Odds of developing genital warts?

[Jenna134]

I'm a 24 year old woman who is concerned about the likelihood of developing genital warts. My ex-boyfriend was upfront with me about a minor recurrence of his genital warts early in our relationship, and before we had any sexual contact of any kind. I had also been previously vaccinated with Gardasil, and received the full series. When the recurrence surfaced, we saw a dermatologist, and 3 months after he was treated and showed no signs of recurrence, we had unprotected sex. Well, we ended up breaking up, and now I live with the worry that one day, I'll develop warts. I also worry about a little thing I noticed:

I suffer from clitoral adhesions. I recall that after removing a bad one, the area became very inflamed. Soon, a small, slightly elevated light-colored spot appeared on my glans clitoris, where I removed the adhesion. I noticed it was more apparent when moist, like after a shower. It reminded me of leukoplakia. On most days, it wasn't visible at all. I assumed it was an area of hyperkeratosis due to the trauma of adhesion removal, (and because I kept picking) at it or some kind of inclusion cyst. I decided to keep an eye on it, because I realized my doctor would probably think I was crazy for pointing it out because a normal person just would never have noticed it. It hung around for about 2 months and then disappeared. Now I'm worried this was some type of genital wart. How likely would it be to develop a wart on my glans clitoris, but not anywhere in the vestibule, where the most friction would have been?

It's been almost 8 months since my last exposure to my ex, and I have no signs of warts (confirmed by my gynecologist, who is knowledgeable of the situation). What are the odds of developing them at this point, and do you think what I described was a wart?

[Edward W Hook, MD]

I have never heard or seen that genital warts can be diagnosed by a black light. This is a new one for me.  I doubt it. EWH

[Jenna134]

Hi Dr. Hook.
I have one final quick question. Can genital warts be illuminated with a black light (UV lamp)? I read this online somewhere and I have never heard of it being a legitimate diagnostic tool. Is it true?

[Edward W Hook, MD]

Yes, your summary of my reasoning is correct.  Your thinking is sound,. There is no reason to worry further.  EWH

[Jenna134]

Thank you so much for your reply! I should clarify that we had no contact of any kind until 3 months after the wart of his was gone. This, coupled with the vaccine, coupled with the fact that the lesion I mentioned appeared in a place where warts don't commonly form, and that I had absolutely no other lesions of any kind in the places they WOULD normally form, should all further support the idea that what I experienced was not a genital wart, correct? I recall you and Dr. Handsfield mentioning the bit about ehy warts form in certain places, so is my thinking sound?

[Edward W Hook, MD]

  Welcome to the Forum.  I'll be pleased to comment.  At this time you have done everything you could possibility do to avoid getting warts and it appears that you were successful.  The HPV vaccine is the most effective means of preventing HPV infections and contains the two types of HPV that cause over 95% of visible genital warts.  This, in combination with your use of condoms until three months after your partners wart had been treated.  

As far as the lesion on your clitoris, you have a good alternate explanation and the lesion you describe does not sound like a wart.  My advice at this time would be to try to keep your hands off your clitoris and the lesion- this can be irritating and cause lesions which might be mistaken for a wart.

Most warts become visible 3-6 months after exposure.  The fact that you are now out 8 months since your last exposure without appearance of a wart suggests that you did not acquire infection form your partner.  I would not worry further about this.

I hope that this is helpful.    You have done everything right. should you happen to get a wart, this is just not that big a deal.  On the other hand worrying and fretting about something that is now out of your control is not in your best interest.  EWH