Hello Dr,

I am a 38 yo male who was diagnosed with genital warts 4 years ago in 2017.  These warts were never or have never been on my penis, scrotum, or pubic area. They have always been on my upper inside thigh where the skin fold meets my genital area or scrotum.  At the time of my diagnoses, I was treated with surgical removal followed by electrocautery.  The majority of them never returned, but there was a few that did.  I found a new dermatologist who began treatment by freezing those that returned.  After returning again, they were once again frozen and began treatment with Immiquomad which caused a bad reaction and discontinued use.  As treatment continued, they began to slowly disappear with the exception of one. Fast forward to last year and that same one returned after 7 months clear.  It was treated in October, and things were looking up until this week when I noticed it returning again.  I saw my dermatologist on Monday and it had indeed returned along with 4 more of the previous spots that she noticed and treated by freeze.  I asked her if I would ever clear this, and she said yes, and that eventually my immune system would catch on, but she didnt seem very confident in her reply.  She has now prescribed fluoroucil and wants to see me in a month.   My question is if this is normal?  Can I expect this to recur for the rest of my life or will my immune system eventually tackle this and clear it even after years of treatment?  I am devastated, and this has taken a serious toll on my mental state.  

Welcome to our forum.  Thanks for your questions.  I’ll be glad to comment.  ---

Thank you Dr. Hook, and thank you for the clarity and prompt reply.  After seeing no visible warts after many months and believing I was in the clear, I began dating someone back in January.  I frequently check myself and assumed it was fine to proceed with this relationship and pursued a sexual relationship.  The relationship ended in March with still no visible warts present which sent me into a depressive and anxiety riddled state.  I've read conflicting information on whether stress and anxiety play a role in immune response, and would like to get some clarity on that?  Could this stress have played a role in recurrence?  I've also stopped marijuana use as I've read that smoking has been thought to suppress immune response.  In the meantime, I will continue to treat the recurring warts as needed(hopefully not for long).  This will conclude my questions, and thank you immensely for this service.  It has helped me and many others with a vast amount of knowledge and facts in a world full of conflicting information

Thanks for the additional information.  The location of your warts is a location unlikely to lead to transmission and hopefully our partners (past and present) have received the HPV vaccine which reduces risk still more.  ---