[Question #4098] Dr. Handsfield; multiple skin tags

32 months ago
Hello Dr,

About six months ago I was shaving and noticed a small white bump on the shaft of my penis where it meets the scrotum. Worried it was a genital wart, I went to my dermatologist (whos a diplomate of the american board of dermatology) and he said it was a skin tag and froze it off. Fast forward to now, I was shaving again this morning and noticed 3 hard little white bumps on the right side of the base of my penis. I went back to my derm and he said it's just more little skin tags, and froze them. They now turned from white to black. They were probably about a 1mm wide, really small. Why do skin tags occur and how can I prevent from getting them? Can I assume this isn't HPV? For some reason I can't shake that they might be. I haven't had sex in 7 months. Can I have sex with my girlfriend ? My birthday is in two weeks and I'm feeling down in the dumps. All other tests are negative. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Welcome to the forum. Thanks for your question. (It is only by chance that I am answering. Dr. Hook and I take the non-herpes questions in turn, regardless of requests for one of us or the other.)

Unfortunately, I doubt I can help very much. Clearly your problem was skin tags, not warts:  no dermatologist would confuse the two, and there is no reason for you to question the diagnosis. Skin tags are a normal anatomic variant, not a disease or infection. Because they are not an STD, I don't know much about them. Your dermatologist undoubtedly knows more about skin tags than I do. To my knowledge, there is no particular cause; they just happen, more often in some people than others. They definitely are not warts and are not due to HPV. You can safely have sex with your girlfriend -- skin tags are not infectious or transmissible, and there is no rational reason not have had sex the past several months.

I hope these answers are at least somewhat helpful. Let me know if anything isn't clear.

HHH, MD
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32 months ago
Yes, thanks so much for the clarification, Doc! When a guy thats not medically educated sees something down there and can't forsure tell what it is, we get kind of freaked out and jump to the worst conclusion. It's kind of pretentious for me to think its something else when 2 prestigious medical professionals are telling me it's nothing to worry about. I will carry on and drop it and not worry about it anymore and take his visual diagnosis and your input as a definitive answer. I got tested tho last month after 6 months of no sex and am negative for everything including hsv1 and 2. I guess what worried me is having 1 six months ago and 3 or 4 now that were so small I barely noticed them under my pubic hair. I guess I'm just worried about hurting someone else. My last question is, when men do actually experience real hpv symptoms and not skin tags , how long does it take for them to be non infectious or for the infection to be cleared by the immune system? I know most sexually active people have, will have, or had HPV and it's safe to say most of us have had it even with vaccination but how temporary is hpv?
32 months ago
Also I was vaccinated for hpv 2 years ago when i was 18 years old after my third partner. Is it safe to assume that any silent HPV I may have gotten from my first three partners has cleared my system in that 2 years and that after i was vaccinated the vaccine protects against the strains that cause genital warts, and that any strain of HPV I have now if I even have it is a silent infection since these skin tags are unrelated? HPV is really hard to understand. How well am I protected? Have had 4 more partners after vaccination. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
31 months ago
Thanks for the follow-up comments.

Precise data don't exist on when HPV becomes infectious for persons exposed, but it's probably before symptoms (e.g. warts, abnormal pap smear) appear, maybe a few weeks after catching it. In general, most HPV infections are cleared by the immune system over 6-24 months.

Warts are uncommon in the pubic area (i.e. in the pubic hair area) -- even more likely to be something else, such as skin tags.

That you were vaccinated adds to the evidence you had skin tags, not warts. You're still susceptible to many HPV strains not covered by the vaccine, but you are 100% protected against infections that cause 90% of genital warts and 90% of cancers. Beyond that, don't overthink it. Disregard HPV:  it's not ever going to be a significant health issue for you or for your sex partners. Just forget about it, like almost everybody else does!
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31 months ago
You got it, Dr Handsfield! Thanks for all the solid information. I know this is my last response but I just had one more question. I was seeing this girl and all we did was make out but she ended up telling me later that her job was escorting. My nose or her nose started bleeding while we were kissing. Am I at risk for HIV from this encounter or no?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
31 months ago
Escorts (expensive female sex workers by appointment) are generally at low risk for STD. Most know the score, care about their health, use condoms for vaginal or anal sex, get tested frequently, and often do their best to choose low risk male clients. The chance she has HIV is extremely low. And if she does, this small amount of blood exposure would carry little if any risk. You really needn't worry about it.

Thanks for the thanks. Best wishes and stay safe.
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