Background: 23/male. I had GW pop-up around 5-6 months ago. I only just got the warts frozen off last week and the warts are falling off. I have been advised to use Aldara 2 weeks after Cryo.

Q1. I know that HPV can be removed in 90% cases within 2 years. I also know that shaving will most likely spread the virus. A hypothetical scenario, if I shave in suppose 1 month, another wart will pop-up at the cut mark. Does the 2-year clearance time reset due to a "new" exposure/reinfection of the virus? 

Q2. Approx. 6 months after genital wart clearance with no recurrence - Is it "safe" to shave? If not, then when?

Q3. General testing question - after HPV I've been scared out of my mind about another STD. I got a complete STD screen on month 1, 2, 3 and 4 (CT, NG, HIV p24 ELISA, HSV1/2 IgG/IgM, Hep-A/C, RPR). All have consistently come out as negative - do you think it is safe to say that I can stop wasting my money on testing now?

Thanks!

Thanks as well for obviously having read previous questions like yours -- or so it seems, since you allude to things we have said on this and other forums. However, you need to understand that the data are not very good on recurrence frequency, time to reliable resolution of HPV and risk of recurrence, and related issues. The various time frames you cite are little more than common sense guesses based on our clinical expoerience. As time passes, we're learning more accurate science about it -- but not enough to give very precise replies to your questions.

Q1:  There are on data at all on risk of shaving and local spread of HPV or warts. It makes biological sense, but nobody has studied shaving frequency, its timing in respect to treatment, or how high the risk of local spread actually is. It is a rough estimate that most HPV infections are gone after 2 years, but I stress both "rough" and "estimate". After two years, I suspect most new episodes of genital warts are new infections rather than recurrence of old ones, but we really don't know for certain -- and it's definitely impossible to know for sure in any particular case.

Q2:  I would think it safe to shave, without risk of spreading HPV locally, 6 months after wart clearance.

Q3:  The standard STD tests are very good -- they virtually never miss infections if done sufficiently long after the last possible exposure. That time is 4-5 days for gonorrhea/chlamydia testing, and generally 6 weeks after all the others, except HSV which never becomes positive in some persons with HSV1 and can take up to 4 months for HSV2. Any and all tests done after those times were superfluous. In addition, I would never recommend testing for viral hepatitis or HSV after any single exposure. The chance of infection is too low.

Finally, I will point out that your concern about other STDs is not necessarily a rational response to having genital warts. HPV is so common that it does not effecitvely predict risk of other STDs. If STD testing were done systematically in men with and without genital warts, the frequency of other STDs would be little if any different in the two groups.

Sorry that more precise data aren't available, but I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD