“We treat people, not just problems.”
John L. Pfenninger, M.D.
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Dr. Pfenninger’s approach at The Medical Procedures Center, P.C. (MPC) is to usually start wart treatment with Candida antigen injection. A small amount of the dead yeast will be injected into as many warts as possible. It is not necessary to inject every wart, but as many as possible will be treated limiting the total amount used to 1 cc. You may want to take Tylenol or Ibuprofen before a visit to help with the discomfort.
The advantages of injection therapy are that it is quick, and there are no scars from the injections or open sores to deal with. You can immediately return to full activity, including swimming, sports, jazzercise, etc…. No special care is needed. With injection therapy, the body’s immune system learns that wart tissue is abnormal. Unlike other treatments, if the warts go away with injection therapy, they rarely ever return.
The side effects of injection therapy with Candida have been very rare. Very rarely someone will develop a rash, hives, itching over the whole body, or swelling. This indicates an allergy and will mean that the patient can no longer receive any further injections. Itching and redness in the area of injection is to be expected, however. Rarely, there will be some mild blistering. Often the warts will turn somewhat black and the crust will fall off. About one-third of the time, a second injection will be needed one month later. Half of the remaining warts will respond to the second injection. For those warts that have not responded to the first two injections, a third one a month later can be tried. (We do not normally give more than three monthly injections, but in some instances we have given them up to five times.) 85% of patients will have cleared their warts after the third injection. If all injections have failed, then another method will be needed.
If you notice a rash after treatment, please call our office as soon as possible. If you develop hives take Benadryl immediately and call our office. (50 mg for older children/100 mg for adults) For children less than 5 years old, check with us about the dosage.
Generally a follow-up visit is scheduled for one month after the first injection. If you are absolutely sure the wart(s) is/are gone, cancel the visit at least 3 days before the scheduled visit or you will be charged a $50.00 “no-show fee”. If you’re not absolutely sure the wart(s) is/are gone, keep your visit. Let us decide if further treatment is necessary.
*Note Regarding the Candida solution – the medicine used for the injection. For your first visit, the medication will be taken from our supplies. However, if further injections are needed, you will need to pick up a bottle from a pharmacist and bring it with you to the second visit. On your first visit, the doctor will write a prescription for you. Many times, one injection is all that is needed. Do not purchase the material for your second visit until you find that it will be needed. If it appears that the wart is not going away with the first injection, then about 2 or 3 days before your next scheduled visit, go to the pharmacist with the prescription and pick up the material. The antigen costs around $100 and may not be covered by your insurance. Be sure the pharmacist knows it is being used for treatment, not just testing. Candida antigen (Candin) is not carried routinely by most pharmacies. The hospital pharmacy is more likely to have it. Call beforehand to be sure they do. Other pharmacies will usually order it for you if you call them a few days in advance. Keep it refrigerated until your office visit. No further purchases of Candida antigen will be necessary even if three or more injection visits are required.
If Candida injections fail, we may try Bleomycin injections, cryotherapy, cantharidin liquid, or other techniques. If more than one treatment of Bleomycin is needed, you will be required to purchase it. Warts are tough but we’ll try our best to resolve them the quickest way, and also limit scarring. Help us by eating a diet rich in fruits and vegetables and taking a multivitamin. We’ll be glad to answer any questions you might have.
Copyright, 2011. John L. Pfenninger, M.D 02/11