[Question #2047] HPV duration, skin tags - Dr. Handsfield

48 months ago
I'm a 35 yr old male.  I've done a lot of reading from valid sources like the CDC, but also message boards (I know not the greatest idea).  Please correct any assumptions or ideas that I have.  That's why I'm here, because I don't know.

So the medical community says that 30% of people will clear genital HPV within 18-24 months.
Is that 18-24 months from date of infection or date that symptoms (actual genital warts) appear?

In your experience/knowledge have you ever heard of genital warts (low-risk HPV 6 and 11) being a risk factor for skin tags?

I'm struggling with the validity of this article from Medical News Today 
http://www.medicalnewstoday.com/articles/67317.php#post
In the article, under the heading:  Risk factors for skintags, the 4th bullet says: 
  • People with the human papilloma virus (low-risk HPV 6 and 11)5
Is this legitimate?

A year after I had my genital warts (flesh colored/flat/smooth/slightly raised) frozen off, I noticed about 15 very small, very slightly raised growths on my shoulders/between my neck & shoulders/neck (2-3 times the size of a period like this --> .) with some having a dark spot in the center the size of 1 period like this --> . )
I don't know if they are skin tags, but they reminded me of my genital warts because of the fact that they were very slightly raised and flesh colored
(color of surrounding skin of shoulders)
I pinched some and scratched all of them off down to skin (left some scarring).
 
I have this the idea in my head that my genital HPV somehow caused those things on my shoulder, whether is be by me touching my genitals and then my shoulders or just the fact that HPV is in my body?




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
48 months ago
Welcome to the forum. Thanks for your question. Directly to your questions:

1) I am unaware of any data, or any consensus by "the medical community", that only 30% of genital warts require 18-24 months to clear. I would have estimated that 80% are gone by then. However, duration of warts without treatment has never been carefully studied. And it's difficult to judge the clearance rate from onset of HPV versus onset of visible warts, because of the variability in incubation period.  That is, warts can appear as soon as 2 months but often don't show up for 6-12 months.

2) By definition, HPV does not cause skin tags. The article you quote cites only an association, not causality. The "association" undoubtedly occurs because some warts are misdiagnosed as skin tags and vice versa. But I am unaware of any scientific data to suggest that true skin tags (not caused by HPV) are any more common in people with genital warts (i.e. caused by HPV).

3) We advise about genital warts only. Warts elsewhere on the body are outside the domain of STD experts and I never attempt to diagnose or treat them. From your description, I am pretty sure the bumps you describe are not warts, which almost never cause widespread skin bumps of the shoulders, neck, etc. Genital warts are not transferred to other body areas, except maybe rarely to the mouth and throat.

My advice is to see a dermatologist, if you haven't yet done so, then follow his or her advice about the skin bumps you are concerned about. But I am very confident they have nothing to do with genital warts or other genital area HPV infection.

I hope this information has been helpful. Best wishes.  HHH, MD

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48 months ago
Thank, you.  I had written these followup questions before your response, so let me know if I need to break up into posts or purchase more.

 

My wife is same age as me.  Been together since 2007.  Got married in mid 2016.  Took a relationship break in Feb 2012 and got back together at the end of 2012.

She had one partner during 2012.

I had the following:  Transexual (TS) (with male genitals) escorts with all contact described (no kissing in any instance):

2012 (I received anal with a condom covered dildo and then I penetrated TS anally while wearing condom.  Showered immediately afterward.)

2013 (TS unprotected rubbed her genitals and my genital together and with her hand.  Then I received anal penetration with TS wearing condom).  Did not shower till maybe 8 hours later.

2014 (TS condom covered oral sex performed on me and then vice versa.  Also condom covered anal sex on each other).  Showered immediately afterward.

July 2015 (I performed oral on condom covered TS.  TS with condom penetrated me, but also touched my genitals bear handed and I did not have a condom on.  At end TS sprayed and wiped down my penis pubic hair area with what I think was isopropyl alcohol, which looking back on it now is what probably made this area susceptible to me getting genital warts).  Did not shower until 10 hours later.  I almost positive I got it during this encounter. 

1.)  I read that you have 7 hours to shower to prevent from being infected.  Any validity to that?

 

3 weeks after that 2015 TS encounter, for the first time in my life I noticed (flesh colored flat) 3 genital warts on top side mid area of my penis, and about 12 on the top side base of penis and surround area identical to the ones in pictured in this article. 

http://www.medicalnewstoday.com/articles/155236.php

2.)  If I was infected July 1 2015, can it be said that it should clear by  July 1 2017 or would it be when symptoms appeared to make it July 21 2017?

