[Question #3642] Is this HPV?

35 months ago
I am married and have been with the same woman for 10 years and we were both screened for STDs prior to engaging in a sexual relationship. I recently had a relationship with another woman on two occasions where I engaged in unprotected mutual oral sex and protected vaginal sex with her. She said she had an STD screen after her last sexual relationship but it was clear, but I don't know how thorough it was. 

12 days after the first of two sexual encounters,  I noticed about 6 white/fleshy colored painless bumps on my scrotum accompanied by a "burning" (and sometimes itching but this doesn't feel like it's unusual) feeling on my entire scrotum and the tip of my penis. There is nothing on the penis itself or visible inside the urethra. The burning sensations comes and goes. I also have itching 2-3 inches around my anal area (though I didn't receive anal sex). There are no visible bumps in the anal area. 

I read that HPV doesn't appear this early after the initial exposure and I had a nurse practitioner and an STD Health Clinic nurse examined me. I also was checked for various STDS and the bumps were swabbed to eliminate HSV2, but the results are a week away.  These medical professionals didn't find the lumps suspicious and think it is possible folliculitis, but given the proximity to the event, that doesn't give me much comfort. I did wash up after sex with very warm water and hotel bar soap and urinated after the encounters. Could this be warts or something else? This is causing me anxiety and I don't want to give anything to my wife. 
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
Welcome to our Forum.  While I find it most unlikely that the bumps you have noticed are warts, before I give more detail, I have to tell you that when I saw the title for your question I thought to myself, so what if they are?  Most sexually active persons will have HPV at some time in there life and there is no reliable way to tell where HPV infections came from for most people.  Further, on this site, our general stance is that HPV infection is a nuisance except for the very small (less than 1%) of persons for whom the infection proceeds to form treatable pre-cancerous lesions (primarily a problem for women).  So, with that as background let me tell you why I find it unlikely that here "bumps" you noted are HPV.

1.  Too soon.  Warts typically take 1-3 months to appear after acquisition of infection.
2.  Unusual location.  Most warts in men occur on the penis.  Scrotal warts are relatively uncommon.
3.  Are you looking harder than before?  Following a worrisome sexual encounter it is typical for persons to look harder for signs and symptoms of infection than they normally do.  this results in people noticing normal findings that have not been noticed in the past.  The normal scrotum regularly has benign cysts that can increase and decrease in size and well as other irregularities.  I suspect that this is what was seen.  That two experienced health practitioners have examined you and felt they were not warts is strong evidence that they are not.
4.  Condoms protect against warts (not entirely but they reduce risk).
5.  HPV infections are less common after oral sex.

When you put all of these reasons together, it becomes very, very unlikely that what you have noticed are warts.  My recommendation is to stop self-examination and move forward without concern.  I hope that my comments will help you to do this.  EWH
---
35 months ago
Thank you for the reply. What is odd is that the symptoms, which now include an itchy/burning sensation around my anal area and a redness that extends about 2 inches to each side of the buttocks, all happened after this new sexual encounter. When reading various reliable websites, the information about HPV varies. I had a couple more questions:

 What could be the possible cause of the itching? Do warts that haven't come to the surface cause large scale itching (like of the scrotum and anal/inner buttock area)?
If I get her test results and she is negative for HPV, and so is my wife, would that, by elimination, mean I likely don't have it? I know it can incubate for years before anything happens so is it possible that it coincidentally occurred now? Also, if it is HPV, will it spread to other areas or through the toilet seat, or if I scratch myself then touch another area of my body? 

Again, thank you for your answers.
 
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
The sensations of itch and erythema (redness) may be normal and are typical of what folks observe when they start looking for signs and symptoms.  Really.  Think for a second of how your shirt feels on your neck- for most people they will become aware of a mild itch.  Further, if you scratch, the itch becomes more prominent- really.

If she and your wife have had sex with others, ever, I would not bet on a negative HPV test.  In fact, for reasons mentioned above, odds are that one or both will be positive.  If either has it, as you point out, odds are that, given your time line, that it was acquired previously.  My advice is to not try to look/find out.

HPV is not spread by scratching.  EWH
---