I've had warts in the past, if bumps there now aren't warts, then what?

[thursday]

I'm a 21-year-old woman; I have had anal warts for just over a year. My doctor is now telling me I am almost, if not completely, in the clear. I have had three surgeries- one last April, one last July, and one in December; the last time (in December) was to remove a single internal wart, which I had never had before.
     Since then, I have had skin tags and a couple larger bumps on my anal area that appear fleshy colored to white, but two different doctors have said they aren't warts.  
     I'm only concerned because if I've had the condition, and there are bumps there now, I don't see what else they could be.  Is it normal for some people to just have bumps in that area? Especially after so much treatment,(cauterization, three surgeries) for warts?  

Do some people just naturally have bumps/skin tags in that area?  

Also, how *can* doctors tell if they are warts or not?  I look at them in the mirror and they look the same to me as warts I've had in the past. So that leaves me wondering how doctors can tell.

     The other part of my question is this: my doctor has told me that I am now basically over the virus. But what if I have sex with someone, can I still transmit it? And then if so, my partner will have the virus, and wouldn't we just ping pong it back and forth? I don't want to just have a choice for the rest of my life of either being celibate or getting the warts again...

Thanks in advance for your help.

[Alan Rockoff, MD]

First, I suggest you look at the answer I sent to "Warts returning" on January 23rd.  The upshot is that you really can't be certain if the warts are noncontagious even after they're invisible, but it's the best you can do.

Your case is complicated by the fact that doctors keep finding small things, some of which they call warts and others they don't.  You are correct to question their ability to tell when the bumps are so small.  I think that after so many surgeries, you might ask the doctors to do a superficial test for biopsy.  Another strategy would be for you to get a prescription for Aldara or other topically applied anti-wart cream.  You should discuss these options with a dermatologist.

But when you get right down to it, transmissibility is impossible to predict.  Even if you were celibate, the warts could come back (and not from "ping-ponging.")  So the best thing is to be as sure as you can that they're gone and go for regular checks once in a while.  No need to have your whole life turn on this.

Best.

Dr. Rockoff

[thursday]

Hi again- what I really wanted to know, though, is if there are bumps there now, that are not warts, as my doctor is saying, then what are they?  Do some people just have bumps/skin tags in that area?


I had asked my doctor to biopsy one of them and he said there was nothing to biopsy because it wasn't a wart.


Just to let you know- I have tried Aldara and the itching was so bad it was intolerable. I couldn't fall asleep. I have very sensitive skin.


Thanks again...
Rachel

[Alan Rockoff, MD]

People get all sorts of bumps--blocked pores and whatever.  If your doctor is really that sure, I'd just forget about the bumps.  Aldara is indeed very irritating, and it appears you don't ned it.

Dr. Rockoff

[thursday]

I know I seem paranoid but I have another question... I've noticed these bumps are spreading even if they are small.  They have spread during the time my doctor keeps telling me they aren't warts.  Are there other kind of bumps that spread like that?

[Alan Rockoff, MD]

I can't say.  You can get nonwarty bumps that appear in the general area, without "spreading" in the contagious sense.

If your doctor is sure, sometimes it's best to take "yes" for an answer . . .

Dr. Rockoff

[thursday]

Well, I went to my gyn today for my annual and the nurse practitioner said yes they were warts... the doctor said he wasn't sure...so I have two no's, a yes, and a maybe.  So now I'm just more confused and annoyed.

[Alan Rockoff, MD]

If the nurse says they're warts, then you need to ask the doctor to either do a biopsy or explain why he disagrees with the nurse.  If you can't get that done, you should consult another office.

Dr. Rockoff

[thursday]

The doctor who said they weren't warts is now saying they could be. I knew they were all along, but I had to wait until they "changed" to have them removed. So now I have to have surgery *again* as opposed to just having them  removed in the office. He's also going to send one for a biopsy.  

I had a question about why my immune system wouldn't be suppressing this by now. Since my second surgery in July, I've been getting small but persistant outbreaks. I'm in there getting warts removed like every two weeks.  Does there have to come a time when this will end?  

And I had a blood test for HIV in September that was negative, just to be sure. My immune system has always been normal.

[Alan Rockoff, MD]

Getting warts has nothing to do with immunity in a general sense.  Having them doesn't mean there's anything wrong with your immunity.

Dr. Rockoff

[thursday]

the nurse practitioner at the doctor's office mentioned Valtrex can be used for warts as well- I was surprised, how does taht work?

[Alan Rockoff, MD]

It doesn't work for warts, just for herpes.  Any implication otherwise is not correct.

Dr. Rockoff

[thursday]

Sorry to keep asking questions but I just keep thinking of them... I shave my vulva but not my anal area, obviously. However, I do shave near the perineum and just around the outer edges of my anal area cause there is a lot of hair there... I was wondering, can shaving cause warts to break out?  I usually use a new blade every time I shave.  It just seems I got warts along the perineum right after I shaved...

[Alan Rockoff, MD]

No, shaving does not cause warts to break out, nor does it generally spread them.

Dr. Rockoff