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HPV and oral risk
Hello Dr Hook,
31 year old male here. I was recently diagnosed with a wart below the lower lip (outer lip not inner lip i.e. not inside the mouth). It is burned and there has been no recurrence now for the past month. Dermatologist said it was called a "filiform" cutaneous (skin) wart because of its shape and location. I even saw her write "not sexually transmitted" on my file. Another dermatologist also said it was unlikely to be a sexually transmitted wart since a filiform wart on the face falls within the category of facial warts, and is caused by a different HPV type (I'm also not promiscuous by the way). One dermatologist said it could be genital but he said it very casually only after I asked. So as you can see, kinda different but not that different opinions.
When I asked whether there would be a probability that this would have spread to my oral cavity (since it was situated quite close to it and probably came in frequent contact with it), my dermatologist said no since the type I had was "cutaneous" (preference to skin) whereas oral HPV is classified as "mucosal". My readings have shown that some cutaneous types can be found in mucosal areas and vice versa though. So as a summary:
1) Do I run any oral cancer risk for myself and would I be endangering my kissing partner at this point? I know Oral HPV is still a study in progress but based on what is known so far, what can be said of this?
2) Any precautions or no-no's at this point? sexually or otherwise (kissing, sharing food or utensils)?
3) I read a study that detected even some typically harmless HPV strains (like HPV2 found in facial and common warts) in a few oral carcinomas. Would that mean that this is a causative agent or maybe just a coincidence or co-infection since as far as I know this type is not oncogenic?
4) I am trying to look at things from a scientific perspective but I also want to know how worried (for others mostly)should I be because it is starting to get to me?
Thank you
31 year old male here. I was recently diagnosed with a wart below the lower lip (outer lip not inner lip i.e. not inside the mouth). It is burned and there has been no recurrence now for the past month. Dermatologist said it was called a "filiform" cutaneous (skin) wart because of its shape and location. I even saw her write "not sexually transmitted" on my file. Another dermatologist also said it was unlikely to be a sexually transmitted wart since a filiform wart on the face falls within the category of facial warts, and is caused by a different HPV type (I'm also not promiscuous by the way). One dermatologist said it could be genital but he said it very casually only after I asked. So as you can see, kinda different but not that different opinions.
When I asked whether there would be a probability that this would have spread to my oral cavity (since it was situated quite close to it and probably came in frequent contact with it), my dermatologist said no since the type I had was "cutaneous" (preference to skin) whereas oral HPV is classified as "mucosal". My readings have shown that some cutaneous types can be found in mucosal areas and vice versa though. So as a summary:
1) Do I run any oral cancer risk for myself and would I be endangering my kissing partner at this point? I know Oral HPV is still a study in progress but based on what is known so far, what can be said of this?
2) Any precautions or no-no's at this point? sexually or otherwise (kissing, sharing food or utensils)?
3) I read a study that detected even some typically harmless HPV strains (like HPV2 found in facial and common warts) in a few oral carcinomas. Would that mean that this is a causative agent or maybe just a coincidence or co-infection since as far as I know this type is not oncogenic?
4) I am trying to look at things from a scientific perspective but I also want to know how worried (for others mostly)should I be because it is starting to get to me?
Thank you
MEDICAL PROFESSIONAL
Glad to help. EWH
Thank you doctor. I appreciate your time and advice on this.
MEDICAL PROFESSIONAL
I thought I'd already answered this. No, I would not worry about oral inoculation from a filiform wart. EWH
Thank you very much Dr. Hook for your feedback. Based on your knowledge, would you assume a high likelihood of oral inoculation from this filiform wart? Because I always wondered: if genital-to-oral HPV transmission is not that likely (though they are both affected by the same strains), then shouldn't a facial skin strain be also difficult to transmit to the inside of the oral cavity? Not sure if you might have the answer to that but thought I'd just ask. Thanks again for putting up with us anxious people :).
MEDICAL PROFESSIONAL
Welcome to our Forum. I'll try to help. We receive many questions about oral HPV infections and there is much to be learned by searching the subject using the search function on this site. There are well over 100 different types of HPVs that have been described and different types have different associations with cancers, as well as a "preference" for different sorts of skin. The HPV that causes filiform warts is not typically the same type that causes genital infections, nor, to my knowledge is it associated with increased risk for cancer of any sort, including of the oral cavity. I am not a dermatologist however and thus rarely deal with filiform warts.
Further, as far as the issue of cancer risk is concerned, please be aware that even those HPVs which are associated with increased risk for cancer rarely lead to cancer and that the vast majority resolve without any therapy at all. I would not worry about risk for oral cancer in relationship to your filiform wart.
As for your specific questions, using the same order as used in your post:
1. See above. I would not worry and certainly would not let it keep me from kissing others whom I care about.
2. No, I see no reason for special precautions.
3. You have posed your question and its answer very well. Stuff happens- people DO get hit by lightning. Whether the reports you mention are describing a coincidence or a true but biologically plausible but tiny increase in risk cannot be said.
4. You sound well informed but I urge you not to let your quest for knowledge drive you off the deep end. Please remember that HPVs are virtually omniscient and what has changed of late is not the relationship of HPV to cancer but our beginning to understand that relationship. With increased knowledge, health care providers do a better job of caring for these problems not worse. Thus I would urge you not to worry further and not to let the "dark side" of the internet get to you and cause concern.
I hope my comments are helpful to you. EWH
Further, as far as the issue of cancer risk is concerned, please be aware that even those HPVs which are associated with increased risk for cancer rarely lead to cancer and that the vast majority resolve without any therapy at all. I would not worry about risk for oral cancer in relationship to your filiform wart.
As for your specific questions, using the same order as used in your post:
1. See above. I would not worry and certainly would not let it keep me from kissing others whom I care about.
2. No, I see no reason for special precautions.
3. You have posed your question and its answer very well. Stuff happens- people DO get hit by lightning. Whether the reports you mention are describing a coincidence or a true but biologically plausible but tiny increase in risk cannot be said.
4. You sound well informed but I urge you not to let your quest for knowledge drive you off the deep end. Please remember that HPVs are virtually omniscient and what has changed of late is not the relationship of HPV to cancer but our beginning to understand that relationship. With increased knowledge, health care providers do a better job of caring for these problems not worse. Thus I would urge you not to worry further and not to let the "dark side" of the internet get to you and cause concern.
I hope my comments are helpful to you. EWH
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
