[Question #5054] HPV Question involving Marijuana; transmission; and clearance.

24 months ago
170 pounds, 5'8, hispanic, and 22 years old.  

I had the wart for a year,  It was a single slightly wart that somewhat looked like a callus.  and it was just removed by a biopsy. 

I had the gardasil shot about 10 years ago 

1) Does the biopsy treat it the same way as cryotherapy? I've heard "Clearing" time only starts when the wart has been removed. is this true/the same for biopsy or only cryotherapy?

2) I currently smoke Marijuana once a day.  Will it take me longer to clear it if I'm a regular marijuana user? I've read on reddit  that if I don't stop smoking weed I won't clear it.  Someone on Reddit said that he had an outbreak right after smoking marijuana so he's connecting the two due to marijuana affecting the immune system. And some other guy on reddit posted a bunch of scary looking studies. 
(Here are the links) 
http://jpet.aspetjournals.org/content/367/1/49.abstract
https://www.karger.com/Article/Abstract/247670

3) How does anyone know they "Clear" the virus? Do you just stop having warts? And at what point do you recommend that I can have unprotected sex with future partners without having to worry about giving it to them?

4) I don't know if this is hippie mumbo jumbo: But I've read on reddit in order to clear it I must follow a healthy diet, exercise, not smoke weed or drink, for two years and sleep well so that my immune system is strong. Is this true or does the body do it naturally w/out supplements? 

5)Do "Medical mushrooms" increase your immune system? would you recommend supplements for the immune system?

6) I currently have a partner, will we ping pong this infection to each other or can we continue to have unprotected sex and clear it together? Will she reinfect me or will i reinfect her? Do you recommend condoms? (Assuming the vaccine doesn't cover my strain) She might have gardasil 9 while I have gardasil (The original one)

 7) Once cleared, if I get sick, will this come back? Is this a life sentence? Will it come back in 3-10 years if I get sick?
Edward W. Hook M.D.
Edward W. Hook M.D.
24 months ago
Welcome to the Forum. I'll try to help.  We get many questions on this Forum regarding HPV and warts and in addition to considering my replies, I would suggest that you read some of our interactions with other clients.  you will find that, in particular, we have discussed the topic of HPV clearance and persistence many, many times.  

Before I address your questions, can you tell me if your wart was a genital wart?  I ask because following the Gardasil vaccinations, genital warts are quite uncommon although people often do get other types of warts.  

Working through your questions:
1.  The term "clearance" refers to a wart going away without therapy.  On the other hand, for many persons an excisional biopsy which removes a wart may be a curative procedure with a relatively low likelihood of having the wart recur.
2.  There is no scientific basis for the idea that smoking pot will in any way affect you ability to clear your HPV infection.  This is a myth.
3.  The term "clearance" can mean either that a visible wart goes away or that HPV that is detectable only with lab tests can no longer by detected.  In either case, the DNA of the HPV remains in the body but is quiescent.
4.  This is BS.  I urge you not to use reddit as a source of medical information.  There are many reasons to want to stay health but the idea that without supplements, etc. you cannot be healthy is just plain wrong.  
5.  I know of no proven benefit to taking "medical mushrooms" in terms of helping you fight infections.
6.  There is no reason to go to condoms because of the wart that was noted.  
7.  Few warts recur unless the infected person gets profoundly immune compromised, such as receiving cancer therapy or getting HIV.  I would not worry.

I hope these answers are helpful. EWH
---
24 months ago
Hi Dr hook, this is gonna sound extremely creepy but you, Dr handsfield, and Terri Warren are my heroes. If you guys are ever in New York I'd LOVE to meet any of you. You guys are the shining light in this shitty world of bad education, and I admire that a lot. Whenever someone gets bad information I immediately recommend people to these forums. I think the work you guys do is absolutely amazing and you guys educate so many people in the right direction. I've been following you guys since I was 14 and was in health class (ever since medhelp)

But regardless, yeah, the dermatologist said it came out positive for a genital wart that had hpv (when the biopsy was done) she said that she was gonna get more genetic testing to determine the exact type.

Here are some follow ups

1) Am I ever gonna be able to not be contagious? Is that what "clearing" also means ? I feel like there's a slight confusion 

2) Really?! I don't have to stop smoking weed?! The whole "Oh your immune system is compromised " bs seemed so legit to me I almost quit completely. I have some pretty major PTSD from my home country's violent gang warfare so sleeping is a nightmare for me without it.. 

3)can I also drink? 

4)When the wart goes away, how long after that am I not contagious?

5) I bought sentry men's plus 50 as a multi vitamin.. does it make sense that I take supplements to make sure my immune system isn't bad to fight this off or is it a waste of money?

6) when you say biopsy cures it.. what do you mean?  Is it because it removes infected tissue? Or is my whole penis infected?

