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HPV recurrent for 4 years now - Male

Male, late 30s. In summer 2009, just getting checked by a derm to "be thorough" is when the warts were first found. Biopsy performed, maybe 3 tiny warts removed, low risk confirmed.

Approx every 4-8 months since then I have gotten 1-2 new ones. Always really small. Always in a similar spot (near base, top of scrotum). If I don't go in, they don't seem to grow or multiply - but they don't go away on their own either. Sometimes depending on where they are, it can be a bit itchy. I don't want to be contagious, so I get them frozen off. Cryo is always successful (as in they do fall off).  A second biopsy in 2010 reconfirmed the diagnosis. In late 2012, sick of the reoccurance, I started Gardasil.  Within 2 weeks of each shot, I got 1-2 new warts. Just finished the 3 shots and just had a new round of 2 small ones removed (was clear before the shot). I theorize the Gardasil stimulated the virus.

Overall since 2009, it's been about 5 reoccurances since the original. Maybe 6 or 7 even..

The cryo is never a big deal except for being really self conscious for a week.  But emotionally- having to tell new partners and never knowing if it's finally gone or not - is taking its toll.

Everything I have read says it should clear in 2 years. Even if I got BOTH types of wart causing HPV, back to back, it should have cleared by now.  I'm otherwise healthy. No other diseases. Annual physicals confirm this.

So:

- Is there something other than cryo that I should be doing to stop the reoccurances? They are not in the exact same spots each time, but the same area. Is there ANY treatment more likely to prevent it?

I believe the cryotherapy my derm performs gets the warts but not the virus in surrounding tissue -so they reoccur. Thoughts are taking 100mg zinc sulfate daily for maybe a year? Rubbing either Vitamin E or Vitamin A/E oil (Derma E Vitamin A with E) on the area daily for a few months?   Using Retina-A on the area for a few weeks?   Need to get at the source...
1 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum.

Unfortunately, I don't think I can help very much. Tthis is really a dermatology more than STD question.  Dr. Hook's and my experience with genital warts is pretty much limited to initial diagnosis and treatment, and we (and most STD clinics in the US) refer patients with problems like yours to dermatologists.

My general advice is to first assure that the recurrent lesions in fact are warts -- but of course if your cryotherapy is being administered by a dermatologist, presumably this hs been done in the course of routine care.

All wart treatments do exactly what the cryotherapy is doing:  they treat the wart tissue, not the HPV in surrounding skin.  However, when warts continue to recur with any particular treatment, it is often worth trying an alternate method.  Other options you could discuss with your derm include laser cautery,podofilox, imiquimod, and others.  (In theory, imiquimod's immunologic mechanism of action might be preferable to the others, but I stress "in theory".  In fact, it's probably no more effective than other methods.)

As for the alternative therapies you mention, there is absolutely no scientific evidence that vitamins, zinc, etc have any effect (and really no theoretical biological reationale why they should).  And although Gardasil is being tried experimentally against established warts, it has no proved effect against them and I doubt it will make any difference.

Sorry I can't suggest a magic bullet.  But eventually your warts will stop recurring.  In the meantime, I hope these comments will help guide your discussions with your dermatologist.

Best regards--  HHH, MD
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