[Question #12875] Invisible flat warts and Vulvodynia, doctor gives up on me

4 months ago

Jan 2024 I was diagnosed with vulvodynia, we did a biopsy and found HPV warts. It is a strain of Verrucae Planae that usually don’t belong there. You can only see them with TCA and with colposcopy as the skin turns whiter than it should (compared to the healthy skin) and it has harsh borders. We used electrocautery in Feb 2024, in March my doc says he can see it still/again.

Another doc didn’t see it, but they didn’t do a colposcopy and it’s hard to see without. In Dec 2024 I get a 2. opinion - he sees the whiter leasions, but hasn’t seen these warts there ever. Jan 2025 my 1. doc does another biopsy and electrocautery. I take Inosine pranobex for 4 weeks. Two days ago I went back - biopsy still has confirmed flat warts and the white area looked the same as before the last electrocautery.

He goes ‚we won’t use any creams so your Vulvodynia doesn’t get worse. We also won‘t to electrocautery again. You should accept that you have GW for life.‘

I don’t know what to do or think now.

H. Hunter Handsfield, MD

4 months ago

Welcome to the forum. Unfortunately, I can't help much. First, HPV and warts are not known to cause vulvodynia. As you probably have learned, that's a difficult problem to understand and treat, but managing your apparent warts is not likely to be the answer.

We STI experts do not get into the details of diagnosis and management of problems like your apparent warts (if that's what you have). Indeed, if our clinics had a patient like you, we would refer her to a dermatologist -- that's where the expertise lies in regard to classification of genital area warts and their treatment. I've never used electrocautery and cannot advise on how the area would look afterward.

All that said, I see no reason that you should expect to have genital warts for life. The large majority of genital HPV infections are controlled by the immune system over time, and I've never heard of a patient having lifelong genital warts.

I hope things go well for you. Sorry I can't be more helpful, but let me know if any of this isn't clear.

HHH, MD

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4 months ago

Yes, the Vulvodynia topic is clear to me and I understand you can‘t help with that, it was rather an additional info as to why my doctor was hesitant to try out various things. I was rather wondering if you have any insight of my special case with those flat warts and agree with my doctor that I will have it for life, which sounds so scary. Also the way I heard it with genital warts, while they are more a cosmetic issue you can mostly only get rid of them by treating them again and again and hoping one day they will stay away? Though my doctor disagreed but that really shocked me. Sorry if not your expertise, this is not my first language. Thanks!

H. Hunter Handsfield, MD

4 months ago

I've already said I disagree with your doctor about genital warts ("flat" or otherwise) persisting for life. I've never heard of that happening. Most warts, genital or anywhere else, are cleared after one or two treatments, or sometimes a few -- but do not need repeated treatment in the way you describe.---