[Question #6015] HPV Transmission

19 months ago
Hello, 

About 7 years ago, I obtained anal warts that since then have been treated by a specialist and gone for about 5 years.  Recently, I had some concerns after noticing some rough, chaffing skin around the area.  I went to my specialist and he advised it was only due to dry skin from the heat and to not worry and just keep the area dry.  A few weeks after, I checked the external anal area again with my finger to identify any potential issues such as bumps and improvement in the chaffing and to dry the area.  Everything appeared normal and was healing well.  However, I had some obsessive thoughts develop afterwards with a fear of re-infecting myself after touching doorknobs, sink facet, etc. and then touching my skin with my finger even though I washed my hands twice before checking the area and also afterwards to maintain normal, proper hygiene.  I am seeking counseling regarding this obsessive thought since I know it is not healthy and is likely not rational.  Would such a scenario introduce any appreciable risk of re-infecting the skin with HPV or is it primarily an irrational thought?  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. Thanks for your confidence in our services.

Thanks also for the detailed information, including your forthright recognition and description of the mental health issues involved. I wish you well in dealing with them.

From an HPV standpoint, the news is good. There are at least four reasons making it very unlikely that the apparent irregularities you feel in your anal area are due to HPV or warts. First, anal warts are unlikely to recur after 5 years of no symptoms. It can happen but is uncommon. Second, from your description, what you feel doesn't seem like warts. (I suspect it doesn't feel the same as when your anal warts were diagnosed and treated, right?) Third, and perhaps especially important in view of your fears, HPV is simply never transmitted by contact with HPV in the environment. Even if DNA testing could detect HPV on doorknobs, toilet seats, etc, there are no known cases of catching warts or other HPV infections by this sort of event. Finally, even if this could occur, people with prior HPV are immune -- or at least highly resistant -- to new infections with the same HPV type. In other words, if your own HPV had contaminated your environment, and you then intentionlly tried to infect yourself with it, you coudn't do it.

Obviously you should ask your doctor to examine your anal area and then follow his or her advice about the cause of your anal irritation. I'm confident recurrent warts are not the problem, but direct exam by a professional is the only way to be certain. In the meantime, do your best to put aside your obsession and worries.

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

HHH, MD
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19 months ago
Thank you very much.  That does make me feel better and I appreciate your thorough response.  I am currently being seen by my specialist for annual check ups and all seems well so far.  He did advise I keep the area dry and use baby powder, etc. to help with this irritation so I am working on that.   He advised it is probably just rubbing of skin in the heat. causing it.  That is right in that it did not feel the same as before with my finger.  I think for this particular situation it was primarily my fear of exposure to the environment and other people touching items like door knobs, etc. and then touching the area of skin with my finger (after washing) that prompted my OCD-related anxiety of a future infection.  I know my last occurrence was sexually related with a clear previous risk factor so I think some of the past fear got the best of me this time.  Knowing that this fear is irrational and that touching a public doorknob as a means of transfer is not a valid concern certainly helps me.  And despite the skin being irritated the risk from touching would still be extremely low due to all the factors discussed?  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Thanks for the thanks; I'm glad to have helped. It sounds like you have a better understanding of the situation. I would add (didn't think to say before) that HPV never causes itching or irritation as the main symptom. If overt warts are present, they can become inflamed and itch. But your symptoms don't suggest HPV at all.---
19 months ago
Thank you very much for your help.  I feel much better now regarding the touching of environmental surfaces such as in this scenario not being a transmission risk and the symptoms of irritated skin experienced.  I will  also continue working on addressing the irrational fears so I can move on and not worry.   
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
You're welcome. That concludes this thread.---