This evening I noticed that it looks like a have one recurring in the same spot as before. It is in the same location as the largest/hardest to treat wart I had previously.

I had a really hard time mentally last time with the warts and they caused considerable anxiety, which I can feel again. 

I am going to make an appointment with my Derm to start treatment again and hope this new one clears as well. 

Is there anything I can do to lessen the odds of recurrence? 

Do recurring warts indicate that they might be from a more dangerous strain? 

Does the fact that I am clearly having difficulty clearing this HPV infection mean that I would have equal trouble clearing a carcinogenic strain? My primary concern here is an increased risk of penile cancer. 

The first thing that I would advise to you is to see an experienced dermatologist and make sure that what you have seen is really a wart and not something else.  It may well be scarring or one of the many, many dermatologic processes that can be mistaken for warts.  Please explain to your dermatologist that you were very concerned about possible warts in the same location more than 6 years ago and that you want to be sure that you know what is happening.  Following this course may result in a biopsy which could in itself be curative if the lesion is a wart.

Having said that, it is rather unlikely that this is a wart.  The further out a person is from successful wart treatment (i.e. that the wart has gone away), the less likely it is that it will recur unless the person become immunosuppressed in some way (and even then it is unlikely that warts would recur this far out).  Further, your HPV vaccine has been shown in some instances to hasten HPV resolution as well as prevent future lesions. 

The genetics of failures of HPV resolution and recurrence is in its infancy.  I know of no data that suggest that a person with a wart recurrence is more likely to develop HPV related cancer unless they are immunosuppressed.

Recurrence of warts  does occur, as Dr. Handsfield explained, in about 70% of treated persons, usually with in few months of initial resolution.  When they do, re-treatment typically does the trick.  Retreatment can be with the same method as used previously or one of the many alternatives.  

I hope this perspective is helpful.  Knowing that you had great concerns regarding the lesions you had in the past, I would urge you to do your best to go down the "what if..." rabbit hole.  It serves no purpose.   Please do your best not to worry- see a dermatologist and find out what this is.  EWH

I know warts are not usually a serious concern, and more if a nuisance but I still find them distressing

I can not get it to see my dermatologist for nearly a month, so I am going to have to be rational and wait for a while.  

A little more context about my situation — I began treating my warts 6 years ago, but I have only been 100% clear of them for maybe 2-3. I received poor advice initially that they would resolve on their own and they grew large and well established. It took lots of treatments over a long period of time to get them to go away. My warts were primarily in my pubic hair area and not actually in my genitals. The area that I am worried about a recurrence had my largest ( almost nickel size) wart that took a very long time to resolve. 

With this context: 

Could it be that the wart never completely resolved? There was nothing clearly visualize, except slightly raised skin

I worry that my immune system may be compromised. Is this always the case with recurrences? I get regular physicals and blood work and have never been told anything is abnormal. 

Could stress play a part in a recurrence? If so, should a be on the lookout for a recurrence everytime I have a stressful period? have been abnormally stressed for a few weeks.

Thanks so much. This forum is the only place online I have ever been able to find any clarity on this issue. 

I know this is troublesome for you.  I suggest that you call your dermatologist and tell him/her office that if there is a cancelation, you would very much like to be seen sooner and will try to be there.  Cancelations are frequent and often at short notice but I hate to think of this continuing to trouble you for a month.

Thanks for the context.  Please remember that warts in that location may not be the types of HPV that cause genital infections but the sort that people get on other parts of their body.  In addition:

You seem to be already assuming that this is a recurrence- don't.  Further, HPV infections progress very slowly, over weeks to months.  I would not worry that stresses will cause recurrence (caution here- this sounds like a rabbit hole type question)

You have one follow-up left.  A word of warning- after that, further questions before you see a dermatologist may not be answered.  

One further word of caution- repeated self examination can irritate and confuse the ability of a trained health care provider to make an accurate diagnosis.  Please keep you hands off and away from the lesion.  EWH

I was able to see my primary care doctor, and his initial reaction was that it did not look like a typical wart, but since it was in the same place as one I had previously it could be possible that it is one. This was reassuring, but we will see what the Derm says. 

Though I know it was not your intent, your advice about not touching the lesion got me thinking about hand transmission. 

I know it is irrational but I have to ask 

Is it possible to spread genital warts with your hands if you have recently used the restroom or touched a wart? Is washing hands enough to prevent this? 

I am worried about spreading it to my family inadvertently, especially my young daughter when changing diapers or bathing.  

Please don't worry about spreading the wart, if that's what it is ( and you now have two of us who doubt that it is) to your family.  

As you know this third response will complete this thread.  EWH