[Question #10647] Genital wart reoccurrence
21 months ago
|
Hello,
A few years ago Dr Hook very helpfully advised me on some questions I had related to HPV , clearance, disclosure etc, after I had a wart frozen off in Jan of 2019. After a couple years, I had no reoccurrence and felt confident I had put HPV behind me. I've started a relationship since which is now in it's second year.
This week I had a reoccurrence of a second wart which was frozen off. I informed my girlfriend who was very supportive. My question is really about how to proceed from here and to understand my situation a bit better:
Based on my reoccurrence after 4 years, is it safe to assume that I'm in the unlucky group, in that my HPV infection is of the latent variety with more warts incoming in future years , or do I still maintain a possibility of clearing the infection if I stick with healthy habits around diet, exercise, etc? I've already received gardasil back in 2018. Furthermore, my girlfriend advised me that she received HPV vaccination sometime in her teens , around 2005/2006. Should she vaccinate with the latest gardasil again? At this stage I would like to know how best to prevent transmitting HPV to my girlfriend if I have not done so already, and what my odds are of truly clearing HPV. I understand that there are no guarantees, but it would be good to know if I still have some chances to clear, and what steps I can take to help the situation.
Thanks in advance for reading my question and for your great work on this site.
![]() |
Edward W. Hook M.D.
21 months ago
|
Welcome back to the Forum. Thanks for your comments and your questions. I'll do my best to help. Several comments:
While I do not doubt you regarding a possible recurrence, this is quite unusual this far out. Are you entirely sure that the lesion that has been frozen was a wart? There are many other genital lesions which can mimic warts. Also, did it occur in the same location as your prior wart?
I'm glad the you have been vaccinated. This vaccination provides good protection from the two HPV types which cause about 90% of visible genital warts. Other HPV infections however do occasionally cause warts. With treatment of this lesion, presuming it is a wart, your likelihood of having a recurrence is modest. In unvaccinated persons, following treatment about 25-33% recur over the next 6 months or so. There are fewer data regarding recurrence of visible warts in vaccinated persons. There are however data which suggest that vaccination does not only prevent infection with new HPV types but may enhance resolution of HPV infections following treatment.
I see no need for further HPV vaccination. Your GF's vaccination was with the vaccine which covered 4 important HPV types which lead to the majority of visible (i.e. types 6 and 11) warts and most precancerous abnormal PAP smears (16 and 18). Her vaccine did not cover the five additional HPV types covered by the newer vaccine (in use since 2014) which is the one you got. She may want to discuss the pros and cons of a booster with the 9-valent vaccine.
Regarding the way forward. Presuming that you have been sexually active, she has been exposed. Further you have been treatment. Thus for both of these reasons I see no reason related to your possible wart to change your sexual habits.
I hope I've covered your questions. AS you know, you have up to two follow-ups for clarification or additional questions. EWH
---
21 months ago
|
Hi Dr Hook,
Thank you for your response, it's good to hear from you again.
I did not consider that this reoccurrence could be something other than a wart, though if that's possible I would be happy to share more details and get your opinion: This new wart did not occur in the exact same area. If I recall correctly my first wart was quite small, maybe 2mm, very dark, hard, oval, raised, and at the base/bottom of the penis. This reoccurring wart was maybe a bit bigger at 2-3mm, round, raised, a browner version of my skin tone (caucasian), soft, and about 2 inches away from where my first wart was, higher up in the pubic area. It was hard to see but I think it had a bit of a bumpy texture to it, and it also had 3 hairs growing out of the side of it, almost as if they were coming out of the same follicle? if that makes sense. My GP remarked that it looked like it had "wart-like characteristics" but he did say it was unusual to see hair coming from the side of a wart. I think I just took his word for it being a wart.
I feel happy knowing that the vaccine my GF roughly got 17/18 years ago would have protected her against the hpv strains most likely to express warts. Without revealing any personal information, would all countries in North America and Europe at this time roll out the same type of hpv vaccine? Would be curious to know if we need to dig more into the exact vaccine she got in our region, or if they were all roughly the same. Was her vaccine still recent enough that she would have some protection, or would it be waning somewhat by now? Lastly is the advantage of getting a booster simply to protect against other strains that were not included in the vaccine at the original time she got it?
Thanks again for your time Dr Hook
![]() |
Edward W. Hook M.D.
21 months ago
|
Thanks for the additional information. Now that the lesion has been treated, there is no way to know but from what you say, there are a number of features which make me seriously wonder if what you saw was indeed a wart. These include:
- The time since your original wart
-Your vaccination status
-that the lesion had a hair growing out of it (most unusual for warts)
-the location- the vast majority of warts are on the penis and while warts do occasionally occur in the pubic area, it is a minority
I'll also mention that, because most knowledgeable clinicians consider them primarily an innocuous nuisance, they just treat them for cosmetic reasons as a "path of least resistance". This additional information makes me less concerned that it is a wart and, certainly reinforces my sense that there is no need to modify the nature of your sexual interactions with your GF.
As for the vaccine, indeed, the nine-valent vaccine was rolled out internationally at about the same time.
Hope this helps. EWH
---
21 months ago
|
Hi Dr Hook
Too bad we cannot know for certain, but everything you have said has been very helpful so thanks again. I do think the risks are low in multiple respects after thinking it through more, which is great. Wishing you a happy winter, I have no further questions
All the best
![]() |
Edward W. Hook M.D.
21 months ago
|
Thanks for your thanks. I'm glad I was able to help. Closing the thread now. Take care. EWH---