I went to my Primary Care Physician (I shaved entire area so doctor could see them – initially she didn’t really know what they were and said maybe warts, razor bumps or herpes).  I had shaved for years before this and never had anything like this at all.

Tested for all STI’s and all came back negative, so I went back the next week and she froze my warts off.  I wanted her to check my anus but she looked so quickly I don’t think she would have seen them even if there was something there. 

A week later they were still there and I couldn’t afford to keep going back so I got my own liq nitro and froze all of them off.  I probably caused a little more trauma then needed, but they all scabbed and went away.

 

At this time (in 2015) I asked my wife if she ever had an abnormal pap and she said yes --around 2011/2012.  I think she said it was low risk, and since then, she’s had normal paps. Can’t say for sure that I never saw a wart on her (because I now know they can be very small, but I’m pretty sure she didn’t have any.  Only a skin tag around her anus.)

 

I had sex with my now wife before the July 2015 encounter but have only had sex with her once since -- on our wedding in summer 2016 (I had no visible warts and there was only penile penetration with condom and very carefully as to not have too much contact in fear of spreading something to her).

 

3.)  I know they recommend you be under age 26 for the vaccine, but is that set in stone?  (Do you recommend my wife get it?)

 

 

In the summer of 2016 through Oct 2016 I had maybe 5 reappear and I scratched them off down to the skin and they bled.  (not a great idea I know)

Oct 2016 I had about 15 growths on my shoulders that I mentioned previously (I removed).  A couple skin tags near under arm, 2 flat slightly raised flesh colored warts on my hand (similar in size to my genital wart), and now in March 2017 a small type wart on bottom of foot near the arch like a had when I was 12 (flesh colored but with tiny multiple brown spots toward the middle).

I’ve never noticed any warts or skin tags on myself (except 1 under my big toe when I was around age 12 and went away maybe 4 years later)

4.)  Can any of these non genital wart / skin conditions be related to my genital warts (i.e. spread from my genitals)?

 

I just don’t know what precautions or proper wash routines I should be taking.

I wear contacts and fear that in addition to the things I have mentioned that something could spread more and I’ll get new growths somewhere or even on my face or eye.  I’ve gotten so much worse in obsessively cleaning everything I touch since Oct 2016 when I noticed the growths on my shoulders that I mentioned previously.

 

In Dec 2016 I noticed 1 more genital wart but have not messed with it and have since stopped shaving the genital area to prevent more micro abrasions.

 

I know there is no guarantee that my 1 remaining genital wart will clear in the 2 years since I got it, but I tell myself I can’t live like this anymore with all the excessive cleaning and that at the 2 year mark in July 2017 I’ll have to stop and just take the chance of whatever happens will happen, I really hope I can.  I’ve been seeing an OCD psychologist since Dec 2016 but have been resistant to change because of this 2 year mark.

5.)  My thinking is that I will be less prone to spread to my myself or my body will be more able to fight it if other parts of my body or genitals come in contact with the 1 genital wart I have currently (i.e. if I touch my genitals and then another part of my body without remembering to wash before I do that.) Any validity to that?

 

So, going forward:

6.)  Would you suggest I get the 1 genital wart I have left ASAP or wait and see what happens in July?

 


The things on my shoulder looked similar to the things my wife has on her face.  So I think maybe I got them from her or maybe I gave them to her.  The reason I started to obsessively clean is because of these incidents and that if I don’t they will become worse or spread.

 

I just really don’t know what to do – guilt, uncertainty.  I wash my arms and hands almost constantly.  I don’t know where to draw the line when it comes the need to wash properly.

If I touch my clothes that I wore to bed I wash arms and hands.

I am very concerned about when I touch my genitals while on toilet and then wipe my anus, that I have to be sure not touch the toilet paper part that will touch the anus in fear of spreading it there.

7.)  Can I spread it to my anus if I touch my penis and then touch my anus?

 

8.)  Do I need to be worried about it spreading by any of the following methods: ?

--My genitals touching an inanimate object and then someone touching that object.

--I touch the faucet handle after touching penis, wash my hands, and then turn off the faucet handle.

--Handling of towels or underwear or clothing that I’ve used.

 

I have basically waited 2 years in hopes that that will decrease the chance of me spreading it to her or other areas of my body.

Correct my if I’m wrong but I mean we eventually have to have sex so I guess I will just wait until July (2 year mark) and have the 1 remaining genital wart removed. 

9.)  With it being removed will this greatly reduce the chance of spreading it to her?

 

 

10.)  I could have high risk as well and not know, and I cannot do anything about it correct?

 

11.)  I know my wife can get pap’s, but for me, are there any test I should do in the future to monitor for possible penile, anal/rectal, or mouth/throat cancer or is all I can do is to watch for any unusually symptoms or apparent physical changes?

