freezing away products are for plantar and common warts and absolutely
not for genital warts. It may damages genital skin and may worsen the HPV genital warts and its transmission.
TCA or other acids will kill your cells (It is not for self treatment), we recommend that you do not apply
marketed acidic product on your body for possible irreversible damages.
Trichloroacetic acid (also known as TCA) which is an analogue of acetic acid in which the three hydrogens of the methyl group have been
replaced by chlorine. It is a strong acid, comparable to sulfuric acid.
HPV: It stands for Human Papilloma Virus. Many HPV has been recognized to this date . Each of them has location preference means they have specific affinity to certain part of the body and It is considered a sexually transmitted disease (STD).
It is responsible for genital and anal warts. There is no FDA approved HPV test for males
to this date. After the eradication of warts there is no way to determine if a patient is HPV
free nor is there a way to guarantee the removal of the virus. In other words, an experienced clinician
may destroy and treat specific genital warts in one or more attempts but he or she can not assure
that the patient will not get new warts some place else. The behavior of this virus depends on many
variables such as the strength of a patient's immune system, whether or not the patient is a smoker, or the
level of aggression of his or her HPV. We will address all these issues on your visit.
What are genital warts ? Visible genital warts usually are caused by HPV. HPV is a virus and
the wart is the outcome, however, remember that not every growth in the genital area is a genital wart caused by HPV.
It must be diagnosed by your medical doctor only. HPV is very common in sexually active men and women
and can sometimes have serious health consequences. About 20 million Americans are currently infected,
and about 5.5 million people become newly infected each year.The virus can infect the genital skin and
the linings of the vagina, cervix, rectum, and urethra.
Condyloma Acuminata It is a type of genital warts usually caused by HPV 6 or 11. It is the most responsible wart on genital.
Verruca Vulgaris It is a type of wart usually caused by HPV 1,2,4,7. If your partner carries verruca vulgaris or HPV 1,2,4,7 then you might be at risk to get that on your genital.
Verruca plana This should not be mistaken by Verruca Plantaris (plantar wart). It is a type of wart usually caused by HPV 3,10,28,41. The other common name for it is "flat wart". They are 1-3 mm smooth somewhat raised. They are common arround mouth, face, hand and arms. If your partner carries verruca Plana or HPV 3,10,28,41 then by skin to skin contact you could get infected with that. For example, If you receive oral sex by infected person with verruca plana on his/her perioral area then you may get verruca plana warts on your genital.
What are anal warts ? It is similar to a genital wart but the warts appear on or around the anus. The infected
area of genital warts could be extended to the anus. Both homosexual and heterosexual individuals are at risk.
Double stranded Human Papilloma Virus enters the skin and passes its DNA to the proliferative
layer of the skin genome and as a result, undesirable proliferations will occur which appear as warts.
Inoculation without manifestation of warts may take from a week to 18 months or more. It means you
may have been infected with HPV but won't develop a visible wart until a much later time. This is the
reason why we ask our patients to return to the clinic for a re-evaluation after 6 months and 2 years to
make sure that they don't have a new wart. Some individuals are naturally resistant to HPV viruses and
don't become infected as easily as others. HPV warts are a contagious infection and spread easier by manipulation
such as scratching or shaving.
Diagnosis : Not every growth on the genitalia is a genital wart by HPV. It must be diagnosed by an
experienced medical doctor. Diagnosis could be confirmed by a biopsy as well, the physician may decide for biopsy,
for example, if the size of the warts are big and bleeding. We provide a diagnostic service after initial consultation
and evaluation. Acetic acid application ( vinegar test) is not sensitive and not a reliable test. One of the
best methods of diagnosis is by visual inspection by an experienced physician.
Experience is major factor in diagnosis warts early and treating them immediately for more successful outcome.
If you have genital warts and it is spreading then you need to make diagnosis quickly and initiate treatment asap.
There is no blood test for HPV or genital warts, so we can't tell the overall status of an individual's HPV.
