[Question #4725] Reoccurrence or genital warts

28 months ago
Hi there. I’ve been to this forum board before but this time I’ve come with a new situation that I’d like some guidance on since we’ve received such different feedback from dermatologists and OBGYNs.

My boyfriend was diagnosed with a few warts in April, needless to say, it’s been an emotional time, but this didn’t change our love life. He had the warts removed and was told there’s a high chance they’ll come back and he’ll have them for life. He went back in September because he think his doctor might’ve missed one, and his doctor said he had missed it too. To be safe, he removed everything he “suspected” was a wart or close, just to give my boyfriend peace of mind. I had my HPV test and pap in July and I was normal, I’ve only had normal paps. I also repeated my Gardasil shots last year. However, we’ve used condoms until this point and we want to cross that line of intimacy. 

Today, my boyfriend thinks he has a new wart (making an appointment to confirm) and is really feeling defeated. He’s convinced he’s going to have this for the rest of his life and I’ve assured him he won’t.  I guess my question is- why do they keep coming back? Is it because of me? Will he have it forever? What information can you provide that might change his perspective? The information is so misleading online and his derm has given him no hope.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Welcome back to the forum. Thanks for your continuing confidence in our services.

Sorry you've had variable advice from different providers. Unfortunately, this is common -- knowledge about HPV and warts is evolving and changing, so it's often difficult for some physicians to keep up. Their perspectives also can depend on their own clinical experience, which often is biased. For example, dermatologist are especially likely to see patients with recurrent warts and other atypcial cases. I'm guessing that's the source of advice that there's a high chance of recurrent warts and that he'll have them for life. That simply isn't true:  the large majority of people with genital warts have prompt clearing with treatment and never have recurrences. You're reassurance to him sounds accurate and appropriate.

That said, I can't tell whether he really had a recurrent wart. Probably not, especially if the doctor him/herself wasn't sure about it. Your own HPV history makes little difference in your boyfriend's diagnosis or risk of recurrent warts.

For the few people who do have ongoing problems with recurrent warts, there is no known cause. People often assume some sort of immune system defect, but none has been found. (This assumes he doesn't have any cause of overt, high level immune deficiency, like HIV, cancer chemotherapy, and so on.) Nothing in this is because of you in any way.

As for changing his perspective, I'll just remind you and him that although nobody wants warts, genital or anywhere else, it's really not a very important health problem, or shouldn't be. Look at it as a minor inconvenience, not an important health problem. Most likely this won't continue long -- but even if he has the occasional recurrent wart as the years pass, it reallly shouldn't be a big deal.

I hope this information iis helpful. Let me know if anything isn't clear.

HHH, MD
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28 months ago
Thank you for your prompt reply! This is all reassuring to hear.

To reiterate, it is likely not a reoccurrence, is that correct?  If it’s not a reoccurrence, is his body just not clearing it or is it a new infection? I guess we’re just trying to figure out what is the source. When will we be able to tell when it is gone for good? He’s just nervous that I’m going to get them and he doesn’t want to pass them to me if we can help it. I understand that too. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
If he had previous GWs within the past 1-2 years, then probably this is a recurrence. The longer ago it was, the more likely it's a new infection. But there are always exceptions and it's rarely possible to know for sure.

However, what is almost 100% certain is that he did not acquire his warts from you. Because of past Gardasil, you are immune to the two HPV types (HBV6, HPV11) that cause almost all genital warts.
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28 months ago
Thank you for your continued guidance. Everything makes sense. Sounds like it’s just a recurrence since he originally discovered them last year and was misdiagnosed. Just a few remaining questions.

1. When can we consider the warts gone for good? 

2. We thought we were in the clear when they were removed in April and September but if we find out that this one potential wart is back, it would be his second reoccurrence. Is there anything preventative we can do? I know this isn’t typical.

3. Should continue to wear condoms? Does it matter?

4. What are the chances that I get warts? 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
1. When they no longer are visible and have not recurred in the next 6 months. This isn't hard and fast, but a pretty good ballpark figure.

2. Sorry, but no specific prevention strategies are known to be effective.

3. Since you've been having sex all along, there is no point in changing your sexual practices now. Condoms are not necessary and never have been.

4. Virtually no chance. As discussed above, due to past Gardasil, you're probably immune to your partner's HPV infection. Even if you had not been vaccinated, if no warts show up within several months of an ongoing relationship of someone with warts, usually they never will.

That concludes the two follow-up questions and replies included with each initial question and so ends this thread. I hope the discussion has been helpful. Best wishes and happy holidays.
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