[Question #6206] HPV warts

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69 months ago
Hello doctors, I am a 32 year old male with a possibility having genital warts.  Like  many others whom have been exposed to HPV, I have my concerns, anxiety, and a lot of stress because of it.  Did a lot of reading on HPV that I’m exhausted.  Back in August 2019, I went to speak with a doctor about these  strange bumps I’ve discovered at the base of my penis.  At the time I just shaved the area a few days prior to my doctors appointment.  I thought they may have been ingrown hairs and tried to pull the hairs out with a needle but no hair was found.  So the day of my appointment, the doctor looked at it  and assured me it wasn’t an STD or anything serious, stating warts have a very specific characteristic (Cauliflower appearance) and mine did not appear to have those same traits.  She also mentioned that when it heals, I will have these raised skin bumps for the rest of my life.   i relieved to hear this.  However, weeks go by and I couldn’t help feel uncomfortable of her answer.  Call it paranoia but I went ahead and got the HPV Vaccine anyways.  Fast forward to October, I still had concerns and went again to the doctors to get a second opinion.   This other doctor told me the bumps I had looked like Molluscum but could also be HPV warts.  He wasn’t entirely sure but decided to freeze the warts off without any biopsy.  I am even more lost now because I was never given a definite answer and was told I will be fine.  
My questions are these: 
1)  Since the bumps were frozen off,  should I still try to get a biopsy or wait to see if there is a recurrence?
 2)  I know warts can be treated but can reoccur and that the virus infection could remain in my system indefinitely.  If warts do not come back after a year or two, would it be safe to say that my immune system cleared my body of this virus? Or is this a life term thing?    
3)   Do supplements really help at all?Currently, I am taking specific vitamins to help my immune system.  B12, folic acid, and vitamin E.
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Edward W. Hook M.D.
69 months ago

Welcome to our Forum.  thanks for your confidence in our service.  I'll do my best to help. Before I address your specific questions, I'll first comment on your continuing concern about HPV and why realistically, this is not something to worry about. 

If you have read our replies to other clients, you are aware that our science-based perspective starts with the fact that virtually all unvaccinated, sexually active adults have HPV and that in more than 99% of those persons, their infection will cause no lasting problems.  In less than 1%, if undetected the infection may progress to readily detected pre-cancerous lesions which can be readily managed with regular sexual health check ups and management by health care professionals. Thus HPV infections are not something to invest a great deal of concern in.  Visible warts are an observable manifestation of HPV infection, primarily caused by two HPV types which are from a health perspective, little more than a nuisance since they almost never progress to pre-cancerous lesions.  Since you have received the HPV vaccine, you can be confident that you are protected against acquisition of new HPV causing genital warts.  Unfortunately many health care providers are poorly prepared to distinguish HPV from other benign dermatological processes like molluscum contagiosum, skin tags, and scarring from part folliculitis and all too often treat them with non-specific, destructive treatments which may make the lesions go away but do little to address any fears that their patients may have regarding what he lesions are or where they came from.  My guess is that this may be the case for you.  Since you were vaccinated, the lesions that were treated are most unlikely to have been newly acquired warts and if it has been more than a year since your earlier lesions were evaluated, are also unlikely to be recurrent HPV either.  (Occurring at the base of the penis, they are also an unlikely location for genital warts which are far more common on the shaft of the penis)

With this as back

1)  Since the bumps were frozen off,  should I still try to get a biopsy or wait to see if there is a recurrence?

No, properly applied cryotherapy is a destructive process designed to destroy the lesion.  There is little to be gained from a biopsy at this time. 

 2)  I know warts can be treated but can reoccur and that the virus infection could remain in my system indefinitely.  If warts do not come back after a year or two, would it be safe to say that my immune system cleared my body of this virus? Or is this a life term thing?    
Most typically, if genital warts are going to recur they do so within a year or less of treatment.  Rarely, particularly in persons receiving immune suppressive medications such as cancer treatments, they can recur at a later time but this is not common.

3)   Do supplements really help at all?Currently, I am taking specific vitamins to help my immune system.  B12, folic acid, and vitamin E.
There are no scientifically rigorous trials to suggest that supplements are helpful.


I hope this information and perspective are helpful to you.  EWH


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69 months ago
In your expert opinion what are some tips or some best treatment options other than freezing the warts off?
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Edward W. Hook M.D.
69 months ago
There are a number of ways to treat visible warts.  If a person (or their doctor) is unsure of whether the lesion is a wart or not , a biopsy is often both curative and diagnostic.  In addition to freezing, other effective treatments include laser.  While more time consuming, there are self-applied treatments which include imiquimod and podophylin.  EWH---
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69 months ago
  Your responses are very helpful!  This concludes my question and you may close this case.  Thank you doctor so much!
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Edward W. Hook M.D.
69 months ago
Thanks so much.  I'm pleased my comments were helpful.  EWH---