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HPV Low Risk - Lingering Questions

Hey Doc, I was diagnosed with Low Risk HPV(Genital Warts back in April, I had them treated with 4 treatments of Trichloric Acid, and just last week my gyno decided to stop the acid treatments and gave me a prescription for Aldara(I still have a couple area's that are not cleared up).
During the time that I was getting the Acid Treatments my gyno told me not to have sex. She repeated this before I left at my last visit when she gave me the prescription...I have been with my current partner for 18 months(unprotected sex the whole time), before that I was with my ex-husband for 17 years...so I either have had this for awhile with no visible warts or I got it from my current partner.  If I understand everything I've read he already has the virus, whether I got it from him or he got it from me, he just does not have any visible warts. Given this information is there any compelling reason we can not continue our sex life as usual?
I have only been using the Aldara a week, and I am not expecting miracles and I realize there is probably not any hard data, but what is a realistic time frame to start seeing results?
One last question... When I had my first Trichloric Acid treatment, my gyno treated a couple areas in the crease of my thigh, this one treatment did not get rid of the lesions, but on my next visit she did not treat them, saying she thought it was just skin tags(which was a relief to me because they had been there for several years and that is what I always thought they were). My question is, if these are in fact warts and not skin tags - and they are not treated, will my body still be able to clear the virus or will still having the warts cause the virus to remain?
Thanks!
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum. These are excellent questions; I'm happy to help.

MedHelp prefers that the forum moderators not overtly disagree with users' doctors.  However, I do disagree with yours; I believe you have a better understanding of the transmission issues than she does, assuming your correctly understood her.  But giving her the benefit of the doubt, maybe she meant you should avoid sex only with new partners and wasn't thinking of an ongoing relationship.  Having had regular sex with your primary partner for many months before your warts were diagnosed, you and he can assume he is already infected with your HPV strain.  He needs to be on the lookout for warts, and should be treated if any show up.  But at this point nothing is to be gained by avoiding sex with him.

Unfortunatlely, I cannot judge whether your continuing skin anomalies are skin tags or warts.  But if they didn't resolve with trichloroacetic acid, my guess is that they are not active warts -- maybe skin tags or simply hypertrophic (overgrown) tissue -- a form of scar -- where the warts used to be.  If skin tags, the imiquimod (Aldara) will have no effect away.  If warts, they'll eventually clear up -- either from the treatment, or on their own.  And it sounds like your gynecologist was uncertain.  In such a circumstance, my advice is that you see a dermatologist -- who probably will be able to tell at a glance.  But if you do that, you should withhold treatment for at least a couple of weeks before being examined.

Finally, in rsponse to your last questions:  The immune system clears up almost all warts and other HPV infections within several months or a couple of years.  The virus may persist in the form of inactive DNA, perhaps for life -- but once they clear up, they rarely recur and cannot be transmitted to partners.

I hope this helps.  Best wishes--  HHH, MD
Helpful - 1
239123 tn?1267647614
MEDICAL PROFESSIONAL
OK, got it.  If the lesion is gone at this time, stop treatment.  If it reappears yet again, do not treat it before you see a dermatologist.
Helpful - 0
Avatar universal
Hi Doctor, I believe there may have been a misunderstanding regarding the question in my second post...so I wanted to clarify. The area I am refering to in my second post, is not one of the areas my gyno seemed unsure of(those areas were only treated once with Acid and then my gyno decided they appeared more like skin tags than warts- I will go to a dermatologist like you advised to get a concrete diagnosis for those areas).
The area I am questioning was definately a wart, it was treated once with Acid and the treatment cleared it, it came back and was treated again with Acid- it cleared again, then it came back. Most recently I treated it with Aldara. I used the Aldara on it three times and now it seems to be gone again. Because the wart keeps recurring I was wondering if continuing to treat the area with Aldara(even though there is nothing there right now)would be beneficial as far as preventing yet another recurrence in the same area or if that is something I should not do? If I am off the mark as far as there being a misunderstanding regarding my question, I apologize. I will not comment again as I know you are busy. Thanks so much! ~ HRA  
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
If the bump is not obviously shrinking after 3-4 Aldara treatments, probably it isn't going to respond at all.  I would reemphasize my advice above:  see a dermatologist.  It is conceivable it's more than either a wart or skin tag, but something more serious, such as a pre-cancerous skin lesion.  Don't be alarmed at that prospect; such cancers are very easily cured long before they might cause serious harm.  Whatever it is, a dermatologist likely will be able to make a diagnosis instantly.  Don't use Aldara for a couple of weeks before being examined.  No harm is likely, but it could mess up a dermatologist's diagnosis.

It would be great if you would like to return with a follow-up comment and let me know what a dermagologist says about it.  Until then, I'm not going to be able to help further.
Helpful - 0
Avatar universal
Thanks Dr. H. I have just one more question if you don't mind. I have one wart, that was treated during my first Trichloric Acid treatment and was gone,  by the my third Trichloric Acid treatment it was back albeit, rather small. It was treated again then, and again gone. By my fifth visit to my gyno it was back again...I began using Aldara and after 3 treatments, again it is gone. Since this pesky little thing seems to be determined to take up permanent residence, I thought I would continue treating the area with Aldara for awhile as long as it didn't cause any major irritation...Is there any benefit to this and/or is it a no no, to continue treating an area where there is no wart present anymore?
Helpful - 0

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