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recurrent wart
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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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recurrent wart

Hey doc. thanks for the forum and your opinion/time. here's my situation and questions:

1) I had a wart burnt off my penis (located just under the glans (glands) where the circumcised skin is) and noticed that it came back. It was diagnosed by a dermatologist. There was no visible signs of a wart anywhere else in the genital area which was examined by the derm. During the time in between recurrence, which was about 3 months, I had protected sex with a couple different girls. My first question, what is the chance that these girls got hpv from that wart? It was 100% protected sex and the condom for sure covered the area of the wart and there was no genital opposition. My understanding is that skin-to-skin means that the wart area needs to be in direct contact with the other person's skin. I read where HHH indicated that hpv needs to be 'messaged' into the skin.

2) Do I need to let these girls know that they are at risk from me? I really don’t want to upset them and I don’t want them to think I’m a jerk. I really thought the warts were gone.  

3) Do hpv strains that cause warts cause cervical cancer? Info on the internet is really confusing about this. I know about hpv 6,11 causing 90% of warts, but what about the other 10%. Are those caused by the cancer causing types?

thanks very much, doctor.
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I'll try to help.  I'll go straight to the questions.

1, 2) Although treatment probably reduces infectivity of HPV, recurrence of the wart suggests you likely were infectious during the interval between the initial treatment and the recurrence.  However, the condoms provided substantial protection for your partners, but not 100%.  All things considered, given the location of the wart, the risk of transmission probably was low.  Also, it is certain your partners have been previously exposed to HPV and will be exposed again, so informing them of these particular events probably would make no difference in their overall risk of HPV infection.  There are no hard and fast answers, but if I were in your position, I probably would not do so at this point in time.  However, some experts would disagree and would recommend you inform your partners so they can be on the lookout for visible warts.

3) The universal statement is that HPV 6 and 11 cause "at least" 90% of overt warts; I don't think you'll actually find very much disagreement on this, at least not among professionally run websites.  It may be 95% or even higher.  There haven't been many research reports on the causes of the last few percent.  They probably are caused by many different HPV types, mostly other low risk types.  The dominant cancer-causing HPV types (16, 18, 31, 45, and others) probably are rare causes.

Regards--  HHH, MD
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Avatar_n_tn
the recurrent wart was located in the exact same area
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Avatar_n_tn
thanks for that. I was just wondering in terms of statistics or probabilites what a 'rare' cause of warts mean in terms of a high-risk strain causing the wart. Does it mean for every wart out there, maybe 1 in 1000 is caused by cancer causing types? Or more? Or less? I know it's hard to put a number on it, but I just need piece of mind that my wart is most likely from a low-risk strain.  
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239123_tn?1267651214
You already know that your wart was "most likely from a low-risk strain" -- at least 90% likely.  It is impossible to estimate it any more precisely.

But it really doesn't matter.  Regardless of this particular infection, it is a fair bet you also have been (or will be) infected with a high risk HPV strain.  Considering all the 30-40 HPV strains that cause genital infection, the two most common are HPV-16 and 18, the two highest risk types.  But even with those types, the vast majority of infections never progress to cancer, especially in men.  Don't worry about it.
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University of Washington
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