The virus does not circulate in blood and that is why we do not do blood test for the diagnosis. There is limited
testing for female consisting of an element of typing for cervix but not for men.
If the HPV causes visible genital skin growth, then the doctor examination is the most important factor.
PAP SMEAR / HPV Test : HPV test and pap smears are primarily for evaluation of cervix such as
detection of cervical cancer or any abnormality. This would not tell you if you have external genital,
anal or perianal warts or not. For example, you could have a HPV warts on your labia majora of the vagina,
anal or perianal warts and yet have normal pap smear with no HPV. However, if you are
diagnosed with external genital warts then we always recommend you to get pap smear to make sure
that you do not have anything internally. If your doctor gets suspicious of genital anal warts which are
spreading then he/she would consider treatment as this could be extended internally (vaginal, anal, urethral)
with possible later complication. On the other hand there is a possibility that your warts go away on their own,
but you must consult with your MD. In conclusion the following are real possibilities :
1) You have Anal, perianal or genital warts and you have normal pap smear with Negative HPV DNA Test
2) You have Anal, perianal or genital warts and you have abnormal pap smear results with Negative or Positive HPV DNA Test
3) You have no Anal, no perianal and no genital warts and you have abnormal pap smear results with Negative or positive HPV DNA Test
STD Test and Genital Warts / HPV
Whenever you get one STD then you might be at risk of others. Lets say you get genital warts, we know you
have got that through sexual contact. It is visible and that is how you found out, at this point you must think about other
STD, then what about STD which might not always have symptom (such as HIV). Once you have one STD, then
you have to be careful for others. You could ask your doctor to screen you for common STDs. We have capability to test you for various STDs on the same day of your visit with same day test result, [CaliforniaSTD.com]. As we do the surgery to remove your warts for you our lab works on your specimen for STD detection. The STD test result would be discussed
by the time we have finished removing your genital warts. If there is any abnormal test we would provide you
with the treatment on the same day. Remember Genital warts are red flag for possibility of other hidden STD. Get tested by your doctor. Please refer to following page for our STD department for further information about other STD:
Many patients with genital warts have anxiety, worry, and feel guilty or unclean. Some are afraid that they
will be asked by their sexual partner about their visible genital wart. Needless to say, the majority of our patients
have obsessed about their genital warts for weeks, months or even years as repetitive treatment has proven
to be a failure in the past. Their obsession to overcome this challenging battle could make them try
alternative methods. Self manipulation and destruction with sharp objects, freezing, remedies, internet
creams, various acid, tea tree oil or silver compound application with undesirable effects are very common.
As genital warts increase in intensity, size and number, the feeling of failure can continue to impact the
patient psychology. We understand the difficult circumstances surrounding genital warts.
The first step to removing the psychological impact is to remove these visible STDs successfully.
Cosmetic Concern: Most of the infected genital wart patients are anxious about the cosmetic
aspect of their genital wart. Nobody likes to have disfiguring growth, especially on his/her genitalia.
Many patients worry about explaining their genital warts when meeting new partners. Genital warts
are noticeable and not avoidable. It is the most common sexually transmitted disease and we understand
the psychological aspect of this disfiguring infection. We always keep the cosmetic of genitalia in mind
while treating these difficult lesions.
Location of Genital Warts:This effects both females and males. In addition to the scrotum, the penis, vulva,
perineum, and perianal skin, genital warts can also occur on the cervix, uterine in the vagina, urethra, anus,
and mouth. Intra-anal warts are seen predominantly in patients who have had receptive anal intercourse; Anoscopy
or anal pap smears might be needed for these patients. These warts are distinct from perianal warts, which can
occur in both men and women who have never had anal sex. We diagnose and treat most of those external wart.
How about Condoms? Although condom use is a must it unfortunately does not protect you totally
from genital warts. Condoms provide protection above the base of the penis but does not provide protection for
your penile base (where there is no condom coverage), pubic area and scrotum area. Many patients
have their original genital warts in those areas but the disease can spread to the penile shaft later.
