[Question #13062] Hpv auto inoculation.
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2 months ago
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Hello Doctor,
Hope all is well.
I am a 29yr old male diagnosed with genital warts on penis shaft and base. Stared with 9 small warts total and have since removed 7 and grown 2 new warts. 4 warts total. As I continue my treatment I wanted to ask a few questions for peace of mind.
1) how likely is auto inoculation in terms of spreading my current genital warts to my anus or mouth? Are there any measures needed to prevent this? To note while probably unnecessary i do wear nitrile gloves whenever handling my genital area and wash my hands afterwards.
2) Will masturbation cause my warts to multiply in the current infected area? I understand shaving can cause spread due to the shaving of wart tissue. I trim but do not shave and use guards in order to prevent nicks on warts.
3) if I have genital warts should I assume I have an undetected oral infection? The reason I ask this is to better understand the risk of giving my partner hpv from giving oral sex to her. We have not had sex as I found I had genital warts a week into us dating.
4) with non genital warts whether on hands or arms, I have always read it is important to keep them covered in order to prevent the spread of warts on the body. In my personal experience I find that dermatologists do not seem to encourage covering of warts or direct one to do so. Yet I have had conflicting responses from primary care physicians. Should warts be covered to prevent spread or is this a minimal risk?
5) lastly i was curious to know if have encountered any studies asserting the effectiveness of inosine pranobex for hpv?
Thank you for your time and knowledge.
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H. Hunter Handsfield, MD
2 months ago
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Welcome to the forum.
Most of your questions are unanswerable; the data just don't exist. I'll do my best with my personal judgments.
1) Auto-inoculation of HPV is generally believed to be uncommon. People with genital warts sometimes have genital infection, but this might occur most often by virus migration through the skin over the short distance from gemtoa;s tp am-rectangle; Essie/
2) Masturbation is not known to spread HPV infection or warts. It has been speculated that saving may spread the virus locally, but to my knowledge this has not been proved.
3) Oral HPV infection isn't rare, but mostly harmless and never causing symptoms. And generally thought to be rarely transmitted by oral sex. Most infections probably are acquired by oral sex on infected partners rather than auto-inoculation.
4) The "most dermatologists" you quote probably are right: no need to keep warts covered. Warts are uncommon on body parts other than genitals, fingers, hands and feet. Most skin bumps on other skin surfaces are not warts, even if they look similar. However, this isn't an STD issue and these are only my own general understanding. A dermatologist would be a more authoritative source about these issues.
5) Inosine pranobex has been evaluated in small studies against warts, but the evidence doesn't suggest it helps much. I am unaware of any data about effectiveness against HPV other than warts.
I hope these comments help a little bit. Let me know if anything isn't clear.
HHH, MD
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2 months ago
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Thank you for your response and answers they are greatly appreciated.
Everything is clear and understood, it does offer some peace of mind.
My only question is regarding the auto inoculation. With it being uncommon, genital warts and the HPv strains causing them are mostly shared through sexual acts. Is the risk for transmission through fomites minimum to the extent where it should not be considered as a concerned possibility? I ask this question in terms of undergarments or bath towels or items that generally touch the genital area? Such as handling these item after contact with the infected area will washing.
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H. Hunter Handsfield, MD
2 months ago
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HPV is not transmitted by fomites, only by direct intimate contact with an infected person. This includes bath towels and undergarments. For example, the household contacts and roommates of HPV infected persons have never been known to be infected even after years of sharing the same toilets, showers, toilets, and even underwear.---
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2 months ago
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Thank you for the clarification your knowledge is helpful and very much appreciated. My remaining follow up refers to transmission of hpv to another person. As I currently have genital warts, I would be considered to have an active infection. Does having an active infection mean the risk of spreading hpv to another sexual partner is higher or would I be as much of a risk as someone with an inactive hpv? As a carrier like most sexually active men is it better to have a biopsy done to determine which strain caused my genital warts or should I assume it is strains 6 and 11 due to likelihood? My concern in this is passing on a high risk strain to my partner (we have never had genital contact) but from my understanding I may pose no more of a risk to her than any other male as we are considered carriers. Thank you for your time and knowledge it is truly appreciated.
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H. Hunter Handsfield, MD
2 months ago
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I'm afraid you're overreacting. There is no point in biopsy; knowing the HPV type(s) involved will not change anything. The risk of transmission of HPV declines with time.
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Even if you happen to have one of them in addition to the one responsible for your warts, having sex with you will not significantly raise your partner's chance of having a high risk HPV or a health problem from it, like an abnormal Pap smear. HPV should not be a consideration in your sexual planning. In other words, you are exactly right in your "understanding" statement.
That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.