[Question #3962] HPV-Genital Warts confusion

33 months ago

I realize that some questions can be anxiety related, and my opinion would be that many questions concerning STI/HPV are slanted that way. So, for that I apologize for any anxiety related to it, it's not your job to help me with that. That being said, I appreciate information to help me understand my sexual health to a greater degree. I appreciate your expertise and explanations, there's just no one else to really ask that has that level of understanding. 


I went to my doctor because I had a spot on my left testicle that turned out to be a mole. I had gone in to my dermatologist to have it evaluated to make sure it was not STI related as it was not. However, I asked him about Genital Warts- their time frame and if they come back and what he mentioned was different from what I've read from experts (you), ASHA and CDC.  My doctor was also different from the dermatologist and more along The Expert opinions here. 


1.My understanding from this site and ASHA was that Genital Warts (GW) are self-limiting in that if they do show up and when they are removed they may reoccur once, but then do not return in men unless severely immunocompromised via chemotherapy/AIDS, etc? I read one answer by Dr. Hansfield that stated that most STD experts, gynecologists, etc...rarely, if ever see recurrences of genital warts once they are gone. Also that some (most?) clear the virus and some notice recurrences, but typically only for a short while and then they are gone.


2. Do they behave like the other HPV's in that once they're gone, they're gone?  


3. My dermatologist said they can come back with just a little dip in the immune system and used the example of cold sores (HSV-1)that come on with fevers and such (I know he has to cover his butt to some degree if something happens). My family doctor said that whenever you get the virus, you get the warts and that if they dont' show up in three months they won't show up ever and he disagreed with my dermatologist in that he stated that they don’t usually come back and they don’t stay latent. That corroborates the general undertone here that they don't come back and I believe Dr. Hook quoted after a three month timeframe from last wart removal?  


4. I’ve never had them that I know of, is it less typical to see a recurrence if you’ve never had them?


5. You are the experts, I’ve just been given some confusing information and I’d like to know the accepted information out there if possible?  


Thank you very much.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago

a1,5) I'm not going to debate (indirectly) with your doctor. Knowledge about HPV continues to evolve, but based on current research and other available information, we stand by our advice on this forum as the consensus among experts.

2) HPV DNA sometimes persists forever, but probably not always. Recurrent active disease (e.g. overt warts) is uncommon, but happens sometimes.

3) There generally are no known reasons, whether a "dip" in the immune system or others, for recurrrent active HPV infections. It appears to be random.

4) First appearance of warts usually is the result of a recently acquired HPV infection, not commonly recurrence of a distant past infection.

Let's make this your last question about HPV on this forum . Thank you.