Question about HPV // Warts vs. Skin tags // Oral sex

[robotdog]

This is a question for doctor Handsfeld, if possible. Several parts, I'll try to keep it clear:::

I recently had an encounter with a girl involving oral sex (giving and receiving). While giving oral sex I noticed what appeared to be a small, fleshy-colored growth in her groin area, I'd say about two inches from her vagina. This was a few millimeters long protrusion--this sounds gross, but almost like a small 'finger-like' tiny growth. Just a single growth. From what I could tell it wasn't rough or didn't have any other characteristics of warts I'm finding online.

FIRST QUESTION: Does this sound more a skin tag, or possibly a genital wart? This sex partner had other visible moles and the like on her chest, forehead, etc..not sure if that makes a person more liable to manifest skin tags?

Regardless of your thoughts on the appearance there...SECOND QUESTION: I'm now slightly concerned about the thought of HPV and oral sex. Let's say that protrusion was, indeed, a genital wart. What is the likelihood that this could spread and generate genital warts in my mouth? I really don't want to be in a situation where I'm inspecting the interior of my mouth or lips for something like this...

And FINALLY--would the wart virus carry in the saliva? ITHIRD QUESTION: n other words...I performed oral sex on the girl. We then kissed. She then performed oral sex on me. Is there a chance that somehow in this indirect exchange that my saliva could have picked up virus from any HPV growths she might have had...passed it to her mouth...and then passed again to my genitals? A bit crazy, I know.

THANK YOU!!

[Edward W Hook, MD]

I think you're worrying too much.  It is the friction/rubbing that causes the microscpic abrasion you're referring to.  Sounds like your rubbing was minimal.  There is no way to know how much friction/rubbing is "enought" however, more friction, higher risk for infection.  I'd try your best not to worry.  EWH

[Edward W Hook, MD]

Oops, I thank marcusjune for catching my typo. The statement should have been "Oral HPV is NOT common".  I apologize for this mistake. EWH

[robotdog]

Thanks, this is indeed very helpful!

I had one final (literally final) follow-up.
I'd read that HPV needs a microscopic abrasion to be passed on, hence the fact that during intercourse (with close skin contact, friction, etc) it's easy for this to happen. But what about less intimate skin contact?
In the incident I initially described--while I did not have sex with this partner, we slept quite close. If the 'skin tag' was actually a wart, and it came in contact in this situation with my thigh, would it be possible to transmit the wart from such non-vigorous contact? Especially considering it'd be from her genital area to a  non-genital area of skin on my own body (my thigh)?

[Edward W Hook, MD]

Welcome to the Forum.  It is impossible to say if the lesion you describe was a skin tag or a wart.  I made an exception to our rule that we don't look at photos on this site to see the picture you provided a link to and it was a reminder of why we don't look at skin lesion photos- it's impossible to say from that picture what that lesion was- if you told me it was a biopsy proved wart, I would believe you but I would also believe you if you told me it was biopsied and was a skin tag.  It could have been either.  Either way however, the likelihood of transmission/acquisition through oral sex is low.  Although HPV infections are common, occurring in over 85% of sexual active adults, oral HPV is common. The HPV virus has tendencies to preferentially infect different body sites and genital HPVs to not particularly often infect the oral cavity. That's not to say it's not possible or doesn't happen, it does, but it is uncommon.  

The fact that your partner has other moles and skin lesions makes it likely that she had similar or related lesions on her genitals.  

Oral HPV infections are uncommon and should not worry you.  

Finally, each time secretions are passed from one body site to another the amount of infectious material present declines over a hundred-fold and with that reduction in infectious material, the chances of transmission diminish as well. The idea that you might get HPV in your mouth from her during oral sex, transfer it to her mouth by kissing and then have her give it to you to cause genital warts/HPV is simply not a likely scenario.

I hope these comments provide some context.  I would not be worrying about HPV from the contact you describe, in part because it is unlikely and in part because there is nothing to be done to prevent it if it was going to occur- there are no reliable, non-research tests available for oral HPV. EWH

[robotdog]

To give a bit of a better idea: the appearance was fairly ballpark close to this:

http://skintagsremove.com/wp-content/uploads/2011/06/skin-tag.jpg

While some skin tags seem to have a circular 'blob-type' shape, what I noticed was more cylindrical. Hope that clarifies some...not sure if genital warts can also present this way.