[Question #5268] Wart - Recurrence and transmission

23 months ago
Thank you for having this forum.  Actual experts who can tell people “chill out.  You’re fine” is a nice thing to have access to. 
My question is on HPV and genital warts, or in my case “wart”.  About 20 months ago, I found a small bump on my outer labia.  I just assumed it was a wart.  I went to my gyno, but the actual doctor was busy, so I saw the NP instead.  She did a sight diagnosis and said that is was a wart.  She prescribed me Aldara.  I started using it and broke out into lesions.  I did some quick internet research and realized this was a common side affect of the cream and often times people mistook it for a herpes breakout.  The wart was not changing at all. I went back to NP and she thought I was actually having a herpes outbreak (didn’t know that aldara could do that).  She tested me and the test was negative.  At this point, I’m concerned about her actual knowledge of STDs and treatments.  She decides to try Cyrotherapy as well.  We did that 2 or 3 times.  It didn’t work.  The one small bump was still there.   I finally took it upon myself to research treatments.  And this may be crazy, but I ordered TCA 80% from amazon.  Used it, and it worked like a charm.  I think i used it 2x times over a span of a couple of weeks and the bump/wart was gone.  

Jump to a few weeks ago, the same bump/wart popped up.  Same place.  I decided to just use TCA again, and it was gone the next day.  

My questions are-  how likely is a single wart going to pop up again almost 2 years later?  
Could she have misdiagnosed from the start?  
I started sleeping with a partner in November. I didn’t disclose prior wart since I had been clear of them for over a year. Now I feel like I should have since this recurrence.  Have I likely transmitted HPV to him?  And if so, does that HPV always show up in warts, or could it be non issue for him.  
Edward W. Hook M.D.
Edward W. Hook M.D.
23 months ago
Welcome to the Forum.  I'll do my best to help. I appreciate your detailed description and find myself wondering if you might be asking the wrong question (I will comment on the HPV/wart issues in a moment).  The failure of your original lesion to respond to Aldara and cryotherapy , as well as the fact that your most recent lesion responded after a day is all rather unusual.  We find that may people (health care professionals and their patients) misidentify genital cysts , skin tags and other dermatological processes as warts rather commonly.  From the sound of things, your most recent lesion is now gone but should it recur, I would start by advising you to see a dermatologist who has some experience with genital dermatology to find out what it actually is.

If the labial lesion you had (twice) was a wart, it would be rather unusual but not entirely unheard of for it to recur after being gone a year.

Finally, with respect to your partner, I would not feel bad about not having disclosed the history of this lesion to him.  You do not know what it was, you did not know it would recur and most sexually active persons who have not had the HPV vaccine (BTW, have you had the vaccine?)  have HPV, irrespective of their number of past sexual partners.  I would suggest you look at some of that many other interactions Dr. Handsfield and I have had with others about the topic of HPV and disclosure with others in the past - there are many. 

I hope these comments are helpful.  EWH