[Question #10939] Recurring Warts and Disclosure
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18 months ago
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Hello, I am a 42 year old man. I first discovered my genital warts when I was around 19-20 years old (2001 I believe). At the time, I was in denial about it and stupidly picked/scratched them off instead of having them treated properly. Of course, they returned quickly and it took many rounds of laser removal, over a couple of years, before they finally went away. I’m guessing they spread and were stubborn to get rid of because of my picking them off? I then went many years (5-10 years or so) with no recurrence. So I thought I had cleared it for sure at this point. Then I had one came back around 2013-14 and treated it. It went away for a couple of years. I’ve since had a few more recurrences… my last being about 6 months ago. I am currently wart free. Can I expect to ever be rid of them for good? I’ve recently begun getting the rounds of Gardasil vaccine… I’m hoping that helps in the future.
My main question is: can I still go by your usual practical advice for disclosure?…. being that after 6 months of no recurrence of warts, that it’s safe to assume I’ve cleared the infection… and therefore disclosure of my previous HPV warts to future partners is no longer an ethical obligation?
Thanks for the help
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Edward W. Hook M.D.
18 months ago
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Welcome to our Forum. Thanks for your questions. I'll be glad to comment.
My first question is whether or not you are sure that the recurrent lesions you have noted are truly warts. They are many dermatologic conditions which can mimic warts and are all too often mistaken for warts by clinicians. The treatment of such lesions is non-specific. Thus what you have noted may not be warts at all.
Second, if they are warts, as you likely know from reading our advice to others, they just are not that big a deal. Most sexually active persons have HPV infection (usually with more than one HPV type) and they rarely cause problems, particularly the HPV types which cause visible warts. Your HPV vaccination will have no effect it these are not warts but if they are, there is some indirect evidence that hey may reduce recurrence/enhance response to treatment. Vaccination will certainly do no harm.
I see no reason for disclosure of your previous warts to future partners. Should the topic come up, I'd suggest stating that you have had warts in the past which were treated.
I hope this perspective is helpful. EWH
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18 months ago
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Thanks for the quick reply.
I’m not completely sure about the recurrent warts to be honest. My GP just visually confirmed maybe one or two of them. The rest I froze from home as it looked to be a wart. I did the “vinegar test” and some turned white and some did not. I never had any sent off for a biopsy.
My follow up question is about the wart types that are not protected by the vaccine. My girlfriend was vaccinated when she was a teenager, but then said she had a genital wart removed later in college. I was with her many years later than that and she never had any active warts while we were together, not that I’m aware of. This was all a couple of years ago. However, during this time is when I had a few warts show up.
Would you put any stock into the possibility that she perhaps gave me a different type of HPV, and that’s why I had a recurrence… and one that isn’t covered by the vaccine? Would deducing to that make any sense and would that change anything about needing to disclose it in the future?
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Edward W. Hook M.D.
18 months ago
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The vinegar test is notoriously inaccurate. I continue to wonder if the lesions you noted were really warts. Sometimes less experienced clinicians assume that lesions are warts when they are not. As I said however, they are not something to worry about.
Your GF may be in the same boat as described above or may have had a wart due to one of the HPV types not covered by the vaccine.
If its been years since her possible wart was treated, I doubt that she would have transmitted that HPV type years after treatment.
Sorting that out would be quite difficult and even if you could, it would not change my advice.
Remember we provide up to three responses to each client's questions. You have one follow-up remaining. EWH
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18 months ago
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Okay, that all makes sense. I’m thinking in the future I should have a biopsy on any suspicious bumps before treating them… rather than making assumptions on purely visual identification. Usually I would just treat them at home any suspicious bump while they are small… “just to be on the safe side”. Would you agree that is the best plan for moving forward… to biopsy any suspicious bumps? Then I’d at least know for sure what it is… if they do ever, in fact, reappear, then of course I’d need to disclose for the following 6 months… and after that time period, there is no need or obligation to.
Also, thanks for all the clarification. It is confusing as there are so many conflicting opinions on the topic of disclosure out there online. It just adds to the anxiety of having this.. not really knowing what is the right thing to do. I’ve personally had health professionals give me completely different answers on the issue of disclosure. By far, the worst part of ever getting GW is the stress and anxiety of disclosing or feeling guilty if you don’t disclose. I broke up with my aforementioned ex-GF last year and it’s always stressful to begin dating or starting any new relationships because I have to rehash this issue in my mind all over again. So, hearing a final word from an expert on HPV who specializes in how this virus really works… I am very relieved that I can put this all to rest going forward.
Thanks again for your help.
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Edward W. Hook M.D.
18 months ago
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Thanks for the additional information. Rather than commit to a biopsy, my advice would be to see a dermatologist should the bumps you mention re-appear. When viewed by an experienced dermatologist, you may not need a biopsy for diagnosis. Besides, if a biopsy was needed, you would want a dermatologist to perform the biopsy.
While I appreciate your desire to do the right thing, if you have recurrent warts, I think you are worrying about about an innocuous, problem that most sexually experienced, unvaccinated persons already have, even if they do not know it. Feeling guilty about non-disclosure is laudable but unwarranted. Perhaps a compromise position would be to discuss any past STIs and vaccination status as the relationship nears intimacy.
This completes this thread. EWH.
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