Warts and HPV

Hello Dr.

I had a filiform wart under my lower lip for months. I had it removed after finding out it was HPV related. The filiform wart reappeared on my chin and face and was also removed. However, the reason I am worried is because when I had that wart, I had genital contact with my boyfriend and we kissed as well. I read that the HPV strains that typically cause filiform warts (HPV1,2,4,27,29 mostly) are usually harmless and not the same as those that cause genital warts though HPV can act weird. My questions are:

1- Is it a high probability that my filiform wart right under the lower lip was initially caused by a genital strain (HPV6,11) and specifically a high-risk one (HPV16,18)? Or is it more likely to have been caused by the harmless strains. I know that warts appearing in and around oral cavity can be dangerous and I am not sure if my wart would be classified as an oral wart by definition (because of its location around the lip) or as a regular common cutaneous skin wart (since common filiform warts appear around the lip as well).

2- Is it a high likelihood for that filiform wart to have spread to my boyfriend’s genitals, or even mine knowing that I used same razor/shaving machine to shave face and genital area (and there might have been blood or lesions in both areas).

3- Since this filiform wart was right around the lower lip, this means it probably came in frequent contact with my tongue, teeth, lips and mouth. Could this imply that I might have a latent oral HPV infection (since my doctor detected no visible lesions inside my mouth)? And if so, is there any danger or high oncogenic risk in this whole story?

In a nutshell: Am I overworrying here? How likely is cancer to emerge from this whole filiform wart story that has been too heavy on my mind?

I have asked a previous dr. here as you'll notice. I just feel that a second final expert opinion would serve as a final closure for this issue. Thank you very much.

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

You seem to be very well informed and I would agree with all your statements.  The answer to all your questions is yes: true about HPV 1 and 2, continue kissing and sexual acitivites with your partner, and oral-genital transmission even though possible, it is quite difficult.  Absolutely right.
Best wishes,
Dr José

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you for your post.  I will answer each of your questions here below:
1.) High risk HPV would not normally cause warts.  Filiform warts in lips and oral cavity are usually caused by HPV strains that do not have a potential oncogenic risk.  But it could also be a simple wart as it was on the lip.  In either case, there would be no risk of cancer.
2.) It is highly possible as they are very easy to transmit, as well as being extremely common.  However that does not mean that your partner is going to develop any symptoms as most people do not show warts, even carrying the virus.  It all depends on the state of his immune systme.  In any case, there is no reason to be concerned.
3.) It is of course possible, but I do not believe that there would be any significant risk of cancer.
I do think that you are overreacting.  No need to be concerned.
Best wishes,
Dr José

[greekman1982]

Thank you for your helpful answers Dr. Just some final clarifications:
I was told that my filiform wart was 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 extremly low and even none. Would that be true?
You also mentioned there would be no significant risk of cancer. Is that like practically no risk and would this mean that I should not refrain from kissing or any type of oral activity and carry on my life normally with my partner? It's just the idea that I would cause him the slightest health risk that really bothers me.
Just asking all these things to put it behind me once and for all.

[greekman1982]

One final thing Dr: I was also told that even though warts are very easily spread, likelihood of transmission from face to genitals is not that high because they usually tend to be caused by different strains. I know I might be coming accross as obsessive, but I just want to have an objective evaluation of where I stand to be able to explain the whole situation to my partner as I value transparency in these things.
A big thanks again for your time and feedback.