STDs Expert Forum
HPV?
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The STD Forum 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.

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HPV?

I noticed a bump (about 1mm) on edge vagina towards groin area about 2.5 months ago No idea how long it has been there, hardish bump that couldnt scratch off. I stupidly did the vinegar test (soaked cotton ball with undiluted white vinegar) couple of minutes. It didn't turn white but left about a 5mm circular burn around it. A few hours later the bump swelled a little and i put a pin in it and it started bleeded a little, didn't pop or anything but was softer to touch. It turned a very pale red colour that evening. Next day bump looked the same. Surrounding skin was raw and weeping, applied some antiseptic cream, poked bump with a pin it oozed a little. Kept applying antiseptic cream
Went to STD clinic next morning, explained put vinegar on it and didn't turn it white and he said its not a wart. He had a very quick glance and said not a wart because there's only one and it is in an area of hair growth,but can't be certain because it has been burnt. he said I'm good to have sex as long as I wear a condom because thats not a high friction area anyway.
When got home the bump was flattened and nearly flush with the skin. Was still flesh coloured and hadn't scabbed or anything, I could still see it but just looked flat, this is 48 hrs after vinegar application. Surrounding skin was still horrible.

Now about 72hrs after vinegar application it is not raised at all. The edge of the burn is starting to scab a yellow scab a little so its hard to tell whether the bump is scabbing, actually hard to see anything but burn.( the bump is toward the edge of the burn)

1. Is this a wart?
2. can i still get a biopsy or has burning it with vinegar ruined that and also that it is now flat make it to hard? can skin near wart be biopsied
3. is the whole genital area contagious
4. what type of physical contact can i have with new man, touching my genitals, oral sex etc
5.how contagious is it for my kids, towels, toilet, soap etc

Thank you for your time
300980_tn?1194933000


Welcome to our Forum. I reviewed some of your nearly 50 posts on the Herpes Community site and see that you worry a lot about STDs and tend to examine yourself quite closely.  I worry a bit about this- there are many completely normal, non-STD irregularities and lesions throughout the genital area which get noticed and the become the subject of unnecessary repeated examinations, manipulations and self-treatment.  (In an earlier exchange Grace on the HSV Community site called this the "crotch watch").  This sort of scrutiny is typically not helpful and can be harmful if it leads to scraping, self-medication, picking, etc. at the lesions as these are all practices which can only obscure what it really going on.  

Further as a point of information, the “vinegar test” is not useful.  Some lesions that are not HPV turn white and lesions that are HPV may not.  It is not recommended.  

With the background, let's address your questions:
1. Is this a wart?
There is no way to tell over the internet. You have been examined by a trained clinician who felt it was not a wart.  Thus, it probably in not.

2. can i still get a biopsy or has burning it with vinegar ruined that and also that it is now flat make it to hard? can skin near wart be biopsied
If the lesion remains, it can be biopsied and you can find out if it is a wart or not. It sounds small enough that a biopsy will probably remove it any way.  If you choose to pursue a biopsy, I would stop applications of vinegar or other substances, as well as other manipulation through repeated self-examination.

3. is the whole genital area contagious
no, if this was, HPV is a local process.  Anyway, worrying about HPB is a waste of time-virtually every sexually active person already has HPV.  Here is something I said to a prior client:   "For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated. "

Here is also the link to a longer, blog-like post Dr. Handsfield made to another client which expresses many of the same facts:  
http://www.medhelp.org/posts/STDs/HPV-Transmission/show/1522088

4. what type of physical contact can i have with new man, touching my genitals, oral sex etc.
See above.  Even if this is a wart, there is no reason for concern or limiting your sex life.

5.how contagious is it for my kids, towels, toilet, soap etc
No, despite the apocryphal things that are found on the internet, HPV infections, if that is what you have, are typically spread only by DIRECT contact, not on towels, toilet seats, soap, or dirty laundry.

