Genital warts

[maximushoney]

Hi doctor, over two years ago I had sex with a commercial sex worker after a drunken night out. The sex only lasted 10 minutes and a condom was used. I am in a monogamous relationship for the past 12 years. Lately I've discovered small growth (like whiteheads) and the tip of my penis and along the shaft. I have showed them to a specialist who after covering them with vinegar was not sure if they were warts or not although he suspected they were not. He told me to keep an eye on them!! I'm extremely worried that I could have developed warts from my stupid encounter and I have two main questions for. 1) do you think it is likely that warts could begin to grow 2 years after my encounter and 2) is it likely for warts to grow on my penis even though I was wearing a condom for the entire encounter? If you could help me with this I would be very grateful!
Thanking you in advance.

[maximushoney]

Hi doctor, just to let you know, I seen the specialist and he confirmed what you said. The spots are just sabaceous cysts and he said the are normal. Although he was unsure about the lump on the tip of my penis he said it was not a wart. Thank you for your help. Do you think I should leave it at this and try forget about it or do you think I should get a second opinion off a dermalogist?

[Edward W Hook, MD]

An STD specialist shoul be fine as well.  EWH

[maximushoney]

It is an std specialist, would you recommend this or do you think I need to see a dermatologist?

[Edward W Hook, MD]

I suspect that what you have noticed are normal irregulairites in the skin around the head of the penis.  I trust that the specialist you will see will be a dermatologist.  EWH

[maximushoney]

Thank you for your response it helps ease my mind, but I am still worried about the spots on my penis. The are like 4/5 small whiteheads just below the head of my penis and are very hard to see. Do you have any idea what does could be as I'm extremely worried about this? I plan to see another specialist this Thursday but I'm living in fear of having something.
Any help would be greatly appreciated!!

[Edward W Hook, MD]

Welcome back to our Forum. I'm sorry that you continue to worry about the possibility of having gotten an STD such as HPV from this encounter two years ago.  There is little reason to worry that the bumps you have seen are HPV.   While no one can (or should) make a diagnosis over the internet.  Given your concerns, I suggest you have a trained clinician, take a look.

With regard to your specific questions:
1) do you think it is likely that warts could begin to grow 2 years after my encounter.

No, the average time after exposure to the development of genital warts is about 6 months.  Two months would be most unusual.  This is likely to be some other process.

2) is it likely for warts to grow on my penis even though I was wearing a condom for the entire encounter?

Condoms are not 100% effective at preventing HPV acquisition but they are highly effective.  This is another reason that the bumps you have noted are not likely to be HPV.

Finally, I would add that the vinegar test for HPV, while ne favored, has now been shown to be unreliable for HPV diagnosis.  the only real way to be sure is with a biopsy.  Personally and based on the information you have provided however, I see virtually no reason to do so in your case.  

I hope this comment is helpful.  EWH