Flat warts on hands > genitals?

[andyinnewyork]

Doctors: I recently was diagnosed with a number of flat warts on my hands (predominantly wrist and back of hand, but with one on the base of my thumb.) The dermatologist prescribed a topical lotion and also began a first round of burning them off in the office. I realize this is a common affliction and not a 'big deal.'

My worry, however, is about the chance (if any) of spreading the flat warts from my hands to other parts of my own body (i.e. while masturbating, etc), or to a sexual partner via hand to genital contact. From what I've read, hand warts are a different 'type' of HPV than genital warts...but different sources seem to vary between "will not spread' and "might happen." In any case, DIRECT contact between the wart and the genitals would need to occur if this would even be a feasible risk, correct?

I'm an anxious, often guilt-ridden person, and I'm wondering how to bring this up with a new sexual partner I've recently been intimate with. I'm worried if I even utter the word 'warts' it's going to cause a huge, disasterous conversation. The dermatologist thoroughly and carefully inspected my own genitals and found no evidence of any types of warts. But since I have these flat warts on my hands/wrists/etc, and my hands came in contact with the new partner's genitals during...whatever you would call it...manual intercourse? ;)...should I be having a conversation with her about this? What would be most helpful would simply be some advice on the way to phrase this, to explain how common this is (I gather about 1/4 of people have certain types of warts on their hands), and so on.

Or, if the chances of transmission are nil and so low as to be neglible, does it seem like this is a conversation that does not need to be had?

[Edward W Hook, MD]

You can't leave this alone, can you.  Yes, the same holds for the possiblity of hands spreading HPV to the anus.

Further posts will be deleted without comment. EWH

[andyinnewyork]

Thank you doctor. Just one final nitpicky query--"anogenital" warts = anal and genital warts, yes? Meaning the chance of hand warts spreading to the anus (by touching or finger penetration) would be just as negligible as hand warts spreading to the vagina through touching, penetration, etc?

[Edward W Hook, MD]

Yes.

That will be it for this thread.  EWH

[andyinnewyork]

I will. but regardless of flat vs common, all your previous comments still apply, yes?

[Edward W Hook, MD]

Sorry, I cannot answer that question.  You'll need to discuss this with your dermatologist.  EWH

[andyinnewyork]

Thank you Dr. Hook. Any idea what the difference is though between 'common' warts and flat ones (what I have), or are they just all different strains (none of which would easily 'hop' to the genital zone?)

(P.S., next week's doctor's appointment is with a psychologist to work on 'letting go' when it comes to some of this sort of thing ;).

[Edward W Hook, MD]

Warts do not become more contagious with treatment. If anything, they become less so.

I would talk with your dermatologist about re-infection.  I suspect he/she will tell you this is a chance occurrence and not something to worry about, nor anything you can reasonably do anything about.  

No change in my opinion about hand to genital contact. This is not something to worry (or obsess) about.   EWH

[andyinnewyork]

Ugh, apologies. Now I'm noticing what could be a small ones on my fingers as well, hard to tell. Your initial response re: the neglible risk of hand to genital transfer is the same whether hand warts were on fingers or other areas of the hand, correct?

[andyinnewyork]

And one last thing (sorry to inundate.) Your thoughts on hand>genital transfer take into account that the dermatologist has ID'ed these as flat warts, not 'common' warts, yes? (I'm sort of in the dark about the exact difference myself...)

[andyinnewyork]

And this might be a question for my dermo, but maybe you know...anything I should do to avoid reinfecting my HANDS with the flat warts? Luckily they're not on my fingers so I'm not too concerned about things like my computer keyboard...but I ride a bike daily, and I'm wondering if the bike handlebar should be a matter of concern...would it be silly to worry about that, or about keeping the area disinfected? It would be a bit of a pain, but certainly better than dealing wiht this issue longer than I need to...Thanks!

[andyinnewyork]

Thank you very much, this is very helpful & does make me feel better. And I agree, I'm very happy with my dermatologist.

Though the one thing I do have to say: The warts on my hand were nearly invisible, i.e. unless one was a hypervigilant hypochondriac (myself, guilty), one would never notice them. NOW, however, due to the freezing in the office...it's a bit of a different story. As my Dr. said they would, the spots are now blistering up a bit--do you have any idea if the warts are 'more contagious' during this blistering process, or if the blisters are popped? And any idea how long they might be contagious post-freezing and topical treatment? It's a bit of a bummer (obviously!) not to be able to shake hands or hold someone's hand without feeling like a pariah ;).

[Edward W Hook, MD]

Welcome to our forum. You ask a good question.  As you wrote your thread, you worked through the issues related to your warts quite well and what I am about to say will, in large part, be confirming what you have already learned.  Further, I want to tell you that the dermatologist who is treating you has done a great job for you as well and sounds to be quite well informed- you have already heard and re-stated to me many of the sorts of questions that are all too often mis-stated by other health care providers.

As you point out, there are many (over 100) different types of HPV and while they are all HPV, they have the tendency to have "preferred" sites of infection, such that the sorts of HPV that cause hand or foot warts do not typically cause genital infections and vice versa.  Hence, your touching and masturbation of your sexual partner with a wart infected hand or finger is not likely to be transmitted to her and is not something I would worry about.  I would not hesitate to mention to her, in passing, that you are having the warts on your hand treated.  If she has held you hand, she knows something is there and if the presence of warts on your hand elicits a reaction or conversation, take it as an educational opportunity, not a problem.  

While in medicine, and with humans, one never says never, the chances that you will transmit the HPV that causes the warts on your hand to our partner during sex or foreplay are negligible and should not concern you.  I hope this response is helpful. EWH