7) If I keep having sex with my girlfriend, am I gonna keep reinfecting myself? Or does it work like herpes where the body builds a somewhat strong immunity?

8) As heavy metal as this may sound, would you recommend I biopsy every wart I get? Or cryotherapy? 

9) If my girlfriend isn't infected, what would be some preventive measures I could take?

10) Okay, from what I gather I see these guidelines please correct me if I'm wrong 

11) If I clear the virus, am I likely to get it again?

1 Time will clear it
2. After six months of no warts it's cleared
3. I can smoke weed and eat what I usually do
4. Biopsy might have cleared me
5.  Don't go to Reddit for medical advice

Why is it that some people don't clear the virus? And how likely is high risk to cause permanent damage? 

Edward W. Hook M.D.
Edward W. Hook M.D.
24 months ago
 Thank you for your thanks. We appreciate it when we hear that our messages are helpful to the people we try to serve.   It will be interesting to find out what type of HPV was in your ward. The HPV vaccine you took should have preventedthe two types of HPV that cause over 95% of genital warts.  I think some of your Followup questions are a bit redundant.  Let's address them.
1.  I think you are a bit confused by the concept of "clearance".  If the wart is gone Ned does not recur for 2-3 months, you should not consider yourself contagious.  Further, the fact is that most people will get HPV 
2.  Correct, I answered this before.  Of course you can do anything to excess but it doesn't sound like you do.
3.  Yes, you can drink as well, once again, not to excess.
4.  I answered this before.  If the wart is gone and does not recur for 2-3 months you are not contagious.  As I also said, particular for your current partner, she is already exposed.  No need to change your sexual practices at this time.
5. If you eat a normal balanced diet, yor probably do not need vitamins or supplements.  There are no high quality scientific studies which indicate a benefit of vitamins for persons eating a normal, healthy diet.
6.  The biopsy removes the infected tissue.  Your whole penis is not infected.  HPV infections are focal.
7.  See comment. 4 above.
8.  No, I do not see a need for every wart to be biopsied.  If warts occur,have them treated.  Cryotherapy is fine.
9.  Repetitive.  See no. 4 above.  Your current GF is exposed.  No need to change your sexual practices at this point.
10.  ??
11.  Can't be entirely sure but between your prior HPV vaccination and treatment, excisional biopsy the wart you had is unlikely to recur.

So, 1-5 are on target.

Hope this helps.  EWH
---
23 months ago
Hi doctor hook! So, they diagnosed me with hpv 31 or 33 (Genetic testing of site)

I had some questions
1) those strains don't generally show warts.. is there any reason why it did for me? 
2) I was googling it, and it seems that people with HIV get warts from high risk types. Should I get tested? 
3) what precautions should I take?
4) How will I know if I have cleared this considering it doesn't generally show warts? Have you ever had a patient like me? Is there a time frame I should wait? 
5) when I went to the dermatologist but she didn't know what she was talking about, so she sent me to an "Infectious disease specialist" with like two star reviews on Google. Should I go?
6) If I had this wart for a long time, does that mean I won't clear it?
7)Should I go to an urologist to check up on oenile cancer ? Is that a concern?
8) Am I gonna ping pong this back with my partner? Or can we clear this together? 

Thank you for everything. Sorry for all the questions I'm just anxious 
Edward W. Hook M.D.
Edward W. Hook M.D.
23 months ago
Straight to your final questions (this is my 3rd response, therefore, as per Forum Guidelines, this thread will be closed after this response without further replies).

1.  All HPV types occasionally cause visible warts but some do it usually (types 6 and 11) while with other types the majority but not all lesions are not visible.  That your warts contained type 31 or 33 (which are in the newer HPV vaccine but probably not the one you got 10 years ago) does not mean that anything is wrong with you.
2.  No.  Testing is not recommended.  If tested and HPV was found, most clinicians would not recommend any specific treatment, just observation
3.  None, the warts are removed, you have had the vaccine which covers the vast majority of HPV types.
4.  You had a visible wart, it was removed by the biopsy.  If it does not recur in the next 3-4 months, consider it gone.
5.  That is, of course, up to you but the ID specialist may be helpful in answering some of your questions.  If you go you may wish to print out this thread and share it with her/him.
6.  The longer warts are present, the less likely they are to clear.  I thought the wart was removed with the biopsy.
7.  No.  While HPV is associated with cancer of the penis, this is a rare disease which takes decades to develop. there is no need for check-ups unless you develop a new visible lesion.  Your dermatologist should have checked you for this - this is their field as well as the urologist's
8.  You asked this question. The answer has not changed. There is no reason to change your sexual activity with your partner who has already been exposed.  There is little risk of ping-pong infection.

I hope these responses are helpful to you. Take care.  EWH
---