How effective is the vinegar test for Genital Warts? What other types of penile bumps could change in appearance when the vinegar is applied?

[NoHPVtest4MenIsBS]

This is my first post on the MedHelp forum.  My questions are regarding Genital Warts (GW) and Pearly Penile Papules (PPP).

First of all, I would like to thank you Dr. Rockoff, Dr. Hansfield, and Dr. Hook for participating in this forum.  I have read many of your answers to posts concerning GW and HPV, and found them very informative.  Considering there is so much contradicting info on the internet concerning HPV and GW. However, I still have a few questions.

This is my situation:

I am a 30 year old sexually active male.  Back in June, I noticed a small bump on the shaft on my penis.  I immediately went to the local health dept. STD Clinic.  I was tested for all STD’s (HSV, HIV, Chlamydia, etc.) Thankfully all the tests came back negative, which was great.  However, I showed the doc the small bump on my penis.  The Doctor originally said “oh, that’s nothing”.  But after a closer look, he applied what he called a “vinegar solution”.  After vinegar was applied he noticed “some change” but didn’t turn white.  Doc said “he wasn’t sure what it was, but he would put some ACID on it to kill it whatever it was”.  I agreed to the treatment and washed off the acid at home 4 hours later.  Before leaving the office, he handed me GW pamphlets.  I asked the doc “so I have GW?” He replied that “he wasn’t sure, but the acid would kill it if was”.

I later read up on the subject of GW from the pamphlets and on the internet and began to FREAK OUT! I read that a biopsy would be able to tell me if it was definitely GW, but since I was treated with the acid this was no longer an option.  I called the Doc at the clinic and I asked if it wasn’t a definite GW diagnosis why wasn’t a biopsy done.  He stated “we don’t do that here” and then began to tell me things like “GW is no big deal”, “everyone has it”, and to “just continue to wear condoms”.  

Sorry to go into such detail, but I found this “maybe GW” diagnosis very frustrating!

So my first questions are:

1) How effective is the vinegar solution test to diagnose GW?  Are there any normal penile bumps that could change in appearance when vinegar is applied?  If so, what are they?


The reason I posted in the dermatology forum is that after I received the acid treatment on my penis.  I began to notice other bumps on my body that looked similar to the pre-treated penis bump.  I noticed on my inner to mid thigh a warty looking bump.  It was yellow colored, raised, but not cauliflower looking (penis bump wasn’t either).  I then noticed a couple more of these similar bumps on the back of my hand.  I went to a different doctor this time, and the doc said that they weren’t warts by visual exam.  That they looked like skin tags, or Kearotis(?).   These bumps were identical to the bump on my penis.

Next questions:

2) I read it is possible to get GW on the thigh, is this true?  If so, is there a test to distinguish a regular wart from a genital wart?


Also I suffer from bad ingrown hairs in the genital region.  All of the Warty bumps, including the one I had on my penis, showed up after I had a bad experience with an ingrown hair.  I couldn’t get rid of the thing, so I began to take hot baths with Epsom salt every day to try to get rid of the ingrown hair/cyst.     That’s about the same time the bump on my penis, thigh and hand started to pop up.


So my next question is:

3.) I have read that Epsom salt baths draw toxins out of the skin.  If you have HPV in the skin cells, is it possible that the Epson salt could bring them out making warts more visible?  (Very strange question…I know).   Can daily Epsom salt baths cause wart like eruptions on the body over time?  I know I’m reaching here, but I’m curious.


Finally, when visiting the STD clinic I also showed the doc my bumps around the rim of the head of my penis.  The doc told me that they were NORMAL, and after researching on the net I believe them to be Pearly Penile Papules (PPP).  They are not very noticeable when flaccid, but when I’m erect 2 of them are very noticeable.  They tend to stick out like spikes coming from the bottom of my penis head.  I KNOW THEY ARE NORMAL, but I would like to get rid of them.  I have read about treatments using CO2 laser and other methods.

Last question:


4.)  Would a normal Dermatologist be able to treat PPP with CO2 laser?  Should I seek a Cosmetic Dermatologist or some other type of specialist?  How could you find a dermatologist that’s experienced with performing a PPP procedure without calling all of them?

I searched on the net, and cannot find many doctors that list that they will treat PPP.


I know PPP’s are extremely normal, but since I had the possible GW diagnosis, I have been over magnifying everything on my Penis.  I know the laser treatment is very expensive, and not covered by health ins.  But I believe if I could have them treated and have a bump free penis again......it may help me move on with my life after this possible GW thing.

Thanks for your time.

[jhigh420]

For your first question, any type of skin abrasion, scratch, etc., will turn white when applied with vinegar. Vinegar rules out the possibility of warts if the skin DOESN'T turn white but is not a definitive test to indicate warts by skin or a "bump" turning white.
As to question 2, it would be extremely rare for HPV to take up residence anywhere besides soft tissue(throat, inside of mouth, vagina, anus). Even inside the mouth is rare. Inside the throat, often with an infant whose mother is infected, can be life threatening.
As for question 3, I haven't heard of any study where it has been theorized epson salts have that effect on HPV. You'll have to do your own research on that one :) I like epsom salts as well, but as far as the extracting toxins claim I'm extremely skeptical. I view it the same way I view claims routine edemas eliminate toxins from the body.  
As for your final question, shopping for a doctor to treat PPP is just like shopping for any other type of specialist. You can call different PCP's in your area and ask for a recommendation from their staff as to who they refer their patients to without getting too specific. Again, you will have to do your own research here. But the truth of the matter is I feel you are far too concerned with this GW thing. I understand it can be scary and frustrating to not know and can even change the way you view yourself
However, it's not necessary to be so dramatic about something you have no idea whether or not you have or may be normal to have. The reason your doctor told you "everyone has it" is because when it comes to the PCR test for HPV DNA, most of the population will indicate the presence of this DNA in said test. Because of this, there is no way to diagnose HPV infection in men. If you don't have warts(which your doctor would have recognized), why worry? If he's so wishy washy about such a diagnosis, maybe you should consider changing doctors.
I, too, have a couple of bumps on my penis that appeared a couple years ago. I, too, was extremely worried. But I had it checked out and they turned out to be nothing. During that period I have had two girlfriends. My ex was recently diagnosed with HPV via pap smear 6 months after we broke up. She was sexually active with another man, so I don't think she got it from me. My fiance and I have been together for a year now, and she's never been diagnosed with HPV. She had a pap around the same time my ex did.
My main concern would be passing on HPV to a female partner. They have a lot more to worry about, cancer, etc. So I just make sure that I told my partner when we first started dating to be vaccinated for HPV. And I repeat that to female friends and relatives as well whenever the subject of sex comes up.