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Avatar universal

HPV wart

Hello Dr.

I had a wart around my lower lip for months (on the outside and not inside of the mouth). Removed it after it was diagnosed as a "filiform" wart caused by HPV. The filiform appeared again on my chin and face and was also removed. Now there are no more clinical lesions or visible warts anywhere for the past few weeks.
I read that the HPV strains that typically cause filiform warts are usually harmless and not the same as those that cause genital warts though HPV can act weird and move from one place to another.

My question is: since this filiform wart was right around the lower lip, this means it probably came in frequent casual contact with my tongue, teeth, lips and mouth (when eating for example or whatever other random acts). Could this imply that I might have caught a latent and infectious oral HPV infection inside my mouth and in my saliva (my doctor detected no visible lesions inside my mouth) and would I be infectious in such a case?

One doctor said that my filiform wart was considered cutaneous typically caused by HPV1 and 2 and since it is not mucosal and there are no symptoms showing, the probability of it having infected the internal buccal mucosa is none. Another doctor said it can be possible but I was not able to understand the likelihood and he said I should not worry.

I just want to know because it's affecting my social interactions as well as my relation with my lover and I want to know which precautions if any I should take (stop kissing? not sharing food? washing anything that touches my mouth?...) or if I am simply overworrying.
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Avatar universal
Thank you for your time.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Alll warts are "typically harmless".  Warts and cancer are different outcomes, generally caused by different hPV types.  Within the limits of my knowledge, which I discussed at the outsets, I believe you can "put this issue to rest".  But I recommend you rely more heavily on your dermatologist's advice.

That's definitely the end of this thread.  Take care.
Helpful - 0
Avatar universal
Thank you for your reply Doctor. From what I know, facial warts are almost never caused by HPV16 and usually the wart-causing strains (such as ones causing filiform facial warts, hand warts or whatever warts) are typically harmless. Would that be safe enough to assume and can I put this issue to rest?
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
The only well documented link between HPV and oral cancers is for HPV 16 (one of the genital HPV types) and a particular cancer that arises in the back of the throat.  And although these malignancies are rising in frequency, they remain quite rare.  There is not likely to be any such risk if your facial warts are caused by a type other than 16.
Helpful - 0
Avatar universal
Thanks again. I hope I can ask one final question to end this and it would be tremendously relieving if I can have a final word on this: with the hype surrounding HPV and oral related cancers, is there any oncogenic potential to me or to others from the wart I had (and its related HPV strain) transmitting to the mouth should that have happened? or oral cancers are usually caused by other strains?
Your help on this website is invaluable and thank you again.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
There are "so many views on the subject" precisely because the data and research are not precise.  Many of the opinions you have received -- including some of my own -- are based on assumptions or beliefs that may or may not be valid.  For example, I am unaware of any data that document the affinity of non-genital HPV types for mucosal surfaces.  What I do know is that the genital types show up frequenly on mucosal surfaces, but not as often in the mouth as in the genital area.

I would urge you to keep an open mind, and to view most opinions on these topics as just that, opinions -- and keep your antennae up for new knowledge as research evolves over the next few years.

That should end this thread.  I won't have any further advice.
Helpful - 0
Avatar universal
Thank you. I believe the only difference between your opinion and that of the doctors I asked would be that they said it is unlikely that the oral cavity (or even genital area in that case) would have been infected because cutaneous facial HPV types usually prefer the skin to the mucosal membranes (such as the mouth or genitals).Some of Dr. Hook's comments on similar posts also seem to agree with that.

If oral to genital transmission is not that easy, then shouldn't facial to oral be also unlikely or rare? There seems to be so many views on the subject.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
As already noted, I'm not much of an expert on your particular problem; you seem to know as much or more as I do.  But from my general knowledge of HPV, I think you can assume it likely that your HPV has also infected your oral cavity.  Fortunately, such infections are almost always asymptomatic, go away spontaneously, and never cause important health problems either for infected persons or their partners.  But this too is a question for your dermatologist.
Helpful - 0
Avatar universal
Thank you doctor, my wart has cleared up and I am a healthy individual. Most of the readings I did suggested that facial warts are in most cases not genital and caused by HPV1/2/4/27/29 as it is quite uncommon for genital warts to spread on the face (nicluding around the lip). Filiform facial warts like the one I had usually grow around the lips, face, beard area, neck, and eyelids and are quite common.
My dermatologist said that is not likely to have been sexually transmitted, and it is not likely at all for that wart to have spread from under the lip to inside my mouth because of the cutaneous/mucosal difference and the fact that oral HPV is not that common.
There are no warts inside my mouth or anywhere else now. But I still have that fear of having HPV contaminated saliva inside the mouth. My question was simply in the absence of any lesions and any warts, should i be worried about being infectious? and how would you assess the likelihood of me having an infectious oral HPV inside the mouth from a simple filiform wart that was external? I do not wish to put anyone at risk of being infected.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.  Thanks for your question.

Unfortunately, I don't think I can help very much.  Oral area warts are not common in adults, and we rarely diagnose or treatment in STD clinics.  (An exception occurs in people with advanced HIV infection, in whom oral warts are not rare.  But since you say nothing to suggest you are at high risk for HIV or have been diagnosed, I assume this doesn't apply to you, especially if you also are outwardly healthy.)

I can't say anything about filiform warts being any different than genital warts, or about the types of HPV that cause them.  It isn't rare to see filiform warts in the genital area, usually due to the typical genital types rather than HPV 1 or 2.

As for your personal contacts, anyone you have been repeatedly kissing -- or on whom you may have performed oral sex -- already has been exposed, probably repeatedly.  Regardless of the HPV type involved, I see no need that such contacts cease at this point; that horse is far out of the barn.  Such partners should be on the lookout for warts at the exposed sites and seek professional advice if anything shows up, but otherwise not worry about it.  However, it would be wise for you to avoid oral contact (kissing, genital) with new partners until your warts have cleared up.  But no precautions are necessary in sharing food or, as far as we know, eating and drinking utensils.

My advice is that you ask the same questions of your dermatologist, if you haven't done so, and also consider printing out this thread as a framework for discussing it.  I'll be interested to know if s/he disagrees with anything I have said.

Best wishes--  HHH, MD
Helpful - 0

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