You have noticed papules in your genital area, and since your STI/ulcer tests are negative, these are likely harmless, non-infectious bumps such as Fordyce spots or genital pearly papules. In most cases, they do not require treatment and are not dangerous. If you wish to remove them for cosmetic reasons, a dermatologist or sexual health specialist can evaluate them and suggest safe options like minor procedures or laser treatment. Avoid using creams or treatments on your own, as this can cause irritation or infection.

It is quite common for a first-line treatment to need adjustment, so please do not worry. Since the initial cream was not effective, several excellent alternatives are available. Your doctor may prescribe other topical medications, such as podophyllotoxin or sinecatechins. Alternatively, highly effective in-clinic procedures can be performed by a healthcare provider. These include cryotherapy (freezing the wart with liquid nitrogen), applying trichloroacetic acid, or removing it using electrocautery or minor surgery. I recommend consulting your dermatologist or urologist to discuss these options and determine the safest, most effective next step for you.

Skin warts are usually caused by the human papillomavirus (HPV), which affects the outer skin and causes small, rough bumps. Warts can appear on your hands, feet, face, neck and other parts of the body. They often spread slowly through skin contact, scratching or exchange of personal items. Some warts go away on their own, but others can last months or even years. The best treatment depends on the size and number of warts, and their location. Doctors might use topical medicines with keratolytic agents, freezing (cryotherapy), chemical treatments, cauterization, laser therapy, or minor procedures to remove stubborn warts. Smaller warts often respond to regular topical treatments, while larger or deeper warts may require several sessions to clear. Try not to cut, scratch, or pick at warts, since this can spread the virus to nearby skin. Keeping the area clean and dry can help reduce irritation. If you notice a wart growing quickly, bleeding, hurting, or changing colour, have it checked by a doctor, as some skin problems can look like regular warts.