[Question #3394] Genital warts

89 months ago

Female 45 just diagnosed with genital warts by dermatologist biopsy confirmed. For last two years at 6 mos intervals for first time in my life had slightly abnormal paps but normal colposcopy and this past fall my pap became normal again. All my HPV tests have always been negative which I know only check for high risk cancer causing strands. But now a few months later discovered a few warts which I think one might have been there during this past time thought it was a skin tag which went away. Could these both be related as I heard low risk strands that cause warts could also cause slightly abnormal paps? My OBGYN is away and NP who examined me after dermo did not think it was related. Being that my pap is now normal maybe warts will clear too. Can I still fight off this virus once symptoms develop and suppress it just like others who don't know they even have it? Dermo was overwhelming and upsetting stating lifelong infection always be contagious and have to tell future male partner. Is mine now in a "disease" state which is different lasting a lifetime with recurrences being more contagious to someone even when I don't have warts than someone who is carrying it never getting symptoms? I've heard on your site after 6 mos of no warts I'm really not contagious anymore but told by dermo they could come back after a period. So much conflicting info and more bad than good. Since 3 questions already I understand if no follow ups will be allowed.

Edward W. Hook M.D.

89 months ago

Welcome to our Forum I will try to help. (BTW, this is all just one, complicated question. You still may make up to two follow-up questions. In addition, we answer many questions about HPV infections and genital warts on the Forum so I encourage you to also continue to look at other interactions on the Forum which discuss questions related to HPV and genital warts. Part of our goal on the Forum is to post these questions so that others can learn from our interactions with other clients on this topic.

Hopefully the biopsy completely removed the wart and if it did, unless it recurs I would not worry further.

The fact that your PAP smears are now normal. Many slightly abnormal PAP smears are due to causes other than HPV and do not indicate a need for concern. Even if the abnormality does recur and if HPV were detected, that is not something to worry about since the reason we do PAP smears is to detect dangerous, pre-cancerous lesions so that they can be treated before they progress to syphilis. i would simply continue to get regular PAP smears.

On this forum we consider genital warts as a nuisance and for this reason we do not feel that it is necessary to inform current or future sexual partners that you have warts. They are widespread (at least 1 in 10 Americans will have genital warts at some time) and do not cause serious complications or sequelae. When they appear, they are usually easily treated by dermatologists or other clinicians. Following treatment about 1 in three warts recur within three months following treatment but they can be re-treated if this occurs.

Most but not all genital warts are caused by just two types of HPV, HPV 6 and 11. Detecting a new genital wart is not a reason for concern.

I hope this information is helpful. If there are specific questions that I have missed, please feel free to use your follow-up questions. EWH

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89 months ago

Thank you so much dr your site has been helpful and things explained in a positive way. Biopsy was done on one wart just to confirm HPV. I have others that I am going to start Aldara cream for. You mentioned paps and which are used to monitor changes for cervical cancer so I didn't understand the "syphilis" comment? And yes mine came back normal now and I never had high risk HPV detected. My main question is even after getting the symptoms of warts can my immunity still fight the HPV virus and suppress it not being contagious anymore and leaving me wart free or is this now considered a lifelong STD with recurrences common? What would be a safe time period to assume I did possibly clear it? I thought it was a risk to a current partner if warts are present to continue sexual activity or could they be immune and doesn't really matter..especially if you been together for awhile? Would it really be ok not telling a partner about current warts or past ones? Also what are the chances a male partner can contract my HPV via orally or hand to genital? Thank you for your time

Edward W. Hook M.D.

89 months ago

Thanks for your follow-up. I apologize for the mention of syphilis in my earlier reply. I had just given a lecture on syphilis and typed the word syphilis when I meant to type cancer.

As for your other follow-up questions:

Your Adara treatment should work well for the warts you have. Your own immunity would fight them even without the Aldara and the Aldara should help the warts to go away. Most scientists agree that the HPV virus may remain present in to your body even after the warts and/or HPV are no longer detectable. That should not be a problem for you however. Remember, the majority of sexually active persons carry this virus.

Once your warts have cleared, you should not be contagious for others and your warts are unlikely to recur if they do not do so in the three months after they have cleared.

Regarding infectivity for others. there is not a lot of specific information on HPV transmission rates related to specific sex acts or per exposure. Infections are already too widespread for this to be easily studied. There is no reason to abstain from se with your current partner- they have already been exposed and as I mentioned to you, we recommend to others that it is simply not realistic to feel the need to warn future sexual partner that you have or have had HPV- as sexually active adults, they have most probably already gotten the infection as well whether they know if or not. (Admittedly not all persons agree with this but most other experts agree with our stance).

I hope these further comments are helpful to you. EWH

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89 months ago

Thank you so much for your response Dr. and putting my mind at ease. Also, with all your hard work about so many diseases it's easy to make a typo :) Lastly, to end this thread. Is it common for these type warts to make their way internally. Mine are mild none were seen vaginally but dermo suggested maybe seeing a proctologist and I would rather wait. Is it correct that since it is transmitted skin to skin, the body part or area that the virus enters is where it only infects? I know the virus can stay dormant for years before exhibiting symptoms, but is it possible that someone can also be a carrier for many years even decades passing it to another but never exhibiting symptoms? Thank you again and hope all on this site feel better

Edward W. Hook M.D.

89 months ago

No, for the most part the HPV viruses that cause visible genital warts are relatively uncommon at the cervix and at other internal sites and, even more importantly, very rarely go on to lead to cancer and pre-cancerous lesions.

You are correct that typically HPV infections are local infections which occur at a site of inoculation and do not spread to other sites on infected persons bodies.

Your question about transmission of dormant infection years after infection cannot be answered. It appears to be very unusual however although this issue cannot be readily studied.

I hope these replies are helpful. I urge you not to worry about your genital warts and to consider more of a nuisance than anything else. With this, this thread will be closed in a few hours. Take care. EWH

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