[Question #3602] HPV & Genital Warts

35 months ago
Hi there. Thanks for the forum. As someone who has had extreme, and diagnosed generalized anxiety disorder and OCD, I've always feared STDs. I've had nothing but normal pap smears and normal blood tests, but I've had high risk HPV twice. In absence of abnormal smears, this is no biggie. I'm dating a guy (3 months now) who recently told me that his dermatologist suspects a few genital warts on his shaft. I saw them when we first started being sexually active, but they didnt look like warts to me. His primary care physician told him they were skin tags so net net, he's getting conflicting opinions. We've always worn condoms. He got the "suspect wart" cut off for a biopsy and he was told warts do not go away - which I know, is not true, according to my gynecologist - and that's only the case if you're a smoker/immunocompromised. My boyfriend has gone crazy with research online but I want to confirm with experts to ease his mind that this is totally normal. He was in a relationship before me so he feels "dirty" but I think thats nuts. My questions are as follows:

1. If they are warts, and he treats them, how long until we have to stop wearing condoms?
2. Is it a guarantee that I'll get the warts? I've had my HPV shots, I redid the series 2 years ago. 
3. Do we abstain from sex until the warts are gone?
4. What's this mean for our love life? This is in no way a dealbreaker for me, I think warts are nothing but a nuisance. They hardly lead to cancer.
5.  Is he bound to get reoccurences? I was told you grow immunity to that particular strain once the warts are gone. 
6. Should I go get checked? I've never seen anything abnormal down there and trust me, I check :).

Thank you in advance!
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
Welcome to ur Forum.  I'll do my best to help.  There are several issues in play here.  I appreciate your mention of your own anxiety issues and it sounds like your BF may have some as well.  I am not the person to help you with your anxiety issues but I will do my best to help you with available data on HPV.  In addition, I would suggest that you and your BF both read some of the other posts related to HPV that are present in our replies to other clients on this site.  Part of our intent is to have those posts present to help folks sort out their concerns related to STIs. 

Before I address your specific issues, please let me provide some generic advice.  First, regarding HPV, current scientific data suggest that more than half of sexually active adults will have HPV, whether or not they know it.  The numbers of prior sexual partners make little difference because the infection is so very common.  Further, in well over 98% of persons with HPV, the infection, if people are aware that they are infected (most infected people do not know that they are infected) is nothing more than a nuisance that will resolve without therapy and cause no lasting problems.  The key to HPV management is avoidance of complications since in a very small proportion of infected persons, the infection can progress over a period of years to precancerous lesions..  The purpose of regular sexual health check ups is to detect infections if and when they progress so that they can be cared for.  Your own experience shows that most HPV infections, even the so called "high risk ones" go away without therapy or progression. 

The second piece of advice I have is to suggest that you ( and your BF) stay off the internet where misinformation and incorrect statements are all too common. 

1. If they are warts, and he treats them, how long until we have to stop wearing condoms?
Start with finding out of they are warts.  If they are and he has them treated, in general, if they stay gone for three months they are gone for good.  To be honest however, because we do not feel that HPV infections are a major health problem, our own stance in that if all else is well , there is no need to use condoms.

2. Is it a guarantee that I'll get the warts? I've had my HPV shots, I redid the series 2 years ago. 
No, the HPV vaccine is VERY effective and reduces risk for warts over 97% .  From out perspective, another reason to not need condoms- you are protected (BTW, good job on being vaccinated)

3. Do we abstain from sex until the warts are gone?
See above.  I would not

4. What's this mean for our love life? This is in no way a dealbreaker for me, I think warts are nothing but a nuisance. They hardly lead to cancer
You and I are on the same page.  Don't let these nuisance viruses impact your love life.
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5.  Is he bound to get reoccurences? I was told you grow immunity to that particular strain once the warts are gone. 
About 1/3 of persons treated for warts experience recurrence, typically within three and certainly by six months after successful therapy.

6. Should I go get checked? I've never seen anything abnormal down there and trust me, I check :).
Nope, just go for your regular sexual health checks.  Given your history, I presume your doctor does the appropriate testing

I hope these comments are helpful.  EWH
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35 months ago
Thanks for your responses, Dr Hook! I read through some of the posts on the website and it seems like your responses are the same: it’s really not a big deal. There was one question I had left that I couldn’t find answered: 

I guess if they reoccur, will they always keep reoccurring? Or do you eventually have “immunity” or something? I would think eventually they go away at some point. 

Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
 Good question. There are no absolutes in medicine however in most instances when warts are treated and recur, they need to be retreated only one time. I hope this is helpful. ---
35 months ago
Hi Dr Hook - thanks for your response and guidance. His doctor confirmed they’re genital warts but it’s no biggie. We feel fully informed now. 

My one last question is unrelated - he got a full panel of STDs and only his HSV1 came back positive. He can’t remember ever having any cold sores or genital outbreaks due to HSV1. I’m prone to cold sores so I always test positive for them. Should I be worried that his HSV1 could be genital? Would it be possible for me to get it on my genitalia? Thank you! 
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
Given that you occasionally get cold sores and that he has a blood test which is positive for HSV-1 means that neither one of you can give infection to the other.  Once a persons has HSSV-1 at any location, they cannot acquired a new infection at any location from anyone else.

FYI, while HSV-1 does occasionally cause genital herpes as a result of oral sex, most people with HSV-1 have acquired it during childhood often without knowing it and often go through life without experiencing cold sores. 

I hope this information is helpful to you.  As you know, the Forum provides up to three responses to client questions.  This thread will be closed shortly without further responses.  Take care.  EWH

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