[Question #13647] Recently diagnosed with genital warts - advice

9 hours ago

I was diagnosed with genital warts 2 months ago. I had multiple clusters at the vaginal opening, tracking deeper inwards, covering a fairly large surface area. They initially responded well to 2x cryotherapy (and warticon application for the more external ones), but the internal clusters returned 2 weeks later.

I had another round of cryotherapy followed by a couple of weeks of aldara. I couldn't finish the course as I had a lot of discomfort and some blistering internally.

Now...most of the warts have gone (for now). I maybe have around five 1-2mm more internal warts which I can only really see when zoomed in with a phone camera and good lighting. The sexual health nurse said she couldn't see anything large enough with the naked eye to do cryotherapy on.

1) Is it likely that the remnant multiple tiny lesions will go away on their own now the larger ones are treated? Would leaving them untreated increase risk of recurrence, transmission or autoinnoculation?

2) My partner and I had unprotected sex for 10 months before I saw the warts. Can we still continue having sex given he has likely been exposed already or should we abstain whilst I have visible lesions? I am also particularly worried about receiving oral sex from him and causing oral or throat lesions in him?

3) I have had my first dose of the gardasil 9 vaccine. I understand the vaccine cannot treat the existing infection, but is there strong enough evidence to say it can help with recurrences or autoinnoculation?

4) I am just worried by the number of warts and surface area that was affected and whether I still have a good chance of getting rid of the infection?

Thank you so much.

Edward W. Hook M.D.

3 hours ago

Welcome to the Forum. Thanks for your confidence in our service. I'll do my best to provide some useful information. It sounds like your infection was rather extensive- had you just not noted them or did they appear relatively rapidly (this would be unusual for warts, particularly a lot of them. Further, it would be unusual for warts to recur in just 2 weeks after treatment. For now I'll presume that you do have warts and organize my comments accordingly.

Let me also caution you from over examining yourself. The genital region has numerous normal irregularities and there are literally hundreds of other dermatological processes that can be mistaken for HPV. I would be skeptical that what you are seeing with photographic magnification represents a recurrence.

Regarding your specific questions:

See my comments above. If the things you have seen are warts they could be remnants from your recent treatment. My advice for now would be to simply observe them and see what happens.

Your partner has been exposed. Does he have visible warts? Irrespective, he's been exposed. I see no reason to change your sexual practices. ORal sex is less likely to lead to infection if indeed what you have are warts. Further, the HPV types that cause genital infection rarely cause oral infections- they don't seem to "like to infect" the throat. Further, cunnilingus is a biologically inefficient process which rarely results in infection when performed on an infected partner.

HPV infections are not spread through autoinoculation. I'm please to hear that you are getting vaccinated. Although unproven, there have been suggestions that the vaccine may reduce recurrences of existing infections.

4) I am just worried by the number of warts and surface area that was affected and whether I still have a good chance of getting rid of the infection?

This question circles back to the beginning of this exchange. Little more to add.

I hope this information is helpful. If anything is unclear, please use your up to 2 follow ups for clarification. EWH

---