[Question #5495] HPV

20 months ago
Hello,

2 months after my last sexual encounter I had very severe vaginal itching in the folds of my labia. It has lasted for months and it seems to have spread to the very top of my genital area in a localized spot. I'm not sure what is going on as I've tested negative for yeast and BV and other STIs, so I am concerned this is genital warts and I just can't see them. A few questions I have:

1. I know genital warts can be itchy, but is it a very severe itch?
2. I know they can occur anywhere, but are they often found on the folds of labia?

Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
Welcome back, but sorry you found it necessary after the reassuring replies you had from Dr. Hook just a few days ago.

1) You are misinformed. Genital warts and HPV do not cause itching at all. If warts become inflamed or infected, they may itch, but in that case the warts always are large, usually numerous, and easily observed. Aside from the bumps themselves, HPV infections are completely without symptoms.

2) Warts can occur anywhere, but are most common (in women) on the labia minor, vaginal opening, anus, and so on. In or out of skin folds is irrelevant. But warts are a lot less common on the labia major, mons pubis, or inguinal area (groin). 

Keep working with your doctor. But you can be sure HPV or warts are not the cause of your genital itching.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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20 months ago
Thank you for your help. I was just a bit confused because I read that herpes can be mistaken for things like yeast infections and I was wondering if the same is true for HPV? Also why can it show up years later if our bodies clear it? Thank you for clarifying for me.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
The yeast/herpes confusion is less common than you might assume from comments on various websites. Mostly they're quite different from one another. In any case, because warts and HPV are so common, and so are various causes of genital itching, of course many people with itching have warts/HPV. This is the likely origin of the myth that HPV causes itching. But all those cases almost certainly are just the coincidence of having both problems at the same time.

Why HPV sometimes reactivates after months or years of being undetectable is not well known. Smoking is a factor:  HPV clearance in delayed in smokers comopared with nonsmokers, and women smokers with cervical HPV also have higher rates of progression to pre-cancerous stages. In rare cases, immune deficiency contributes -- e.g. HIV infection, cancer chemotherapy, and so on. But no known trigger or immune abnormality can be found in the large majority of persons with recurrent HPV. 
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