I'm just full of questions...

I first want to thank you for your help and tell you what a great site this is...I have yet another question.  I have read that cigarette smoking increases a person's risk of developing warts.  Is this true?  
Also, before I found this site I had browsed many other sites for information on HPV.  Most of them said that over two-thirds of people exposed to warts will develop them within 3 months!!!  Of course, I don't believe them after asking you about it, but I'm still floored by those statistics.  I found it hard to believe when I first read it anyway; it just doesn't make sense--if it were true, I would think obvious genital warts would be a lot more common than they actually are!  Any idea where they get these numbers from?  Is it just outdated information?  Thanks:-)

[H. Hunter Handsfield, M.D.]

Thanks for the thanks!

Smoking is definitely related to development of pre-cancerous changes of the cervix, and perhaps cancer itself, in HPV-infected persons.  There may have been a couple of research studies that showed an association with warts, but I don't recall for sure.  If there is such an effect, it probably is fairly small.  In any case, smoking doesn't cause warts or cervical changes per se; HPV is still the cause, with smoking apparently affecting disease expression.

As you state it, the information from the other sites clearly is wrong.  Are you sure you understood what they were saying?  Among persons who get visible warts, it is likely that something like two thirds show up within 3 months.  But among all persons who catch HPV type 6 or 11 (the main wart-causing HPV types) a small minority get visible warts.

Send me the URL of any site that actually says most infections result in actual warts.  I won't hesitate to tell them they're full of @#$% (but perhaps with a bit more diplomacy than that....)   ;-)

HHH, MD

[Rose78]

I was wondering to about the dormate period of HPv.  I recently had a pap smear test that came back with HSIL.  The nurse said to come in for a caposcopy (not sure if that's how its spelt) and an HPV test.  In Feb, my boyfriend and myself were tested for all STDs and the test came back negative. (this was six or more months after we had been with any other person)  When I told the nurse this, she explained that HPV can show negative even when you have it.  I was wondering about that fact.  Is there any period when you can say, ok I am STD free? and What other STDs can show up negative, but because of dormancy periods will not show up at the time of the test?

[H. Hunter Handsfield, M.D.]

You have put your finger on one of the most disconcerting thing about HPV infections.  Yes, you can catch HPV and have no symptoms and nothing show up on pap smear for months or years.  Similarly, there is no test to be sure HPV infection has gone away.  However, the large majority of infections clear up spontaneously over several months.  So once your infection is treated (at colposcopy, your provider may cauterize or cut away any visible areas of abnormal cells), the likelihood is that your infection will resolve.

In a way, none of this matters.  HPV is so common it can't be avoided anyway, except by permanent lifelong monogamy; and the high-risk types that cause HSIL are not going to cause any visible problem in your partner(s).  So getting HPV and transmitting it are, for practical purposes, normal events that are part and parcel of normal sexuality.

To answer your last question, all STDs (all infections, actually) have their own incubation periods, the time from acquisition until a test will be positive.  They are very short for some infections (a few days for gonorrhea), longer for others (1-6 weeks for chlamydia, herpes, syphilis, HIV), and longest (weeks to months to years) for HPV.

Regards--  HHH, MD

PS:  Do be certain to follow-up with your colposcopy.  The vast majority of HSIL will go away by itself, without progressing to more advanced pre-cancerous disease or cancer itself.  But don't take the chance.

[Rose78]

I have one other question.  HSIL in my case is caused by HPV.  I have a LEEP scheduled for later this month.  My question is, how will this affect my boyfriend?  Will he show any symptoms? ie genital warts or anything.  I know there are no test to see if he has HPV, but I don't want to harm him in any way.  What should I do?  

Also, as for the other STDs we were tested for back in Feb.  We can assume that all results would be consistent if the test were repeated today, right?


Thanks for your help

[H. Hunter Handsfield, M.D.]

Your partner has already been exposed to your HPV, almost certainly is already infected.  Undoubtedly he is asymptomatic and will remain that way.  He probably won't get warts; different types of HPV cause HSIL and genital warts.  Continued sex (with no requirement for condoms) will not harm either of you in any way.

A comment about your opening line:  Of course your HSIL is caused by HPV "in your case".  HSIL is caused by HPV in everybody's case, because all HSIL is caused by HPV.

Relax about your partner's health, and don't let your HPV infection interfere with a healthy, mutually rewarding sex life!  Best wishes--

HHH, MD

[is there a cure]

If you have active warts and they are treated by freezing or burning, will you always have to worry about infecting others and having warts come back yourself?

[sara l]

Hi i'm 17 and have only had 2 sex partners. I have a few questions i would like to ask but ill try to make it as fast as i could. the first one is can you get STD"s from using someone elses shaver or toothbrush? i havent had sex for a year after i had to get an obortion for personal resions and about 6 months ago i noticed little bumps that look like goose bumps inside my vagina that comes and goes and im freaking out. about 4 times; at cosco, walking to the bus and getting my nails done i would get dizzy, started shaking to the point i fall or sit my self down, i would loose eye sight but was still able to hear and get this really bad head pains, then i would be ok. my stomach feels sore all the time and iv been having diearea . for about  1 month my eye lids would get swollen when i would cry but my eyes would stay that way through out the day. the strange thing is that my twin sister has been going through the same sympthoms as me. can you please help give me an idea of  whats wrong with me?

[normal?girl]

hi, im 17 too and am scared out of my mind that i may have herpes. I went to the doctor to have it checked but she says its not herpes and I am totally normal but i still have a feeling it is herpes.  Can you tell me what you think? Okay, on my vulva, it is red and has small hard white bumps and Ive had this for about 5 years or even more. Ive researched herpes and even though Ive never had intercourse before and the pictures Ive seen look nothing like my bumps i still have a feeling it is not normal. And, if it is not, can you tell me what is wrong? Are these bumps normal??