Suspect Genital Warts.. uncertain what to do

[MikeT73]

Hello, Doctor

My question is regarding what I fear might be genital warts and, if so, how I deal with it.

First, I'm a 32 year-old male. I am about as far from promiscuous or sexually active as you can imagine; my last sexual partner was over 3 years ago.

Recently, I've noticed a small, very small, patch of odd-looking skin just above the shaft of my penis that was obscured by pubic hair. It's the same color as the surrounding skin and, honestly, can be, and has been, easily overlooked. It could have been there for weeks or months for all I know. It doesn't hurt. Doesn't itch. No bleeding or oozing. My first thought was "skin tags".. But, as I read the description of them, and saw pictures I realized what I have doesn't seem to fit that description; or at least the one I'd read/seen.

I looked further and found what looks to be very similar to what I have... that cauliflowered appearing cluster of sorta tiny bumps. In addition there are a couple tiny bumps right near that spot on the base of the shaft itself. Again, they don't hurt, they don't itch. The area most affected is barely the size of a dime.

Fearing this might be an outbreak of genital warts and having read up on every site I could find on the topic... I've gotten a bunch of different information, nothing that has answered any of my concerns definitively and am ultimately confused and concerned.

For one, I am in the early stages of a new relationship and it's quite likely - or would have been - that she and I would engage in intercourse in the near future. Not now, though.. not knowing I might have warts. I could not consciously risk passing it on to her.

My first question is... though I know it's very common it's still something that, I fear, might turn her away if not explained properly. That it is highly infectious and that we should avoid sex.. but it's not something to be feared. Not deadly, I'm not diseased and it is treatable, with a vaccine for HDV fairly close to release, as I've read. What might you recommend I say to her to explain the situation in a thorough and reasonable manner so as not to bring about any unwarranted concern? Is there a good online resource you might point to?

Second... I'm in-between jobs currently and have no insurance. I would likely not be able to afford a doctor's visit at this point, unless they were able to work out some kind of payment plan or something.

What measures can I take to help treat this in the meantime? Is there any kind over-the-counter product to help at least get rid of the warts that you would recommend? I've looked into several whom, of course, all strongly recommend themselves. I'd much prefer an objective outside opinion from someone who knows what they're talking about.

And... are there, perhaps, clinics I could go to to see a doctor to have it at least examined and identified either way, for an approachable fee (ie.. couple hundred dollars, tops)?

Thank you so much for your time and advice.

Regards,
Mike

[Alan Rockoff, MD]

You ask good questions, but they do not have definitive answers.  I suggest that you get rid of the warts any way you prefer.  There is no certainty that Aldara will get rid of the problem forever, even though in theory it "gets to the root" of things.  My own preference would be for freezing--a lot faster and less irritating when warts are localized, as yours appear to be.

Dr. Rockoff

[MikeT73]

Well, they offered options... One of the options was to freeze them off. Another was Aldara. My understanding (and please correct me if I'm wrong) is that Aldara addresses the cause, while freezing them off only eliminates the symptom.

Through all the reading I've done online about this, and it has been a bit confusing to put 2 and 2 together at times.. this is what I understand about the virus and warts..

- The virus is extremely localized in the skin, specifically to the spots that warts would actually form. So, you could touch the skin an inch away from where a wart has formed and not be of any risk (assuming that patch of skin isn't also affected). Direct contact with the affected spots of skin is necessary to allow it to pass to someone else.

- When there are warts present, the virus is most contagious and most easily transferred to someone else. When warts are not present, the virus is "dormant" (assuming it's the type that causes warts). It's still contagious, just not nearly as much. So, eliminating the warts reduces the risk of someone else getting infected, though not substantially.

- Eliminating the warts while the virus is active is only eliminating the symptom.. it does not affect the cause (the virus). So.. by freezing off the warts, all that's really happening is you're eliminating the visible symptom of the virus.. the virus itself is unaffected, still "alive and well" in the skin, and new warts may well grow in their place.

- Using something like Aldara, which (as I understand) goes to the source of the warts, the virus itself, by building up the body's immune system to attack and "shut down" the virus; eliminates both the symptom *and* the cause. This would seem to be the most ideal solution.

Those are the general details, as I understand them. If I'm wrong, please correct me. I'd like to know so I can be better informed.

I tried asking the dermatologist this question and he seemed to indicate that it's not a "guaranteed" answer either way.

Can you truly eliminate/cure a current infection of the virus from your skin/body through appropriate means... Or.. is it really in your system forever?

Is there ever a case when someone affected can have an active sex life and *not* still be at risk of infecting someone else, assuming protection is used, etc? Again.. this is based on having treated a current infection.. nothing to do with whether or not they might contract it again down the road from another partner, etc.

Thanks again...

[Alan Rockoff, MD]

I am surprised that the doctor gave you Aldara.  There are much simpler ways to get rid of a couple of warts, if that's what they are.  If I were you, I would get another opinion from a STD clinic (the health department is a good idea.)  Even if they are warts, a single freeze with liquid nitrogen should get rid of them.

Dr. Rockoff

[SammyC149]

What was the name of the cream that she prescribed you?  We're they over the counter or what?

[Alan Rockoff, MD]

You seem to have more or less diagnosed yourself with genital warts.  However, you should not diagnose yourself.  You need to see a doctor in person.  When you do, I am confident that you will find that you do not in fact have genital warts, just some unimportant irregularity in your penile skin, of no significance.  Then you will be able to proceed with establishing a relationship with your new friend free of anxiety over warts.  

Many hospitals have walk-in clinics.  If there are clinics in your town specializing in sexually-transmitted diseases, that would your best bet for a reliable opinion.

Take care and good luck.

Dr. Rockoff

[MikeT73]

Okay, went to the Dermatologist (great doctor.. patient, informative, etc)

Sure enough I have a couple warts. He gave me a couple samples of Aldara (or something like that) and a prescription for a normal supply. Going out of town so the samples should carry me over 'til I get back.

In any case, thank you for the feedback!

Take care...
Mike

[MikeT73]

Wanted to clarify something I said in my description...

The barely dime-sized portion of the growths is the one above the base of my penis.. the cauliflowered looking spot. Not the smaller ones on the shaft itself.

Re-read what I wrote and realized it could have been confusing.

Thanks!

[girl522]

You should be able to go to the STD clinic at your local health department or a planned parenthood for little or not cost at all.

[MikeT73]

Ahh.. good tip.

Might have to consider that in the future :-)

As it stands, I've made an appointment to go see a dermatologist tomorrow morning. Going out of town for 5 days tomorrow eve, so I wanted to get that done before I left.. so I can at least know what it is.. or isn't.

Thank you for that suggestion, though... Very helpful!