[Question #13425] HPV in men

1 months ago

I’m 29M. Skin tag history since college in the pubic area. Recently, I nicked one shaving, then a month later had sex (Oct 2024). Nov 2024: one dark, round “wart” with tiny dots on groin; cryotherapy, did not return. Also a flat velvety nickel-sized patch at base/scrotum judged “not HPV”; I removed with ACV, it peeled. Mar 2025: a few tiny bumps that did not look like a typical wart on hair-bearing base/groin/inner thigh; only one looked cauliflower-like on inner thigh; all treated with cryo. Last treatment Apr 2025; none since. None on the shaft or scrotum. Completed 3-dose HPV vaccine in 2025. Now laser hair removal. I shaved multiple times in Jan, March, and Sep. Plan: abstinent until Apr 2027 (2 yrs wart-free). Questions: For men, how long is HPV transmissible once warts are gone? If bumps recur at different hair-bearing sites but treated promptly, does the clock restart? Thoughts on the flat velvety patch? Is 2 yrs wart-free a conservative, safe cutoff to resume sex?

Edward W. Hook M.D.

1 months ago

Welcome to our forum. Thank you for your questions. I’ll be glad to comment. Let me first point out that the dates in your description appear to be off. Please check and let me know if it is truly been two years since you’ve noticed any of the lesions you describe.

Second, from your description it is unclear Whether any or for that matter all of the lesions you describe or HPV related warts. The descriptions, with exception of the cauliflower appearing one, sound like something other than HPV. There are many types of genital dermatological lesions, which can mimic warts and shaving, can lead to development all sorts of lesions which are sometimes mistaken as warts. Irrespective, if you have been two years without the appearance of new new lesions, it is very unlikely that you will experience Recurrent warts, particularly since you have received the HPV vaccine. Most warts, if they are going to recur, do so within six months of treatment.

In science and medicine, one can never say never as new observations are made regularly however, the longer it has been since HPV lesions have recurred, the less likely it is that they will. On relatively rare occasions, following longer periods long latent HPV can recur however this is unusual and your HPV vaccine makes it even more so.

I do not have an explanation for the velvety patch although again, it certainly does not sound like a wart. That’s a question for a dermatologist.

Finally, regarding your question regarding resumption of sex, we do not necessarily recommend abstinence because of an HPV diagnosis. If partners are sexually experienced and have not been vaccinated statistically, it is likely that they already have HPV infection. About 80% of unvaccinated, sexually active persons will have or have had HPV. If they have been vaccinated, the chances of HPV Are very small. I certainly see no reason for you to be practicing abstinence if two years of passed since you have noticed any lesions, which may have been HPV related.

I hope this information and perspective is helpful. EWH.

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1 months ago

Thank you, Dr. Hook. Clarifying my timeline:

Nicked the skin tag beginning of October 2024, had the sexual encounter end of that month → a non-definitive lesion on hair-bearing groin skin in Nov 2024 (dermatologist examined it with a simple magnifying reading lens; not clearly a wart).

Mar 2025: I switched to a more professional dermatologist that used a derma-scope and asked him to remove 2–4 tiny bumps on hair-bearing base/groin/inner thigh. He judged that most of them are not HPV warts but some “could be” and decided to cryo everything. Zero recurrences in the same spots post that.

Only a tiny barely visible cauliflower-like on the inner thigh that could’ve been there for a very long time (+5 years).

Last treatment Apr, 2025; no recurrences since. No lesions on the shaft or glans, only hair-bearing skin.

Since the last treatment, my dermatologist told me to wait three months then continue shaving and sexual activity, i’ve waited more than five months and shaved and to this day nothing showed up that is concerning.

Follow-ups:

1 From Apr, 2025, is Apr, 2026 “low risk” and Apr, 2027 a conservative “very low risk” cutoff?

2 Does having no shaft/glans lesions reduce transmission risk further?

3 I’ve met a virgin partner who unfortunately does not want to get the vaccine. What is the safest approach in that scenario?

Edward W. Hook M.D.

1 months ago

Thanks for the clarification. I remain skeptical that the lesions you described were due to HPV. The location is unusual as is your description In follow up.:

1. See above

2. Yes. Further, as I described above, transmission is really not much of a concern as any future partners either already are likely to have HPV or have been vaccinated.

3. In my opinion, your future partner is making a mistake. The vaccine is safe and effective. If you have HPV, and it is not clear that you do, she will get it if she does not receive the vaccine. Condoms reduce the likelihood of HPV transmission, but do not eliminate it, particularly if you anticipate more than just a single Future encounter.

EWH

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1 months ago

Thank you again, Dr. Hook. This will be my last question. I know you’ve already said there’s no reason to be stopping sex, but I’d like to clarify one point. I’m encouraging my partner to get vaccinated, but if she ultimately does not, and if I did have HPV, would I remain contagious to her and others forever? Or does the immune system typically suppress the virus to a point where it is no longer transmissible after ~24 months?

Edward W. Hook M.D.

1 months ago

While there are not detailed data, the more longstanding an infection the less likely transmission is to occur. It certainly remains in her best interest to be vaccinated.

This completes this thread which will now be closed. There should be no need for further questions on this topic. Take care. EWH

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