[Question #4642] Genital Warts - Worried about disclosure

29 months ago
Hello,

I recently noticed that I have what appears to be genital warts- a cluster of 3 flesh colored bumps on my pubic area. I'm devastated, because I haven't had sex in over a year and got the vaccine in '08, so I thought I would be in the clear for HPV. I'm going to planned parenthood on Tuesday but am a complete ball of nerves and sadness.  Especially since I've read some of the horrible things people say about folks with genital warts. I feel gross and like I'm riddled with STIs, especially since I already have HSV1 (which I'm not even sure if it's genital or oral). I have a few questions for you regarding HPV:

1. Why don't you feel disclosure is neccesary? Only ~25% of people get GW, isn't that means enough to warrant a disclosure? 
2. Does most of the medical community agree that GW doesn't need to be disclosed?
3. When am I safe to start having sex again?
4. Since it took over a year for my HPV to show up does that mean that it will take even longer for my immune system to clear it from my body?
5. What circumstances call for the disclosure of GW?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
Welcome to the forum. Thanks for your question. And also for reviewing other questions like yours, as evidenced by some of the questions you ask. (I happened to log in a few minutes after you posted your question. Most users shouldn't expect nearly real-time replies!)

The pubic area -- assuming you mean somewhat away from your labia and vaginal opening, particularly in the pubic hair area -- is an atypical location for genital warts to first appear. And if the bumps are fleshy and soft, that also would argue against warts, and there are plenty of other causes of skin bumps. So you're doing the right thing in your plan to have them professionally evaluated, and Planned Parenthood clinics usually are excellent choices to assure expertise in STDs. I'll give brief replies to your questions now -- we can get into more detail later if the diagnosis is confirmed.

1,2,5) Issues around disclosure of warts or other HPV infections are complex. We and most STD experts do recommend disclosure to current sex parnters. You may be confused by our advice to some users about past partners, or to future partners after warts/HPV have resolved. Rather than generalizing, if the diagnosis is confirmed, it would be easier if you just ask about specific current or past partners you have in mind and let's deal with them case by case.

3) Probably you could continue sex with current partner(s), i.e. no need to stop now. Same deal if a new partner is aware and doesn't mind. Otherwise, typically a couple of months after the warts respond to treatment.

4) Time for warts to appear isn't known to have any influence on how long they will last or that active HPV infection may persist.

I look forward to hearing from you after your clinic visit. I hope these comments are helpful in the meantime.

HHH, MD
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28 months ago
Okay so I just got back from Planned Parenthood. I made a mistake, this weekend I was anxious and it applied apple cider vinegar on the three bumps which caused them to scab over and flatten. The nurse that saw me said that because they healed/went away so quickly, she’s assuming they weren’t originally warts. I did have another bump I was concerned about and she confirmed that it was a cyst. I’m upset that I did the ACV test because now I won’t know for sure if I had genital warts. So my questions are:


1. Can genital warts also have ingrowned hairs in them? My bumps did look like warts  according to reddit’s subreddit r/dermatology (I submitted photos anonymously to the Reddit dermatology section and several supposed dermatologists  said they looked like they could be wartlike). But all three bumps had an ingrown hair in them. 


2. What do I do now? Should I tell potential partners about this? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
I too am sorry you treated the bumps with vinegar. In fact, vinegar has no effect on warts -- although related chemicals are sometimes used for treatment (e.g., bi- and trichloroacetic acid), vinegar isn't nearly strong enough to do so. So the fact that the spots are now less prominent than before argues against warts. In other words, I agree with the nurse who examined you.

1) A hair emanating from skin bumps is strong evidence against warts. I suppose it could happen once in a while, but generally not.

2) You should say nothing at all to current, past, or future sex partners.
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28 months ago
Hello again,

An update: 

So the cluster of three bumps that I had in my pubic hair area scabbed over and went away, revealing a flat surface (after I put the acv on it). A few days ago I noticed a bump that was in the same spot, it feels kind of like a cystic pimple that I’ve gotten on my face quite a few times. It’s not really raised but when I put my finger over it I can feel it in my skin... Could this be a wart? Should I have it checked out? I can’t stop looking at my pubic area, it’s almost obsessive. I’m just super worried about this. 

Also, you mentioned earlier that it’s atypical for warts to first appear in the pubic area. Is it possible that I unknowingly had internal warts and unknowingly spread the virus to my pubic area? 

Also, I’m fairly certain I got the Gardasil shot but it was back in 2007/2008. Do you know if that 07’ version of the shot protected against the 9 strains like the most recent one does? Would it be worth it for me to get another round of shots? 

Thanks
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Warts don't appear as cyst- or pimple-like bumps, so I doubt you have a wart. It's conceivable that whatever you had before has recurred:  if the treatment and healing sealed over a sebaceous gland pore, a cyst or pimple could develop at that spot.

Gardasil requires at least 2 and preferably 3 doses to be effective. I hope you had more than a single shot. If not certain, it wouldn't do any harm to be revaccinated. I don't recall exactly when the newer version (Gardasil-9, covering 9 HPV types) replaced the original vaccine, which protected against 4 HPV types.

That completes the two follow-up questions and replies included with each original question, and so concludes this thread. I hope the discussion has been helpful.
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