 

12.)  Since there’s a possibility that I may spread to her, then there is a chance that if I perform oral sex on her that I can get oral HPV and vice versa?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
48 months ago
You're asking for much more than is practical on a forum of this scope. Questions must be max 1500 characters, about 300 words. Quick responses to the numbered questions, but I have neither the time nor the energy to read all the details.

1.)  I read that you have 7 hours to shower to prevent from being infected.  Any validity to that? I've never heard of anything like this, for HPV or any other STD.

2.)  If I was infected July 1 2015, can it be said that it should clear by  July 1 2017 or would it be when symptoms appeared to make it July 21 2017? The time to clearance is very approximate and some HPV infections last much longer. If visible warts are present and clear up, the virus probably is usually gone, at least within 3-4 months after the wart disappears.

 3.)  I know they recommend you be under age 26 for the vaccine, but is that set in stone?  (Do you recommend my wife get it?) After age 26, insurance probably won't cover vaccination, and it costs $500-600 for all 3 doses. Since new HPV infections are uncommon after age 26, and it isn't at all clear you are infected, I would not recommend your wife be immunized.

4.)  Can any of these non genital wart / skin conditions be related to my genital warts (i.e. spread from my genitals)? See my reply above. Genital HPV types don't take well to skin in most areas of the body, and I doubt your current skin problem is HPV. But you'll need to see your own doctor about it.

5.)  My thinking is that I will be less prone to spread to my myself or my body will be more able to fight it if other parts of my body or genitals come in contact with the 1 genital wart I have currently (i.e. if I touch my genitals and then another part of my body without remembering to wash before I do that.) Any validity to that? I've never heard anything like this and doubt it makes any difference.

6.)  Would you suggest I get the 1 genital wart I have left ASAP or wait and see what happens in July? I don't know that you have a wart at present. If you think you do, see a doctor for diagnosis and treatment. I don't know why you would want to wait 3 months to get it treated or have the diagnosis confirmed.

7.)  Can I spread it to my anus if I touch my penis and then touch my anus? Anal warts occur occasionally in people with genital warts, without obvious anal sexual exposure. Self-inoculation is probably the most common way it happens. So the answer is yes, but it's probably unlikely. And of course only if your genital lesion really is a wart.

8) Genital warts and HPV are never transmitted by these methods, only by direct skin-to-skin sexual contact.

9.)  With it being removed will this greatly reduce the chance of spreading it to her?  Yes, assuming it is a wart; if not, of course no risk.

10.)  I could have high risk as well and not know, and I cannot do anything about it correct?  iIt is common to be infected with more than one HPV type, so if you have genital warts, it is possible you also are infected with a high risk type. However, even the high risk types rarely go on to cause cancer. This should not be a serious worry.

11.)  I know my wife can get pap’s, but for me, are there any test I should do in the future to monitor for possible penile, anal/rectal, or mouth/throat cancer or is all I can do is to watch for any unusually symptoms or apparent physical changes? No, nothing to do except be on the alert for symptoms. Most likely none will occur; and if they do, almost always the problem is easily curable at such early stages. No big worries.

12.)  Since there’s a possibility that I may spread to her, then there is a chance that if I perform oral sex on her that I can get oral HPV and vice versa? This may be possible, but probably unlikely. And oral HPV rarely progresses to cancer; throat cancer due to HPV remains a rare problem, despite lots of media attention to it in recent years.

HHH, MD



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48 months ago
Thank for your responses Dr. Handsfield.  I really appreciate it.  Just for further clarification on number 7.
Original question with your answer:
7.)  Can I spread it to my anus if I touch my penis and then touch my anus? Anal warts occur occasionally in people with genital warts, without obvious anal sexual exposure. Self-inoculation is probably the most common way it happens. So the answer is yes, but it's probably unlikely. And of course only if your genital lesion really is a wart.

Please correct me if my conclusions are incorrect:
So if there is a wart, self-inoculation is possible in areas but mostly limited to the genital, anal, and oral area.
Once the wart is removed or has cleared, self-inoculation is possible as well....but would this probability be reduced because there is no visible wart or is it more dependent on time?

Thank you very much again.




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
48 months ago
Probably all true. But don't forget the main message:  Having HPV is an entirely normal, expected consequence of being a sexually active human being. Happily, most infection are harmless. But assuming you remain interested or curious, please limit further online research to medically sponsored and/or monitored sites, and entirely lay of those dominated by people with HPV or concerned about it. That's the worst possible option for useful information. Good sites included CDC (www.cdc.gov/std) and ASHA, the sponsor of this forum (www.ashasexualhealth.org).

That completes the two follow-up questions and replies included with each thread, and so concludes this discussion. Thanks for the thanks; I'm glad to have helped.

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