HPV Infection Questions

[needsomeadvice1]

Dr. Handsfield  –

I have an array of questions about my recent diagnosis of genital warts (HPV).   My dermatologist noticed a few bumps and diagnosed me with warts and from what I have read that is the only way to confirm what I have.   That being said I have the following questions I hope you can answer:

1) My doctor told me if I have no symptoms for 2 years I can be pretty sure my body has eliminated/suppressed the HPV and I can go on with my dating life as if I was never infected.  You have suggested just a few months without symptoms.  
2) If I were to infect people, since I had warts, does that mean I will always give other people warts or a better chance of giving them warts or are warts random as a side effect of all strains of HPV?
3) How long do flare up’s keep recurring for most people?
4) Is there anything I can do, supplements, medicines, etc to speed up the process of my body dealing with the virus?
5) My doctor told me there is no way to determine what strain of HPV I have without significant costs (thousands), is that true?  I understand some are more dangerous (which he said are very rare in men) and some take longer for the body to cope with.
6) Dr. Handsfield, I saw a response to similar questions from you in 2007, 5 years later has knowledge/your option changed?  See link below:

http://www.medhelp.org/posts/STDs/Possible-HPV-transmission/show/249391

[Edward W Hook, MD]

At any instant in time over 10% of sexually active Americans have visible genital warts so in fact, our repeated statements that "everyone has them and you should not be concerned" remains our stance.  I should point out that within our statement that most people have HPV we should add that most people have MULTIPLE HPV infections.  Further, while your warts may not be something you can "brush off", you should.  Stuff happens.  We live in a hypocritical society that both worships sex and sexuality and then acts like STDs which occur from time to time as a downside of sexual activity make a person somehow a bad person.  This is an unrealistic and, I might add, peculiarly American perspective, at least compared to Western Europe where a more mature outlook towards sexual health has led to far lower STD rates of all sorts than we have in the U.S.

There are many mechanisms of wart removal. Freezing is among the more widely used by dermatologist, is highly effective and should not scar.  I suspect your scar will go away over time.

The proportion of U.S. women who have had HPV vaccine is steadily increasing and at this time, I believe, approaches 40%.  EWH

p.s. If you are worried about further HPV infections, get the vaccine.  You would need to pay for it but perhaps it can help you toward peace of mind.  It is highly effective for men.  EWH

[needsomeadvice1]

I understand the cancer issue is not a risk to be overly concerned about.  On this forum you often just dismiss HPV because everyone has it.   However, everyone does not get warts or those strains of HPV.   How common is that?  Do you still recommend to behave as if you did not have it after 3 months?  Its not exactly someone people just brush off getting, as I can attest to personally.

Also, what is the most common method of removal?  My original warts were frozen off and they seemed to have left a pretty unattractive scar, also something that makes it a more severe thing to contract that I think it portrayed on this board.

What amount of younger women (I am only 28 so 26 and younger are in my dating age range) get the HPV vaccine?

[Edward W Hook, MD]

While in science one can never say never, HPV 6 and 11 are rarely associated with cervical cancer.  Your question however suggests that you are over reacting to the issue of HPV and possible cerivcal cancer however.  With proper use of PAP smears there is virtually no risk of cervical cancer, even though virtually everyone gets HPV.   EWH

[needsomeadvice1]

Dr. Hook, is HPV 6 or 11 the kind that cause cervical cancer?  Also, lets say we get all the warts removed and I never see them again.   Can one day I have unprotected sex with a possible future wife and not have to worry about transmitting it?

[Edward W Hook, MD]

If you are concerned about the possibility of transmitting warts and/or find them troublesome, I suggest that you get them treated, if your dermatologist has not.  This clearly reduces the probability of transmission.  the problem is that after treatment of virtually any sort 20-30% of warts recur.  If they have not recurred in 3 months after therapy, then they are unlikely to do so.

The other preventative measure is that the HPV vaccine is recommended for all persons under age 26.  The Merck vaccine has HPV 6 and 11 activity and prevents nearly all warts.

Finally, not all exposures lead to transmission of HPV.  Condoms reduce the likelihood of transmission substantially (50-60%) further.


Any/all of these measures might help. As I said however, should transmission occur, there is little logical reason to make a big deal out of it.  I hope these comments and perspective are helpful. EWH

[needsomeadvice1]

Dr. Hook -

Thank you for your response.  I understand that if you have an HPV strain that has no side effects that it doesnt matter.   Since I have warts I have either strain 6 or 11.   Which would mean if I started dating someone, it would be fairly likely that they eventually get warts themselves.  Which is if they respond like I have, is extremely depressing and confusing.   Seems like an unfair thing to put someone through?

[Edward W Hook, MD]

Welcome to our Forum.  Dr. Handsfield and I share the forum and take questions depending on our availability.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients

I'll go straight to your questions:

1) My doctor told me if I have no symptoms for 2 years I can be pretty sure my body has eliminated/suppressed the HPV and I can go on with my dating life as if I was never infected.  You have suggested just a few months without symptoms.  
Our opinions have not changed. Untreated, most HPV infections go away without therapy in 18-24 months.  Following treatment however, if a wart has not recurred in 3 months you can safely assume it will not.  We think your question about "resuming you dating life" is irrelevant since most people already have HPV and or are exposed.  

2) If I were to infect people, since I had warts, does that mean I will always give other people warts or a better chance of giving them warts or are warts random as a side effect of all strains of HPV?
Your question is hard to follow. Over 90% of warts are caused by just two strains HPV 6 and 11 , both of which are in the Merck HPV vaccine.  Some HPV 6 or 11 infections however may not cause visible warts.

3) How long do flare up’s keep recurring for most people?
See 1 above.

4) Is there anything I can do, supplements, medicines, etc to speed up the process of my body dealing with the virus?
There are no proven naturopathic or nutritional supplements proven to help HPV clearance.  

5) My doctor told me there is no way to determine what strain of HPV I have without significant costs (thousands), is that true?  I understand some are more dangerous (which he said are very rare in men) and some take longer for the body to cope with.
That is not true.  Biopsy specimens can be types for several hundred dollars but why would you want to. It has no impact on anything about your illness.  Further, now that your wart has been treated, typing is probably  not possible.

6) Dr. Handsfield, I saw a response to similar questions from you in 2007, 5 years later has knowledge/your option changed?  See link below:
I reviewed this post.  The statements Dr. Handsfield made remain accurate.

EWH