I had the gardasil 4 vaccine in 2009/2010 prior to sexual contact. The second vaccine was delayed but I received all 3 shots. In  early 2019 I saw I had vestibular papillomatosis near the top area of the vulva had it checked by a dr and they confirmed that’s what it was. A few months later I had a thrush infection and I had stupidly applied steroid cream to the fourchette and some of the bottom of the vaginal opening. Maybe a few days or weeks later I noticed 2 growths on the forchette one on either side that resemble thin skin flaps? They don’t seem cauliflower or anything like that and are mobile. Then I noticed a few bumps in the opening plus vp in the opening as well.

I have since had cereal screenings x 2 one abnormal in 2019 then a year later was normal again. 

My question is! 

1: these have been untreated for 6 years now and have remained the same they haven’t grown or anything. If they were genital warts wouldn’t they have at least regressed or changed ? 

2: can genital warts appear after the use of steroid cream ( as it was short term)?

3: can this be an atypical case of genital warts ? 

Thank you for your time 

 

First, you apparently know that vestibular papillomatosis is quite common in young women and not abnormal, and entirely unrelated to HPV. Second, having had the full course of the quadrivalent HPV vaccine (Gardasil 4) before you became sexually active, you are immune to the two HPV types (HPV 6 and 11) that cause about 90% of genital warts. It wasn't at all "stupid" to use a steroid cream for your apparent yeast infection (thrush) and that certainly has had no effect on your susceptibility to HPV or genital warts. 

I don't understand "cereal" screenings -- is that a typo? "Cervical" screening, i.e. Pap smears? Please explain further. What was abnormal about one of them? You also say nothing about your sexual lifestyle. Presumably you have been sexually active since vaccinated 15 years ago -- knowing a bit about your sexual partnerships might help evaluation your risk for HPV. However, although all sexually active persons get HPV, your immunization has made it very unlikely you have or ever will have genital warts.

Those comments partly answer your numbered questions as best I can, but to explicit:

1. You were at no significant risk of genital warts 6 years ago (even if sexually active); and warts are unlikely to persist unchanged for 6 years. They would have cleared up or, less likely, spread with appearance of additional warts.

2. Steroid cream is not known to trigger onset or appearance of genital warts.

3. For the reasons already stated, I doubt you have genital warts. However, I'm somewhat surprized you don't report the results of your medical examination(s) over the years. Presumably you have had professional gyn exams ("cereal" screening?). And presumably your doctor(s) did not diagnose the bumps as warts. But if you have not seen a doctor in person, that's obviously your next step now. In the meantime, it seems very unlikely you have genital warts.

My final advice is that you consider immunization with the updated HPV vaccine (Gardasil 9), which covers 5 additional HPV types not protected by your previous vaccine. However, the need for this depend a lot on your current sexual lifestyle and hence risk for ongoing HPV exposures.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

- I noticed these growths after my first sexual partner 6 years ago and have noticed nil further change or any growths on my husband (of 3 years). 

I am also due to my pap/hpv test this year but will complete that post partum  as I’m currently pregnant. 

- is there any significant risk to my child if indeed these are warts ?

- I have read many articles, journals that sometimes untreated genital warts can persist unchanged for many years is this mostly in unvaccinated people ? Only because I’ve read so many mixed responses 

But thank you for your help