Aa
Follow up questions
Dear Dr Handsfield, Dr. Hook,
I recently had a checkup after 6mos. following a positive biopsy in June and given the all clear. I then noticed another spot a week later near the bottom of shaft, top of hair area. The dermatologist said he didn’t think it was anything but wanted another look in two weeks of me not messing with it.
1. If the derm says it isn’t anything, but isn’t 100% sure, is it my moral obligation since I have been positive for a wart before and because of the proximity to the previous wart being about 3/4” to 1” away to get another biopsy. Ultimately I may have a biopsy done to ease my mind but don’t know if this would put me at ease because can it read positive because it is so close to where the other one was even if this isn’t a wart?
2. Would the entire genital area be positive during a biopsy forever or am i misunderstanding a biopsy, would it just reflect the bump that is being tested individually? The reason being the other area was cryofreezed a few months before the biopsy and still read positive. Can pathologists be overcautious and say positive just to cover themselves if it looks a little abnormal resulting in an inconclusive or false positive causing me more worry and uncertainty?
3. I have also been fighting warts on my fingers and palms for the last 6mos and I think I have them under control, do I have to wait certain time after having those treated before touching a girlfriends vagina, how transmittable are hand warts if I can’t see them anymore? What are the odds of a small one being transmittable if I missed it.
4. I have had a few doctors say genital warts can cause cancer in women, why is this, it goes against most things i have found in researching this?
5. If it is a wart how can partners be protected if a condom doesn’t cover the affected area, wait another 6 months and is the 6 month estimate for protected or unprotected sex I have always being protected besides this one mishap, just curious? I value your opinion
I recently had a checkup after 6mos. following a positive biopsy in June and given the all clear. I then noticed another spot a week later near the bottom of shaft, top of hair area. The dermatologist said he didn’t think it was anything but wanted another look in two weeks of me not messing with it.
1. If the derm says it isn’t anything, but isn’t 100% sure, is it my moral obligation since I have been positive for a wart before and because of the proximity to the previous wart being about 3/4” to 1” away to get another biopsy. Ultimately I may have a biopsy done to ease my mind but don’t know if this would put me at ease because can it read positive because it is so close to where the other one was even if this isn’t a wart?
2. Would the entire genital area be positive during a biopsy forever or am i misunderstanding a biopsy, would it just reflect the bump that is being tested individually? The reason being the other area was cryofreezed a few months before the biopsy and still read positive. Can pathologists be overcautious and say positive just to cover themselves if it looks a little abnormal resulting in an inconclusive or false positive causing me more worry and uncertainty?
3. I have also been fighting warts on my fingers and palms for the last 6mos and I think I have them under control, do I have to wait certain time after having those treated before touching a girlfriends vagina, how transmittable are hand warts if I can’t see them anymore? What are the odds of a small one being transmittable if I missed it.
4. I have had a few doctors say genital warts can cause cancer in women, why is this, it goes against most things i have found in researching this?
5. If it is a wart how can partners be protected if a condom doesn’t cover the affected area, wait another 6 months and is the 6 month estimate for protected or unprotected sex I have always being protected besides this one mishap, just curious? I value your opinion
MEDICAL PROFESSIONAL
Your dermatologist is the best person to decide how to treat your warts. It is not normal to treat the surrounding, normal-appearing tissues. (How far would you extend it? Impossible to know, thus pointless.)
There is no way to know whther you are "part of the percentage that never clears". But since that's rare, I don't know why you would be concerned about it. Whether or not HPV DNA persists in the infected tissues isn't important. What matters is whether warts reappear, or if other complications of HPV develop, or if the virus can still be transmitted. In a large majority of infected persons, these things don't happen.
There is no way to know whther you are "part of the percentage that never clears". But since that's rare, I don't know why you would be concerned about it. Whether or not HPV DNA persists in the infected tissues isn't important. What matters is whether warts reappear, or if other complications of HPV develop, or if the virus can still be transmitted. In a large majority of infected persons, these things don't happen.