According to CDC, While available scientific evidence suggests that the effect of condoms in preventing
HPV infection is unknown, condom use has been associated with lower rates of the HPV-associated diseases
of genital warts and cervical cancer.
"The available scientific evidence is not sufficient to recommend condoms as a primary prevention strategy
for the prevention of genital HPV infection. There is evidence that indicates that the use of condoms may
reduce the risk of cervical cancer."
I have Persistent warts what do I need to do now?
Life is filled with beauty and darkness. We fight to win, sometimes victorious and sometimes not, but the
point is that we get up and fight again learn a life time experience and put it behind us. However, as human
we go to fight to win and not to lose and that is why we stop fighting if there is no chance of wining at all.
If you want to win then you need to have the right tools and preparation. You need all your strength and
you must have excellent knowledge of your enemy's behavior. Genital warts are product of the virus
which work from your own body cells. First, you need your immune system as strong as it can be. If you
are worried or depressed then your immune system may weaken. Get educated and read about your condition.
I have tried to cover all the aspect of genital warts and give you detailed information from my clinical experience.
The more you read, the more prepared you are. Do not scratch or manipulate your warts. Do not smoke. Do not
use any over the counter remedies such as non-prescription creams, gels, sprays which could stimulate the viral
shedding and worsening of your condition. Do not shave the area with blade. Try hair clipper with protective shield
instead. Do not use over the counter anti itching medicine such as hydrocortisone. Keep a close eye on the effected
areas. If your previous removal techniques have failed over and over then you might need to give it a second thought
and a different approach, but do not lose hope. Ask your doctor all the question that you may have. Ask about the pathophysiology of HPV wart, treatment outcome, success rates, cosmetics, before and after pictures, healing time,
possible adverse effect of treatment, doctor's experience of treating genital warts and what do you need to do to protect yourself etc.
So what about treatment of genital warts?
There are many different treatment approaches available for genital warts. All it comes to doctor experience.
We approach each genital wart differently. There is no easy way out, there are no pills you could take
to eliminate them. We look at them carefully one by one; how big they are, what thickness
they have, their location, the color ( if pathology needed), if previously treated, associated with scar or
not, how old they are, rapidly growing or slow rate of growth ...etc
Needless to say, we certainly do not enter our patient exam room with a liquid nitrogen canister in hand
to spray every single wart regardless of nature and location of genital warts. Based on Dr. Arani's
personal clinical experience, cream is not as effective for prominent bigger warts, although he would
definitely not recommend Non-FDA approved creams at all on genital warts. You could irritate the
warts and facilitate the viral transmission. We have seen cases of local complications where some
of these creams contain peeling acid such as glycolic acid (ingredient used or skin peeling in cosmetic cream)
and for marketing purposes they try to sell them for genital wart treatment. Genital warts are a medical
condition and must be treated by a physician only. Our approach for treatment might be different
from person to person. It depends on location, size, and quantity of warts. Our goal of treatment
of genital warts is
"One Time Treatment for Each individual wart"We might have no control on a new growth of genital
warts somewhere else but the idea is to keep the population of genital warts at zero percent for certain
period of time. If there are be no "parental warts" then there is higher chance that there won't be any
offspring's. We could do surgical destruction for what we see, but obviously we can not do surgery
for what we can't see, so we keep our eyes wide open and we map your skin. We look at the area
with a scope, we make sure we take all your warts off of your body and we wish for the best. We
have had a very high success rate treating warts using this method.If you have been treated in the past
for your genitalwarts you will most likely understand the above statement more easily.We frequently
see patients with multiple treatments of their warts with significant relapse rates. Our goal is to treat
genital warts with no relapses on the same wart at the treatment site. Please take your time and look
at some of following before and after pictures. We have treated tens of thousand of warts in our center
to date. We have many more pictures available to you upon your request at our center. Although
there is no 100% guaranteed on any type of surgery, we are proud to have a very high success rate in
As majority of our patients come to our center from far distances, it is our goal to try to limit your
treatment session to one visit. If you have numerous warts or extensive anal warts then we might need to
divide your treatment visits.
