[Question #10405] GW
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23 months ago
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Hello (40/m). I discovered several very small GWs while shaving my pubic hair about 6 weeks ago. Since that time, I have been treated with cryo and aldara as well as supplemented with AHCC and L-Lysine. All of the GWs have cleared and I went back to my dermatologist who evaluated me and he said that he could not find any new growths. I have another follow up in one month…. My biggest fear is spreading this to potential future partners.
1. Is there any biopsy options to test the skin in men to see if the virus is still present?
2. Or is it a wait and see for 4-6 months to see if there is any recurrence? If no recurrence then can go on assuming cleared without need to share details with potential partners?
3. Are there any off label systemic / oral antivirals that can be used to help assuage fear that the virus is lingering? I am also planning to use cidofovir gel in 1% form.
Thank you so much.
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Edward W. Hook M.D.
23 months ago
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Welcome to our Forum and thanks for your questions. I'll be glad to comment. We receive many questions about HPV so let me reiterate some generalities about HPV before addressing your specific questions. Concerns about HPV should be addressed with vaccination with the HPV vaccine. Worrying otherwise about HPV is virtually a waste of time as virtually all unvaccinated persons (over 85% at a minimum) will acquire one or more typically more HPV infections during their lives. The vaccine is safe and highly effective. If you are not vaccinated, any future potential partners who are not already vaccinated most likely have one of more HPV infections and your likelihood of transmitted your now treated infection to others is vvirtually zero unless your warts recur. With that preamble, let me address your specific questions:
1. Is there any biopsy options to test the skin in men to see if the virus is still present?
The short answer is no. Further, follow-up testing for warts is not recommended. (see below)
2. Or is it a wait and see for 4-6 months to see if there is any recurrence? If no recurrence then can go on assuming cleared without need to share details with potential partners?
If lesions are not present, there is no evidence that partners are at risk. When treated warts recur, they typically do so within 2-3 months following resolution, The longer you are without visible recurrences, the less likely it is that your warts will recur.
3. Are there any off label systemic / oral antivirals that can be used to help assuage fear that the virus is lingering? I am also planning to use cidofovir gel in 1% form.
If lesions are not present, I would not suggest further treatment. Most HPV treatment is inflammatory and irritating. Better to simply watch. The fact that you have recently been seen by a trained specialist who saw no evidence of recurrence is good news.
Having addressed your questions, I would not repeat my suggestion for you to seek the HPV vaccine. Your level of concern is out of proportion to the medical significance of an HPV infections which, for the vast majority of persons with them, are innocuous and inconsequential. EWH
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