STDs Expert Forum
Couple Of Questions About Genital Warts
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Couple Of Questions About Genital Warts

Hi doc,

i've been living with HPV for about 14 months and my last genital wart recurrence was 2 months ago.

I have several questions regarding genital warts and HPV that cause it..

first of all, health organization and doctors believe that we can heal our own HPV infection within 24 months time. My question is, let's say these people never treat their genital warts with anything, if one day their body has been able to suppress the virus, would the genital warts fall off by themselves? Let's say tomorrow I have new warts, would it be possible that once my antibody has cleared up the virus then the warts would disappear on its own? Or I still need a treatment like electrocauterization and the likes?

My second question, is there any difference in terms of chance for me to infect my future sex partner when there's active wart? Let's say i have active warts atm and I have sex with someone and let's say next week I don't have any active wart and I have sex again. Would it be any different as long as the HPV hasn't been cleared up yet?

My third question.. i have scars, several big ones, on my penis shaft due to electrocauterization last year (ever since then, I always treated my new warts with ACV or aldara, never with electrocauterization anymore). Do you know any cream/treatment that can help me to remove or at least fade these scars? I dont think the scarring will go away on their own as I have a bad skin type and it's been a year since I got those scars. I ever tried to apply bio-oil on them for a month but it seems i dont get any effect from that..

my fourth question, do you think it's possible for someone to get HPV type 6 and 11 but never get any genital wart?

my final question, is it effective for someone that already has HPV already then he/she takes gardasyl to fight it off?

Im sorry that I asked you five times but I hope you wont bother answering them all, thanks a lot!
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Welcome to the forum.  Judging by your many comments on the HPV community forum, many of which are reassuring to other users with their own questions, you have done a lot of research on these issues and are quite knowledgeable.  For some of your questions, you may know as much as I do.  Because genital warts are generally considered a minor health problem (regardless of the emotional distress they can cause), there has not been much research.  Most of what we know is based on clinical observation and common sense, not on firm data.  That said, I'll do my best.

1) Almost all warts, whether genital or the hand or foot warts common in childhood, clear up eventually on their own, even if never treated.  When untreated, they appear to "melt away" -- i.e. people just notice one day that they are gone.  But I suppose sometimes they may dry up and flake off.  If and when new warts appear, it probably usually just means the virus has persisted in tissues and for some reason the immune system has failed to keep them in check as well as it once did.

2) STD experts generally assume infectiousness for partners depends in part on viral load, i.e. the amount of active, transmissible virus in infected tissues; and that viral load likely is higher in overt warts than in asymptomatic infection.  We hope, therefore, that treating overt warts reduces the potential for transmission to partners.  However, I stress there are absolutely no data on this.  It's not much more than educated (and hopeful) guesswork.

3) Anti-HPV treatment has no effect on existing scars.  Over time, scars in general tend to soften and become less prominent.  In severe cases, special treatments might improve them.  This is an issue for a dermatologist; I have no experience with this.

4) The best estimate is that 60-70% of people who acquire HPV 6 or 11 develop visible warts.  That leaves a large minority (30-40%) who have only asymptomatic infections.  Typically it takes 6-12 months before visible warts appear, and they rarely show up before 3 months.  Therefore, some apparently asymptomatic infections may simply appear late -- sometimes long after the exposure.

5) Neither of the HPV vaccines (Gardasil or Cervarix) has any effect whatsoever on existing warts or HPV infection.

I hope this helps.  Best wishes--  HHH, MD
PS: sorry about the mistype for the fifth I'm expecting your answer for all of my questions! Thanks! ^^
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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