How to Choose a doctor for your Persistent Genital warts Treatment
You might not be close to our center. Although we have special accommodation for our out of state patients and we have treated many of them in past. Not everyone could come to our institution for their treatment. You may live in other coutry or very far from us. There is a very simple rule to pick a right doctor in your area / your country.
You make sure to ask to see before and after pictures and ask to see lots of them. A physician with great experience should have treated many warts with great success and should have many cases to support that. The key is not just treating but treating with success. Ask how confidence your physician is to remove your warts. That is all. These 2 simple easy patients understanding element could assist you to find the right expert.
What would happen if you do not treat your genital warts
There are many possible complications and we only mention few of them below:
1) Possible extension to urethra causing urinary obstruction
2) Possible extension to anus causing anal bleeding, fecal incontinence
3) Disfiguring genital
4) Loosing elasticity of genital skin, this is very important as the penis needs elasticity of skin for erection and vaginal entry needs
to be stretched for penetration
5) Decrease sexual sensation of genital skin
6) Itching, bleeding, sloughing
7) Pregnancy complication (always treat them before planning for pregnancy)
Laser Treatment with high relapse rate
Laser is a device that has recently been used by different health providers for treatment of genital warts. Laser
intensity and depth has of penetration is pre set. This is the reason that many patients with laser therapy have
high relapse rate of recurrence of genital warts. The depth of the genital wart is not even and equal, so laser
will not completely destroy the wart. Once again destruction of genital wart is very challenging and each
individual wart needs different attention. There is no unique routine procedure for all.
Partial Treatment Of Genital Warts
Treatment of genital warts should be complete and you should not leave any wart behind.
After you have completed your treatment, you should go back to your doctor in about 6 months
(depends on your doctor's decision) for re-evaluation to see if there are new warts(which should be immediately eradicated).
Reconstructive Genital Warts Treatment
The majority of our patients come to our center after having had a variety of different treatments in the
past with relapses and scar development. We primarily approach these cases with micro-scissor excision
and in some cases partial scar revision. Our minor micro-surgical procedure approach is completely painless.
What CDC recommends:
According to Center of Disease Control, the treatment of genital warts should be "guided by the preference of these patient, the
available resources, and the experience of the health-care provider".
1) Preference of patients :We always discuss the treatment plan with the patient before a procedure
2)Available resource : Our clinic is not only equipped with freezing device, but we also have wide range of modalities and equipment for
genital treatment to choose from
Surgical removal tangential scissor excision or tangential shave excision Electro surgery cautrey Bipolar Hyfrecator Infra red Thermal cautery
Cryotherapy device (freezing)
3) Health care provider experience: Dr. Arani has treated many patients with genital warts - patient happiness is our ultimate goal.vj
High risk HPV Causing Cancer:
"Of greatest importance, persistent infection with certain types of HPV is a leading cause of cervical cancer. Progression from cervical cancer precursor lesions to invasive cancer is a slow process, estimated to take 10�15 years. Cervical cancer is an uncommon consequence of HPV infection in women, especially if they are screened for cancer regularly with Pap tests and have appropriate follow-up of abnormalities. The purpose of screening with the Pap test is to detect cervical abnormalities that can be treated, thereby preventing progression to invasive cervical cancer, and also to detect invasive cervical cancer at a very early stage. If detected early and managed promptly, survival rates for cervical cancer are over 90%. In the past 40 years, widespread cervical cancer screening using the Pap test and treatment of pre cancerous cervical abnormalities have resulted in a dramatic decrease in the incidents and mortality rates due to cervical cancer in the United States. However, each year in the United States, an estimated 12,200 women develop cervical cancer and 4,100 women die from it. Of women in the United States who develop cervical cancer, about half have never had a Pap test. Because genital HPV infection is most common in men and women who have had multiple sexual partners, abstaining from sexual activity (i.e. refraining from any genital contact with another individual) is the surest way to prevent infection. For those who choose to be sexually active, a monogamous relationship with an uninfected partner is the strategy most likely to prevent future genital HPV infections. For those who choose to be sexually active but who are not in a monogamous relationship, reducing the number of sexual partners and choosing a partner less likely to be infected may reduce the risk of genital HPV infection."
