Dr. Levine answers: I am delighted that some of the APDA website subscribing patients are experiencing benefits from topical verapamil however, based upon the many men I have seen who have tried topical verapamil none have noted any significant benefit what so ever. There is, of course, a population of men who may have spontaneous resolution of their deformity. In the modern literature it has been reported as being less than 13% of men experience resolution of their penile deformity. In addition, there is a population of men who injure their penis, develop a normal scar, which over the course of time heals spontaneously following the normal healing process. This is not Peyronie’s disease.
Although some pharmacists claim that the drug takes only five minutes to “soak in,” so far the research which has been done on one brand of topical verapamil, has not demonstrated that any drug truly gets to the target tissue (i.e. the tunica albuginea), which is where the Peyronie’s plaque develops. Therefore, a 10-minute application may be just as good as a 2 minute or 2 hour application. The irritation that you experience may be due to topical vaso-dilation (blood vessel engorgement) caused by verapamil, or it may be due to the various emollients and enhancers that are in the gel/cream. If you want to continue with this therapy, one option would be to consider application of a 1% topical steroid cream, which can be purchased over the counter and applied after you wash off the drug.
In terms of continuing with treatment, another option would be to step up the therapy to either an iontophoresis program, which has been demonstrated experimentally, in one study, to reach the target tissue in 70% of patients, and can be done at home. The Physion Company of Italy now has FDA approval in the U.S.A. for their iontophoresis (EWDA) delivery system for verapamil. About 50% of my patients have demonstrated improvement when using verapamil solution or even saline alone. Prior research has suggested that electric current may in fact activate the healing process, which may explain why some men with saline respond to this treatment. Further research is ongoing regarding this phenomenon. Another approach where you could continue verapamil would be to find a Urologist in your neighborhood who might be interested in injecting verapamil directly into the plaque, which is performed every two weeks for 6-12 injection treatment sessions.