Hi Doctor: I have been under treatment for anal warts for the past 4 weeks, using Aldara 5% cream. In Steven Goldstone's book, he states that people with T Cell counts below 150 should not be using this medication. I just had my T Cells read (like having tea leaves read, I wonder?) and they are pretty stable at 218, so that isn't the problem. My question is this: The proctologist who is treating me has commented on the extremely tiny quantity of cream that comes in each dose (and at that, the amount of warts that I have is not enormous, not by a long shot); he is convinced that this is simply a ploy on the part of the manufacturers, so that patients will have to extend their treatments. Between the 2 of us, we have agreed that the next 4 weeks of my treatment (i.e., the second half of my therapy), that I will be applied a double-dosage. Actually, this was my idea, and my proctologist told me that it was all right with him. Do you think that there is any possibility of adverse effects from this strategy? Thanks for all your help.

I think this strategy is unlikely to be truly harmful -- you may experience a bit more local irritation this way -- but I also have no evidence that says your warts will go away any quicker. Why not give it a try and see what happens?