Overseas and out of state patient accommodation
We have many patients that come to us from long distances. Please find the following nearby hotel for your accommodation.
Please call us in advance in order to expedite treatment and diagnostic services before you arrive.
Out of state patient may accommodate in the nearby Radisson Hotel
3540 South Figueroa Street , Los Angeles California 90007
Reservations: (888) 201-1718 US Toll Free
HPV vaccine : There are 2 FDA approved vaccines in USA, one made by Merck and other by Glaxo Smith. I will briefly explain both of them.
Gardisil made by Merck introduced in 2006 covers 4 different HPV Types 6, 11, 16, and 18. First 2 types are responsible for majority of genital warts and last 2 are responsible for cervical cancer. In other words, type 6 and 11 are low risk and 16 and 18 are high risk HPV. The main components of the vaccine are purified inactive proteins from aforementioned HPV. The vaccine will not infect you, but will boost your immunity to fight against the virus. Vaccine are given in series of 3 shots on day 0, 2 months and 6 months. We have this vaccine available in our medical center for administration.
Cervarix is made by Glaxo Smith received FDA approval in 2009. It will cover Type 16 and 18. We usually prefer Gardisil for our patients as our practice focus on Genital warts and Gardisil will cover that, However, Cervarix remain as approved Vaccine for prevention of cervical cancer please consult with your physician to choose which one is right for you.
Will HPV Vaccine help me if I already have HPV? According to the vaccine insert: Yes, you
may get a benefit from the vaccine if you already have HPV. This is because many people are not infected
with all 4 types of HPV, which are contained in the vaccine. In clinical trials, individuals with current or past
infections with one or more vaccine-related HPV types prior to vaccination were protected from disease
caused by the remaining vaccine HPV types. HPV Vaccine is not intended to be used for treatment for the
above mentioned diseases. Talk to your health care professional for more information.
How About Partner and Sex: Patients always concern regarding sex with their partner. This is a very sensitive subject needs to be addressed. If you carry the diagnosis of genital warts then you are contagious. Some people don't develop genital warts after getting expose to HPV and some people develop severe case of genital warts. To this date we don't know why certain people are naturally more immune than others. You could be more contagious if you have untreated genital warts and significant advance visible disease. We will address your concern in detail in your visit and will give you basic advice and answer all your questions.
How about Internet remedies/creams/solutions/ointments?
There are many of these available online.We mostly know of these products through our patients and their unpleasant experiences. These products cause adverse and undesirable effects. They irritate and stimulate viral shedding which would increase the number of warts. Scars, loss of skin, and increasing size of warts are very common as well. If this happens then returning the product ("100% guaranteed") will not fix the damage and your real loss is your health - not your money. Read the following FDA guideline and be careful especially when it comes to your sensitive genital organ.
Examples of adverse reaction with self treatment , Internet remedies and cream application
According to Food and Drug Administration (FDA)
Promoters of fraudulent health-care products often use similar claims and practices to lure consumers into buying their goods. The FTC and FDA advise consumers to be suspicious of:
Claims that the product is "natural" or "non-toxic," suggesting it does not have side effects. "Natural" or "non-toxic" does not necessarily mean safe. Some "natural" supplements contain potent stimulants; others can result in negative interactions with medicines. Testimonials from people who claim amazing results. Testimonials often are undocumented and are not a substitute for scientific proof. Claims that a product is a "scientific breakthrough," "miraculous cure," "secret ingredient" or"ancient remedy."Claims that the product is an effective cure for a wide range of ailments. Claims that use impressive-sounding medical terms. Claims that the product is available from only one source, and payment is required in advance. Claims of a "money-back" guarantee. Web sites that fail to list the company's name, physical address, phone number or other contact information.