HPV, Abnormal pap smears, Precancer, Escharotic or Destructive treatments-what you should know
Feb 05, 2026
Recently I have had 3 women ask if our practice perform escharotic treatment for HPV. While we are Holistic, we are still EVIDENCE based. I trained1988-1991 w/ a MD gynecologic expert, and gynecologic oncologist-cancer specialist -President of ASCCP (the American Society for Colposcopy and Cervical pathology) and have been part of a number of research studies to treat cervical precancer and HPV including a chemotherapeutic agent 5-FU and Interferon an immune enhancer.
While management & treatment should incorporate patient personal preference & values, the Hippocratic oath includes doing no harm. Many escharotic or destructive therapies that naturopaths and Holistic Practitioners recommend are not well studied or evidence based, and in fact, can increase the risk of actually developing a cervical cancer later on by burying abnormal cells and allowing normal cells to heal over the abnormal ones after escharotic treatments making it difficult for pap smears to detect abnormal cells until it's too late. To understand this one must understand the natural history of HPV, it's replication, cervical histology and cytology and how cervical cells grow, reproduce and slough. One of the women I spent over an hour with on the phone, had received many destructive (either chemical solutions), freezing, cryotherapy, years ago, thought her problem was resolved 10-20 yrs ago and now has a bad precancer requiring a cold knife cone biopsy. The sad thing is that many women are not educated in this area of science, or frightened by either their traditional family MD, gynecologist or naturopath and so they resort to doing their own research and are swayed in their decision making, not understanding the true risks, pathophysiology of this virus and disease it can cause. Women deserve and we owe it to them to explain all of this so they can make an informed and empowered decision about their care!!!
Another woman (not my patient, I recently read about) was pregnant, had an abnormal pap smear and her provider told her she should follow up after delivering the baby. (she should have been referred to a specialist for a colposcopy but was not) She complained of persistant bleeding the entire pregnancy, (despite cervical length and risk of placental problems were not a factor and ruled out) and this woman ended up with a stage 3 cervical cancer and had to undergo a hysterectomy, chemotherapy and can't have any more kids.
My point here is the following. Women need appropriate triage and treatments. Destructive therapies (escharotic, freezing/cryotherapy and laser vaporization- all older forms of treatment, are no longer used and (this is proven with many studies most which were done bewteen 1981-2018) are not recommended for definitive treatment for true cervical precancer and cannot guarantee that all the abnormal cells treated are gone EVEN AFTER BIOPSY PROVEN FOLLOW UP WITH A NORMAL COLPOSCOPY. Abnormal cells can get buried, In the late 1980's and early 1090's when cryotherpay destruction was used, if the treatment failed and abnormal cells persited/recurred, you were done and recommended to have an excision procedure. We generally only treat lesions and high grade precancers/CIN that have a significant risk of actually becoming a cancer and do so with excision LEEP or cold knife cone biopsy (the size of your thumb finger nail and this tissue is removed but regenerates well and can actually have less risk of infertility or cervical incompetence than repeated escharotic treatment that can cause scarring or multiple LEEPS necessary due to too many destructive treatments or attempts to treat HPV,) . It is extremely important to pathologically examine the specimen looking at the peripheral and deep (endocervical margins) to PROVE the precancer is gone. Any time an ablative/destructive treatment is done, there's no specimen, no proof that the precancer/dysplasia is gone and this creates a risk. Many of the studies of various destructive/escharotic treatments only show up to 60% of dysplasia/precancer being treated to be resolved. Do you want to be in that 40 % of that have persistant or latent precancerous cells that rear their ugly head years later and become a more aggressive precancer or worse yet, an invasive cervical cancer???. I WOULD NOT!!
Furthermore, we do not treat HPV infection alone. This is managed with on- going surveillance and screening to see if high risk HPV persists being expressed because the immune system isn't effective. Treatments to clear HPV infection include bolstering the immune system via lifestyle changes such as adequate sleep, stress reduction, elimination of toxins from cigarettes, marijuana, alcohol and any other substance that can suppress the immune system. HIV infection and immune supressive drugs used for chronic diseases can also increase the risk of cervical precancer. Dietary additives of mushrooms, ginger, turmeric w/ pepper can all enhance immune functioning along with the above-mentioned measures.
THE MOST IMPORTANT THING YOU CAN DO FOR YOURSELVES AND KIDS IS TO GET YOUR GARDASIL 9 HPV VACCINE. Inoculate your child when they are 8-11 yrs old, before they are a tween to prevent most of this from occurring. As my mother always told me, "an ounce of prevention is worth a pound of cure" (and less head ache and risk of infertility, cancer and dying.)
Finally, buyer beware. There are people that profess to be women's health experts and are Chiropractors. Seriously ??, They study the spine and immunity. What does this have to do with cervical pathology and I have a hard time believing they are qualified to offer these treatments. Some chiropractic schools offer, at most, only the most cursory classroom instruction in these subjects more likely than not occuring at in house chiropractic in school clinics, where the vast majority of their clinical training takes place and do not include any OB/GYN training. Chiropractic post graduate training generally consists of weekend lectures in hotel conference room settings. They do not do residencies before going into practice. Again the Title of "Doctor" including for Chiropractors or even Nurse Practitioners with PHD's for that matter can be confusing.
Chiropractors do not study cervical disease like OB/GYN's. It's a different yes, albeit integrative health discipline. It's like being a Board Certified Nurse Practitioner in Women's Health doing spinal manipulations. Women do your research. You are smarter than this !!!
Please see the 2 links below from the American College of OB/GYN that have accurate patient information about anormal pap smear management and HPV as well as another from the publication, "Science Direct", about various escharotic studies.
https://www.acog.org/womens-health/faqs/abnormal-cervical-cancer-screening-test-
ttps://www.acog.org/womens-health/faqs/hpv-vaccination