HPV and Immune System

Hi Doc,

I am a 36 year old male who got HPV (warts) approximately 8-10 years ago. Throughout this time I have battled with them to the point where about 3 years ago I just gave up and they stuck around. I had cryotherapy a month ago and 7 of 10 did not return. The remaining 3 were frozen again a few days ago.

Based on responses I have read elsewhere these things usually clear in 8 months (my doctor told me that people have these on and off their entire lives). Therefore, my situation appears to be non-standard. While I am not concerned about my immune system, as I am generally healthy, but have asthma (well controlled). I exercise on and off, have had some stressful jobs in the past, drink alcohol (8-18 drinks per week) and smoke marijuana recreationally.

What would be your suggestion from someone who is not clearing (I have not seen this covered yet)? Other thoughts on treatment (Aldara just burned my skin as I had a pretty bad reaction -- but would try again)? Are there immune system supplements that I should take (vitamins, etc,)? Thank you

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  I'll try to help.

My main response is that I am skeptical that you still have warts.  When wart-like bumps persist for more than several months, and certainly when they do so for years, usually there is no longer an active HPV infection or actual warts, but scar tissue only.  Since your warts apparently have been professionally diagnosed, perhaps that's exactly what you have. However, if you have not been evaluated by a highly experienced clinician in such matters, such as a dermatologist, that would be wise.  Equally important, in this situation sometimes warts are actually precancerous lesions and should be diagnosed by biopsy.

Otherwise, I have no advice except to keep trying different treatments (freezing, cautery, podophyllin [or podofilox/Condylox], etc); sometimes warts respond just fine to alternating therapies.  There is no immune boosting precedures that is know to help.

Best wishes and good luck with it -- HHH, MD

[H. Hunter Handsfield, M.D.]

I meant to also say that STD specialists don't typically manage patients like you.  In my STD clinic, we refer all patients with such problems to dermatologists.  So I would reemphasize my suggestion that you see a dermatologist if you have not yet done so.

[MNBoston]

Thank you very much. Your response was very helpful.