[Question #3473] HPV from hand/oral-symptoms

36 months ago
7 wks post exposure. Prev question was closed prematurely. Asian massage: finger her, body touching, me sucking nipple briefly, and single brief lick near penis head. NO genital-to-genital contact. No STI symptoms so far. I'm married 16 yrs, my 2nd sex partner ever. This is my first (and last) extra-marital contact, ever. I am my wife's only partner ever.
1. Reading you from past yrs on medhelp, and just today, words implying "Zero HPV risk from oral or hand-jobs". Is this true? Always couched with "no matter anway, as most people are already infected". Knowing my exact case, please tell me your thoughts on my chance of genital warts, or any other HPV? Obviously, a 1st infection dx could ruin my marriage.
2. I see/feel some very small bumps near the licking site on penis, I noticed at 6 wks. 1 looks like healing pimple, but same for 5 days. What should I look for?when,where?
3. I don't see MC mentioned here much; What are chances of MC infection appearing over the next several weeks/months? What should I look for?when,where?
4. Normal marriage sex maintained, no disclosure yet. Is she at risk of infection with HPV/warts, keeping in mind I'm her only partner in her life?
5. If (1st ever) warts or abnormal PAP appear on either of us, will this be directly resulting from my exposure, or coincidentally appearing from my sole other relationship 20 yrs ago?
6. How many cases of HPV have you personally seen contracted by an exposure such as mine? Any?

Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Welcome back to the Forum. This time I happened to pick up your question (Terri takes only questions of HSV).   I cannot comment on "premature closure" except to say that threads on this Forum are administratively closed after either three responses to questions or no response/interaction in a period of over 30 days.  Perhaps the latter issue was operative in your exchange with Terri.

I did read your exchange with Terri and agree with her assessment- this was a no risk encounter with no reason for concern.  I agree with Terri that there is no appreciable transmission of STIs, including HPV through masturbation (hand to genital or other non-insertive contact).  In science we say things like "no appreciable transmission" because we can never say never since new discoveries are made every day and incredibly rare things do happen- for instance there are people who have been struck by meteorites falling from space but such events, like transmission of HPV from through masturbation as to not be a realistic concern.  As for your specific questions:

1.   Please see comment above.  Further, it is likely that you have HPV from your first marriage (I think I may have read that in your earlier interaction with Terri).  In your specific situation however, given the virtual absence of risk from the exposure you have described, I see no reason for worrying ab out HPV from your dalliance.
2.  You may be detecting normal skin structures.  If you are really concerned, these should be looked at by an experienced dermatologist but I would not be worried.
3.   Nothing you reported suggests risk for MC.
4.  No
5.  This is an unanswerable question but I would not related it to your more recent misstep.
6.  Zero.

Clearly from your post, you remain worried and perhaps guilty about the extra-marital encounter you have described.  I also find myself wondering if you have been searching the internet for possible consequences of your encounter.  If that is the case, I urge you to stop.  the internet is far more often misleading and anxiety provoking than helpful.   EWH
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36 months ago
Thank you so much, my anxiety is greatly reduced. I'll try to take it to heart and put this behind me. You said the internet is not my friend, I agree. Virtually every other site contradicts your advice, possibly from sites of questionable motives or understanding, even some govt sites (states,different countries). Which leads me to questions out of curiosity, deep respect:
1.What's your team's motivation, or mission statement? Clearly not $,as I can't imagine you profit from the $25 fee. Are you seeing this as kind of a mission, to prevent suicides/marriage breakups? What gets you up in the morning, and what is your day job? Most advice you give attempts to calm down or downplay the exposure. I appreciate this.
2.Do you have strong pushback in conversation/conferences/journals with other specialists because of your stance?
3.Just a thought: You've seen how hard it is to get past the guilt aspect, combined with the uncertainty of a "ticking time bomb". I wonder, if hearing you say not to worry, then in a few months I turn out to be "struck by an asteroid", as it were, would I go back and pay the $25 to tell you that you were wrong? I think I would not, therefore, maybe there are more asteroid strikes than you know about?
4.I've seen charts, most say HPV can be transmitted via oral and hand-genital routes. Have you thought about producing your own STD chart, that jives with your advice here? Any published papers you have done?
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
1.   We carry out our activities on the site out of service to clients who are in need of information. As public health professionals we are aware of the huge amount of anxiety and and resulting misinformation out there. We seek the help with accurate science-based information. 
2.  No, our scientific peers, in general, agree with us.
3.  If that is your belief, that is your perogative.
4.  I have published over 300 papers in scientific journals on a variety of STI topics

 Please feel free to believe my replies or not. Nothing more to say. EWH
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36 months ago

Thank you for your response. I believe what you say, I just wanted to hear why you think you are more believable than other sources. I forgot to mention in my post yesterday (although I mentioned in my first one 6 weeks ago) that there was an intense hand job that finished my exposure. I wanted to make sure that was clear, and that doesn't change your assessment. My brain sure works hard to make me worried. Terry seemed a bit less emphatic than your response. I appreciate everything you do, and your professionalism and patience. Since the exposure, in the last 2 weeks, I've noticed some small "new" warts on my hand. I had warts in my late teens (hands and plantar), but never again, or I haven't noticed until now. I can fathom these may be related to the massage, which also heightens my awareness in the genital region. How soon do warts usually appear after exposure? Is this different for different people, or different sites?

Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
I am aware that the masturbation you received was "intense" and left you somewhat sore afterwards.  No change in my assessment. 

Typically it takes about 3 months on average for warts to appear following acquisition, sometimes taking as long as six months.  Further, the types of HPV (there are over 100 different HPV types) that tend to cause hand and plantar warts are different than they HPV types that cause genital infections.  Thus, I am confident that the lesions you have noted on your hands are unrelated to the masturbation you received 7weeks ago.  OTOH, your posts make it clear that you are being more vigilant for lesions than you might normally be.  In these situations, it is not at all unusual for persons to notice skin lesions and abnormalities that were previously unnoticed.

This is my third response to this series of questions.  Thus, as per Forum guidelines, this thread will be administratively closed in a few hours.  There will be no further replies from me although you may make further comments before closure if you wish.  I hope my comments have been helpful.  Please try not to worry about your no risk encounter.  Take care.  EWH
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