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STDs (Expert Forum)
HPV Transmission, Treatment, etc.
Answered by
Edward W Hook, MD - HIV Prevention, stds
Welcome to the STD Forum, which 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.
HPV Transmission, Treatment, etc.
by MH2056, Mar 21, 2008 01:26PM
Hello. This is a circuitous tale, but it pertains to my question(s). I recently had a basal cell carcinoma removed from my face, and after the procedure my dermatologist wanted to perform a full body scan. He took notice of a "flat, asymetrical nevus" on the base of my penis near the pubic area. I had been aware of this blemish for approximately 5 years, only discovering it after adopting some good grooming habits. I simply thought it was a mole, as I have many. My dermatologist emphatically said it needed to be removed, and directed me to a urologist for the procedure. I decided to get a second opinion from another dermatologist who was not adverse to examining it and taking a biopsy.
Clinically, and under magnification, the new dermatologist thought it did not resemble a mole, but rather the remnants of a wart. The biopsy resulted in a diagnosis of a condyloma (hpv) with dysplasia, but benign. Questions:
1. Is a wart always contagious, even if it is a remnant?
2. I'm still healing from the biopsy, so I'm not sure if the wart will grow back. If it does, as a new wart, is it now more 'contagious'?
3. Why haven't warts appeared in more numbers on my penis? I've certainly touched that area pre-biopsy then proceeded to urinate, etc. with the same hand. Seems like it would have spread. Could it be dormant due to an immune response?
4. My new dermatologist's follow up plan involves cryosurgery. Is this recommended? How effective is it? Do treatments ever 'unleash' hpv?
5. Do you recommend divulging this information to new sex partners? From what I've read, hpv is so common exposure is almost inevitable.
As for my story, I'm a 35 years old male with a history of 7 sex partners. I've used safe sex practices with every partner, and only ceased using condoms when in a long-term relationship. I'd imagine this is why my hpv appeared on the base of my penis, as it was largely unprotected.
Thanks for reading. I look forward to your response.
Clinically, and under magnification, the new dermatologist thought it did not resemble a mole, but rather the remnants of a wart. The biopsy resulted in a diagnosis of a condyloma (hpv) with dysplasia, but benign. Questions:
1. Is a wart always contagious, even if it is a remnant?
2. I'm still healing from the biopsy, so I'm not sure if the wart will grow back. If it does, as a new wart, is it now more 'contagious'?
3. Why haven't warts appeared in more numbers on my penis? I've certainly touched that area pre-biopsy then proceeded to urinate, etc. with the same hand. Seems like it would have spread. Could it be dormant due to an immune response?
4. My new dermatologist's follow up plan involves cryosurgery. Is this recommended? How effective is it? Do treatments ever 'unleash' hpv?
5. Do you recommend divulging this information to new sex partners? From what I've read, hpv is so common exposure is almost inevitable.
As for my story, I'm a 35 years old male with a history of 7 sex partners. I've used safe sex practices with every partner, and only ceased using condoms when in a long-term relationship. I'd imagine this is why my hpv appeared on the base of my penis, as it was largely unprotected.
Thanks for reading. I look forward to your response.
Doctor's Answer
by Edward W Hook, MD, Mar 21, 2008 05:50PM
, Mar 21, 2008 05:50PMTo: Shazaam72
The issues of wart (or HPV - human papilloma virus) epidemiology are rather complex. If you search this site using the search terms HPV or warts, you will find much information to supplement what I am about to tell you. I urge you to do so.
HPV infections are extraordinarily common. women are better studied than men and the estimate is that around 85% of sexually active women will have a sexually acquired HPV infection at some time in their lives. The figures for men are likely to be similar. They are transmitted by direct contact. the wart you can see should be assumed to have infectious HPV particles in it and therefore to be transmissible to others. Condoms protect against wart transmission/acquisition. As for your questions:
1. If there is wart still there, the best thing to do is assume it is contagious. Once a wart is gone, whether it is surgically removed or by some other means, our rule of thumb is that if it does not recur for 6 months (about 20% recur), then the persons should no longer consider themselves contagious.
2. There is nothing to say that a new wart is more contagious than one which has been present a longer period of time.
3. Warts are local processes. They do not spread out much following acquisition. You do have an immune response to your HPV infection and it is likely to help prevent re-acquisition of HPV.
4. Cryosurgery is a recommended, highly effective treatment for warts. No treatment does not "unleash" HPV
5. You are right, the infection is almost ubiquitous. At the same time, disclosure is the best policy. Remember, condoms do protect from HPV.
Hope this helps. EWH
HPV infections are extraordinarily common. women are better studied than men and the estimate is that around 85% of sexually active women will have a sexually acquired HPV infection at some time in their lives. The figures for men are likely to be similar. They are transmitted by direct contact. the wart you can see should be assumed to have infectious HPV particles in it and therefore to be transmissible to others. Condoms protect against wart transmission/acquisition. As for your questions:
1. If there is wart still there, the best thing to do is assume it is contagious. Once a wart is gone, whether it is surgically removed or by some other means, our rule of thumb is that if it does not recur for 6 months (about 20% recur), then the persons should no longer consider themselves contagious.
2. There is nothing to say that a new wart is more contagious than one which has been present a longer period of time.
3. Warts are local processes. They do not spread out much following acquisition. You do have an immune response to your HPV infection and it is likely to help prevent re-acquisition of HPV.
4. Cryosurgery is a recommended, highly effective treatment for warts. No treatment does not "unleash" HPV
5. You are right, the infection is almost ubiquitous. At the same time, disclosure is the best policy. Remember, condoms do protect from HPV.
Hope this helps. EWH