Hi Dr. Handsfield, thanks for your posts. I did have a biopsy on this new spot and it confirmed that this was a new wart. Against my wishes the area around the biopsy of the first wart the first time wasn't treated (they said not necessary) and a new wart appeared 6 months later in addition to the one slightly below. Now the new derm doesn't want to treat the area around the new biopsy I feel the same thing will happen again, in addition he used a different freezing technique dipping a tweezers which I don't think will kill them as good. I managed to kill the most of the warts on my hands with persistance and there was many more of those but even those keep spreading they are really small and hard to see for the most part. He also thinks the hand ones could possibly have been the cause, having warts on both areas have made me twice as depressed and paranoid constantly fearing transmission back and forth and avoiding touching the genital area. I know warts are harmless heathwise but this has devastated me socially (no dating and fear of transmitting) and financially spending $1,000s on two little bumps and not getting results is making me crazy. Every time I see another one it is $100s to treat. How do I know if I am part of the percentage that never clears.
MEDICAL PROFESSIONAL
Welcome back to the forum. However, I am concerned that you are spending too much time and emotional energy worrying about minor health problems. This is your third question on this forum. Nobody wants genital warts or other HPV infections, but being infected is not abnormal and rarely leads to serious health outcomes, as long as certain precautions are taken, such as regular pap smears in women.
To your questions:
1) Direct examination by a dermatologist is far more accurate than any guess I can make about the nature of this problem. If s/he isn't concerned, neither am I -- and neither should you be worried about it.
2) Although HPV DNA can persist indefinitely (the experts debate how often this is the case), most HPV infections clear up to a point they cannot be detected by biopsy or any other method. Biopsy is never done to diagnose HPV in people without abnormal pap smears, warts, of other visible lesions.
3) It is doubtful the lesions on your fingers and palms are warts. Multiple hand warts are rare in adults and would always clear up on their own in a few months. If you are concerned about this, show them to your dermatologist then follow his or her advice about it. However, in the off chance you actually have hand warts, you can be confident they are caused by one of the non-genital HPV types that would be unlikely to be sexually transmitted.
4) Some doctors probably don't understand warts and HPV, and others may simply use the terms loosely without carefully thinking about it.
5) I'm not sure I understand this question. There is no hard and fast interval for HPV clearance and inability to transmit to partners; the more time passes without recurrence, the more likely the infection is gone and will not be transmitted to partners. At this point (6+ months) it is likely you are home free.
I'll close by reemphasizing my opening comments. Please read this thread, which gives an overall perspective on genital HPV infections. You should find the information reassuring: http://www.medhelp.org/posts/STDs/HPV-Transmission/show/1522088
Best regards-- HHH, MD
To your questions:
1) Direct examination by a dermatologist is far more accurate than any guess I can make about the nature of this problem. If s/he isn't concerned, neither am I -- and neither should you be worried about it.
2) Although HPV DNA can persist indefinitely (the experts debate how often this is the case), most HPV infections clear up to a point they cannot be detected by biopsy or any other method. Biopsy is never done to diagnose HPV in people without abnormal pap smears, warts, of other visible lesions.
3) It is doubtful the lesions on your fingers and palms are warts. Multiple hand warts are rare in adults and would always clear up on their own in a few months. If you are concerned about this, show them to your dermatologist then follow his or her advice about it. However, in the off chance you actually have hand warts, you can be confident they are caused by one of the non-genital HPV types that would be unlikely to be sexually transmitted.
4) Some doctors probably don't understand warts and HPV, and others may simply use the terms loosely without carefully thinking about it.
5) I'm not sure I understand this question. There is no hard and fast interval for HPV clearance and inability to transmit to partners; the more time passes without recurrence, the more likely the infection is gone and will not be transmitted to partners. At this point (6+ months) it is likely you are home free.
I'll close by reemphasizing my opening comments. Please read this thread, which gives an overall perspective on genital HPV infections. You should find the information reassuring: http://www.medhelp.org/posts/STDs/HPV-Transmission/show/1522088
Best regards-- HHH, MD
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.
