HPV: Concerns About Recurrence and Treatment Options

Regarding cauliflower recovery?

Hello Doctor: In August 2018, I was diagnosed with HPV types 11 and 16, and I had visible warts.
After undergoing two rounds of electrosurgery, they did not recur.
In 2020, I was tested again and HPV type 11 was negative, but HPV type 16 was still present.
In October 2022, I was tested again and HPV type 16 was still detected.
I would like to ask the doctor:
1.
It has been three years without any new warts, and HPV type 11 is negative.
Is there a possibility of recurrence when my immune system is compromised?
2.
Since HPV type 16 has been present from 2018 until now, is there a possibility that HPV type 16 could cause warts?
3.
Recently, I noticed a small white bump on the outer side of my labia.
In late November, during a gynecological examination, the doctor said it was a skin tag.
I found very few pictures of skin tags online; could you please explain what a skin tag is?
4.
I am concerned that the doctor might misdiagnose it since it is still small, and I worry about transmitting it to my current boyfriend (as warts can be contagious).
However, I had an HPV test in early October, which only showed HPV type 16 positive.

5.
I have been experiencing recurrent Candida infections, and the doctor has prescribed suppositories.
I asked if oral medication could be prescribed, but the doctor said suppositories are sufficient.
Why is oral medication not prescribed? Can I purchase fluconazole over the counter to take?
Thank you very much for your assistance!

G, 20~29 year old female. Ask Date: 2022/12/02

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the HPV that primarily causes genital warts is mostly type 6 and type 11.
The high-risk HPV types associated with cervical cancer are types 16, 18, 31, 33, 35, 45, 52, and 58.
Glands generally refer to structures that secrete vaginal lubrication.
Sexually transmitted infections are typically acquired through intimate contact with an infected individual.
Patients can try the following methods to alleviate symptoms and avoid infecting sexual partners: 1.
Keep the genital area clean and dry.
2.
Avoid using scented soaps or bath oils to prevent irritation of the wart-affected areas.
3.
Condoms can reduce the risk of transmission, but if the infection is present in other areas of the body, such as the scrotum, condoms may not provide protection.
4.
It is recommended that regular cervical cancer screenings be conducted for a stable female partner to mitigate severe complications.
5.
Maintain a healthy lifestyle, including a balanced diet, regular exercise, and strengthening the immune system, to reduce the chances of recurrence.
6.
There is currently a vaccine available for prevention, but it cannot be used for treatment.
7.
With appropriate treatment and healthy behaviors, there is a possibility for the virus to clear, which should be assessed by a physician.
Regarding vaginal candidiasis, the primary treatment methods involve the use of suppositories and topical creams.
For patients with drug resistance or recurrent infections, oral medications may also be used.
The recommended dosage for Diflucan is 150 mg as a single dose, but liver function should be monitored for abnormalities.
It is advisable to consult a physician for evaluation if symptoms do not improve after one week.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2022/12/02

More Info

Understanding HPV and its implications can be quite complex, especially when dealing with recurrent infections and treatment options. Your situation raises several important questions regarding HPV, its persistence, and the associated risks. Let’s address your concerns systematically.

1. Recurrence of HPV and Immune Response: You mentioned that you have not had any visible warts (condylomas) for three years, and your HPV type 11 is now negative. This is a positive sign, as many individuals can clear HPV infections naturally, particularly with types that cause warts. However, HPV type 16, a high-risk strain, remains present. While it is possible for HPV to reactivate or for new lesions to develop, especially if your immune system is compromised (due to stress, illness, or other factors), the absence of visible warts for an extended period suggests that your immune system is currently managing the virus effectively. Regular monitoring and maintaining a healthy lifestyle can help support your immune function.

2. Persistence of HPV 16: HPV type 16 is known for its association with cervical cancer and can lead to precancerous changes in cervical cells. While HPV type 16 can cause warts, it is less common than type 11 for this purpose. The presence of HPV 16 does not guarantee that you will develop warts; however, it does necessitate careful monitoring through regular Pap smears and HPV testing, as persistent infection with high-risk types can lead to more serious health issues over time.

3. Understanding "Linea": The term "linea" is not commonly used in the context of gynecological examinations. It’s possible that your doctor referred to a "linea" as a benign anatomical feature or a normal variant. If it is a small, white bump, it could also be a sebaceous cyst or a normal skin tag. If you have concerns about its nature or if it changes, it’s advisable to follow up with your healthcare provider for further evaluation.

4. Transmission Concerns: Your anxiety about transmitting HPV to your partner is understandable. HPV is primarily transmitted through skin-to-skin contact, particularly during sexual activity. If you have not had any visible lesions for a significant period and your recent tests show only HPV 16 without any warts, the risk of transmission is lower. However, it is still possible to transmit the virus even when there are no visible symptoms. Discussing your HPV status with your partner is crucial for mutual understanding and decision-making regarding sexual health.

5. Recurrent Yeast Infections: Chronic yeast infections can be frustrating. Your doctor’s recommendation for topical antifungal treatments (like suppositories) is common, as they are effective for localized infections. Oral antifungals, such as fluconazole, are typically reserved for more severe or recurrent cases. If you feel that your condition warrants a different treatment approach, it’s reasonable to discuss this with your healthcare provider. Self-medicating without professional guidance can sometimes lead to complications or resistance.

In summary, while HPV can be a persistent issue, many individuals manage it effectively with regular monitoring and a healthy lifestyle. It’s essential to maintain open communication with your healthcare provider about any changes in your condition and to follow their recommendations for screenings and treatments. If you have ongoing concerns or if new symptoms arise, do not hesitate to seek further medical advice. Your health and peace of mind are paramount.

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