[Question #5421] Are these warts and what can I do to treat them and prevent spread of warts?

23 months ago
I have four bumps on my scrotum - one is larger (maybe the size of half a pea) and the three are smaller (a larger pin head size) and all are smooth. They don't hurt and or otherwise bothersome. I am concerned they are HPV.  A) How can I know if it is?  B) If this is HPV, will and can they spread to other areas of my genitals and if so, how does that happen and what can I do to prevent it?  I have had sex with my partner with these, not realizing what they could be. Should we worry about her being infected? If she is, can she further spread the infection on my genital area, i.e. on my penis shaft and head?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
Greetings and welcome to the forum. Thanks for your question.

We cannot diagnose anything -- we don't attempt to provide direct medical care. However, genital warts almost never are smooth bumps, but irregular and -- guess what? -- wart like. You can see images of typical examples if you just google "genital warts". The large majority of genital skin conditions are not STDs. (I have a book titled Genital Dermatology Atlas. As the name implies, it is filled with photos of genital skin conditions like rashes, bumps, and so on. Of it's total 320 pages, only 15 pages cover STDs.) The only way to know for sure is to see a doctor to be examined. But from your description, warts seem unlikely.

To your other questions:  Even if you have genital warts, it is rare to spread them to other parts of the body. Also, you really needn't worry about your partner. Everybody gets genital HPV, often several times. If you have had sex with 3 or more persons in your life, there's already a 50% chance you have (or have had) HPV, which very likely already includes your penis. Just like you, your partner probably has also been infected and may be carrying the virus. Getting HPV is a normal, expected consequence of being sexually active. If you and your partner have not been vaccinated against HPV, you should do that. The vaccine protects against the 9 types of HPV that cause most warts, cancers, and pre-cancerous skin changes; it's one of the most effective vaccines ever develooped, and all people should be immunized with it. I suggest discussing it with your doctor -- and that your partner do the same.

Bottom line:  Probably you don't have warts, but see a doctor to know for sure; and also discuss HPV immunization.

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

HHH, MD
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23 months ago
Thank you Dr. HH. A couple quick follow up questions. If I had the HPV shot (1 dose Gardasil at age 40), will exposure to HPV after this protect me from infection? Is it true that if I had a strain in the past that Gardasil cannot protect against reinfection with the same strain? If these are warts, is it likely they will resolve on their own? If so, what is the average timeline on that? What's the likelihood of reinfection for a healthy person?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
Three doses of vaccine is ideal, but protection is excellent after two doses. Only one dose has little benefit. At least get the second.

People have substantial immunity to any prior HPV infection. If you had any particular type before, you won't get it again. More recent research suggests the protected from past infection isn't as strong as once thought, but still pretty good. Having vaccine probably provides that additional margin of protection against reinfection with previous types.

Warts generally resolve on their own. However, your age is an additional argument against warts. New genital warts are not common at age 40; as already discussed, almost certainly your bumps are something other than warts. They probably will not go away on their own. Stop screwing around and see a doctor!
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23 months ago
Thank you. Final follow up. 1. When washing my genitals, would touching any warts spread them to other areas?  2. If I had a more recent possible exposure by someone, would my age still play a role in being less likely to get them? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
1) Warts are not easily spread to other body sites. No risk from washing or other handling of the lesions, even if they are wart (which almost certainly they are not). 2) Yes, new warts are quite uncommon after around age 30. It can happen, but not frequent.---