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HPV/Scar/Recurrence
Hello Doctor,
Starting about 2.5 years ago I had outbreaks of genital and anal warts. I had them treated with cryotherapy repeatedly, and one had to be surgically removed, it was between my legs, between my anus and scrotum. This left a small bump which I assumed to be a scar.
After my last session of cryotherapy (treatment took about 18 months) I used Aldara and applied it to where I had seen warts, but also applied it liberally to this little scar (just in case, I thought). I guess I was too liberal because I developed an ulcer in that spot and went to the doctor immediately. He confirmed that it was from the over use of Aldara, and swabbed the ulcer for a PCR test to see if it was previous site of a wart. He also confirmed that I had no other warts present (I had been 5 months free of recurrences by this point). The test was negative for HPV.
After this, I had one more exam at 6 months wart free, by another dermatologist. The spot that was once an ulcer was once again an irregular bump of "new flesh" had grown back. I felt this bump change and grow a little bit but just recently I was nervously picking at it and it came off, which I thought was more typical of a wart. There is now just a small wound.
My worry is whether this was a wart all along. I ask because I was told by my doctor that after 6 months without a recurrence, I would no longer need to advise new partners of my HPV status (I was stringent about this during my "infectious" period). Although I always use protection, I have indeed had new partners since.
My question is, do you believe the swab test was reliable if only the Aldara induced ulcer was present and not the bump in question? Also, even if the "bump" that grew there was indeed a wart, would it have it been considered a fresh recurrence, or rather a stubborn wart that had not been fully treated. Basically, Im wondering if I need to restart the 6 month clock and advise past partners.
Thanks very much for bearing with me,
Starting about 2.5 years ago I had outbreaks of genital and anal warts. I had them treated with cryotherapy repeatedly, and one had to be surgically removed, it was between my legs, between my anus and scrotum. This left a small bump which I assumed to be a scar.
After my last session of cryotherapy (treatment took about 18 months) I used Aldara and applied it to where I had seen warts, but also applied it liberally to this little scar (just in case, I thought). I guess I was too liberal because I developed an ulcer in that spot and went to the doctor immediately. He confirmed that it was from the over use of Aldara, and swabbed the ulcer for a PCR test to see if it was previous site of a wart. He also confirmed that I had no other warts present (I had been 5 months free of recurrences by this point). The test was negative for HPV.
After this, I had one more exam at 6 months wart free, by another dermatologist. The spot that was once an ulcer was once again an irregular bump of "new flesh" had grown back. I felt this bump change and grow a little bit but just recently I was nervously picking at it and it came off, which I thought was more typical of a wart. There is now just a small wound.
My worry is whether this was a wart all along. I ask because I was told by my doctor that after 6 months without a recurrence, I would no longer need to advise new partners of my HPV status (I was stringent about this during my "infectious" period). Although I always use protection, I have indeed had new partners since.
My question is, do you believe the swab test was reliable if only the Aldara induced ulcer was present and not the bump in question? Also, even if the "bump" that grew there was indeed a wart, would it have it been considered a fresh recurrence, or rather a stubborn wart that had not been fully treated. Basically, Im wondering if I need to restart the 6 month clock and advise past partners.
Thanks very much for bearing with me,
MEDICAL PROFESSIONAL
I'm glad to have helped. Thanks for the thanks.
THank you doctor, this reassures me. I want to act ethically when it comes to my HPV and possible transmission to others, but I have a hard time tempering excessive worry with practicality. This has reassured me ahead of my dermatologist's appointment.
MEDICAL PROFESSIONAL
Welcome to the forum.
Of course nobody, no matter how expert, can make a diagnosis from afar based only on a written description. But from all you say, I strongly doubt you still have a persisting wart, or that this is a recurrent wart. It's rare for warts to persist this long; even without treatment, most go away within a year or so. And certainly scarring is a possible explantion for the bump you feel, given the over-treatment and ulceration in the past. I would expect the HPV swab test to be negative, and I would consider it reliable.
Also, I agree with your doctor that 6 months is a reasonable interval; with no persistence or recurrence of warts at that time, most people probably are non-infectious and need not discuss their past warts with new partners.
I hope this has helped. Best wishes-- HHH, MD
Of course nobody, no matter how expert, can make a diagnosis from afar based only on a written description. But from all you say, I strongly doubt you still have a persisting wart, or that this is a recurrent wart. It's rare for warts to persist this long; even without treatment, most go away within a year or so. And certainly scarring is a possible explantion for the bump you feel, given the over-treatment and ulceration in the past. I would expect the HPV swab test to be negative, and I would consider it reliable.
Also, I agree with your doctor that 6 months is a reasonable interval; with no persistence or recurrence of warts at that time, most people probably are non-infectious and need not discuss their past warts with new partners.
I hope this has helped. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
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