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Male HPV - Genital Warts Concerns

Hello there Dr. HHH, I have read through your forums and watched your youtube videos, I appreciate that you're educating many people and helping people with stress and fear due to STI's and misinformation.  Thank you.
To the problem:  I have been in a monogamous relationship for about 3 years now, recently broken up due to stresses about HPV and GW.
Help with my obsession please!
I am a 25 y.o. male, semi regular exercise, no underlying health condition.  About a year ago when my grandma passed away from lung, bone and brain cancer I was extremely stressed and noticed some darker brown (fair asian complexion) bumps in my pubic area, around base of shaft, circumsion scar and just under the head of the penis.  Thought they were ingrown hairs since they're small and I shaved at the time.  A month or two passed, still present so went to local RN she diagnosed me with genital warts and proceeded with Cryotherapy along with Aldara.  In about 6 weeks I was cleared by her, I noticed 3 small bumps that were tiny but she said they'll go away on their own.  This was in May.

Then in December I noticed that they got slightly larger and darker, so I went in again and she froze them off and she recleared.

1) I have presented GW and been treated multiple times, I was clear for about 6 months, then treated again about 2 months ago for some "stragglers".  I am now looking at some small bumps that are not the same colour as the gw from before.  Its been about a year.  What is the usual clearance time for Genital Warts, after having it for a year and being clear for months at a time? If new bumps do arise, does this mean I'm still fighting off the same infection and losing due to stress?

2) Should I apply Aldara that I have left over from previous treatments to these "suspected bumps"?  They are flesh coloured, no cauliflowering from what I can see.  

3) Should I be concerned that its been a year, have suspected bumps and been treated a month ago?
3 Responses
300980 tn?1194933000
MEDICAL PROFESSIONAL
Welcome to our Forum.  I'll be answering your questions.  Dr. Handsfield and I share the forum.  By chance you got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

I think these concerns are best addressed by starting at the beginning.  With all due respect to the nurse who has been providing you with care, these may or may not be warts.  As you may have noted in reading other posts on this Forum, there are a number of other skin irregularities which can be mis-identified as warts and which will typically respond to the non-specific effects of wart treatment.  You may or may not have warts.  

If you do have warts, to have a recurrence several months after apparently effective treatment is not unusual.  In fact it occurs about 20-40% of the time following therapy for proven warts (and non-wart irregularities come back even more often).  The need for repeated treatment is not unusual.  

In answer to your specific questions:
1.  Without treatment HPV infections typically eventually go away by themselves. Because there is little health risk associated with visible warts they are less well studied than the "flat" warts which cannot be seen but which cause abnormal PAP smears in women.  Nonetheless, the available data suggest that even without therapy visible genital warts will go away without therapy over time but that this time may be as long as 2 or more years. Therapy of the sort you have taken will accelerate this.  

There is no data to suggest that stress slows the resolution of warts.

2.  You have to decide what to do.  Personally, I would suggest a second opinion before you seek treatment, perhaps by a dermatologist.  While there is no reason to worry that a repeat course of Aldara will harm you, your concern makes it seem reasonable to be sure that you are dealing with warts before you embark on treatment.  If you seek a second opinion, please be sure that it is clear that the reason you are doing so is because you really want to know if this is HPV or not.  Since many providers feel that warts and there treatment are not a big deal, they do not worry about treating possible warts.

3.  No, this is not a reason for concern, even if it has been a year.

I hope my comments and suggestions are helpful.   It appears that you are quite concerned about these bumps.  For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.  Try not to worry.  If these are warts, this is just not that big a deal.  EWH
Avatar universal
Thank you for your reply Dr. Hook, it is greatly appreciated in knowing that even without treatment within two plus years it will be resolved.  Even better to hear that my treatments will lower the 2 year mark.

I have tried to be very responsible and take all the necessary precautions to accelerate this healing process and not interact and potentially pass on the warts.  

I have recently went in for another visit with another practitioner on campus, she has said that these suspected bumps are sebaceous cysts and strongly doubts they are hpv related warts.  I'm glad to hear this, my question is will these react to aldara?  And if they are these cysts will they go away or cause any detrimental effects on my overall health?  

Once again thanks for your time and work, mental health is starting to be balanced again!
300980 tn?1194933000
MEDICAL PROFESSIONAL
Glad to hear that others who have had the chance to examine you do not think the lesions you had were warts.

I'm not sure if sebaceous cysts would respond to aladra or not.  Aldara does cause a non-specific inflammation which causes many sorts of skin lesions to go away so it certainly is a possiblity.  It would not suprise me if sebaceous systs (which, incidentally do tend to recur) responded to Aldara.  EWH
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