I hope these comments will be helpful. EWH
6 Comments
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Avatar_m_tn
Thankyou for your response. I haven't always been this paranoid about std it is only since I had a stupid one night encouter. 3 months agdo, and I have been obsessed ever since.Witmy question is it a wart I know you cannot tell over internet but cna a wart disappear that quickly with vinegar, I guess I was just wanting to know if you felt it was more likely not a wart based on its reaction to the vinegar. You also said that it should not interfere with sex. Are you saying I should continue to have sex even if this could be s wart. I know HPV is mostly harmless if I pass it on but it is also the social stigma attached to it if someone caught it from me.
Just some clarification on the biopsy, can only a lesion be biopsies, can you biopsy the skin under or near it ?
I was thinking of telling my new partner the situation that not sure what it is and may never know if lesion doesn't come back and he can decide whether he wants to have sex based on the information. Does this sound like a responsible approach.
Thanks again.
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Avatar_m_tn
I have a couple more questions. My questions are using the assumption that it is a wart. I have been reading through other posts to try and find answers esp regarding oral sex and HPV. Most answers I have read are related to high risk strain of HPV and not when warts are actually present. So if I have one wart near groin can I have oral sex performed on me, is this high risk of transmission. Can I cover the wart to reduce the risk? Similarly with him touching my genitals. Also can masturbation spread the warts around the genital are?
I am also interested to know, do you get infected at the point of contact. I'm just trying to figure out why I would have only 1wart. I have been examined at clinic and they didn't find anything else that suggested warts.
I have read that digital insertion can cause anal warts, how does this happen. I didn't think warts on other parts of body could be spread to genital area.
Thanks again.
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300980_tn?1194933000
You have already received a long and inclusive answer and suggestions.  The replies to your continuuing questions, particularly the "what if" questions will be brief.

Vinegar does not make warts go away.

I said I would not suggest changing or alter your sex life based on this lesion, whther or not it is a wart. The rationale is mentioned repeatedly in the statements and link provided above.

The stigma you perceive associated with HPV infections is based on ignorance.  Stand up and fight it.

Why would you biopsy apparently un-invovled skin- this makes no sense if you want to know what the lesion is.  Further discussion of what a biopsy could and could not do should be taken up with a dermatologist.  

You might tell your partner you have a skin lesion and that you don't know what it is.  discussing what it might or might not be seems a bit much to me.  Find out what it is, then discuss it.

For your what if questions. The issue of oral HPV, which includes warts is broadly discussed on other posts on this site.  You don't even know that you have a wart.  I would not worry about issues of oral transmission.

HPV is not spread by anal masturbation

EWH
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Avatar_m_tn
Thanks again for your responses, just a follow up question, you stated that vinegar will not make a wart go away, can I conclude from that then that because I no longer have a bump that it wasn't a wart. The std nurse was under the impression that I have essentially burnt the wart with the vinegar. It was a once only application but was enough to burn surrounding skin.
Also a couple of questions out of curiosity, why do people not take antivirals after having warts removed? Is it because it could interfere with body's natural ability to fight it off?
One more, if you believe you have been exposed to HPV but never show warts would it be correct to assume that you are clear of the virus after 6 months from the exposure?
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300980_tn?1194933000
You are getting off topic. For general information on warts and HPV you can either search this site for additional questions and answers or go to the web site of the American Sexual Heallth  Association (ASHA).  This thread will be complete after this reply. There will be no further answers or replies.

Vinegar burns the skin because it is a dilute acid but the strength of the acid is not sufficient to destroy warts, particularly after a single application.

There is no antiviral therapy which kills HPV, thus taking antiviral therapy (not sure what you mean by this) after wart removal would be a waste of time and money.

In general, if you have had sex, you have HPV. This is discussed many times on this site.  Here is one reply to another client - "For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  For men there is far less risk of any sort."

This will conclude this thread.  EWH
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