Acetic Acid Test Results for HPV Concerns in Gynecology

Acetic acid test

Hello, doctor! During my visit to the gynecologist, the doctor mentioned that there might be a "small HPV infection" below my vaginal opening.
When I asked if treatment was necessary, he said it wasn't and that everything looked fine, so I shouldn't worry.
However, I still feel concerned.
I looked in the mirror and didn't see anything unusual; there weren't many granular formations, just something resembling hair follicles.
When I performed the acetic acid test, a small area below the vaginal opening quickly turned white, resembling a scar!
1.
I heard that only warts turn white.
However, could it be possible that I have a tear or abrasion at the vaginal opening that turned white upon contact with acetic acid?
2.
I usually don't feel anything unusual during my showers and have no symptoms.
Today, there was indeed a reaction to the acetic acid, and it felt stinging; the white area looks like a "scar" and is slightly raised (swollen).
Does this indicate a positive test for warts?
3.
If I indeed have warts, why didn't the doctor say I have condyloma but only mentioned a possible infection and has no plans for treatment? Is it possible to have warts without needing treatment? Thank you for your professional insight!

Danxin, 20~29 year old female. Ask Date: 2014/01/14

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
In many cases, acetic acid can cause whitening, which is not necessarily indicative of HPV infection or warts.

2.
Even if it is indeed an HPV infection or warts, as long as the immune function is normal, many cases will resolve on their own.

3.
Since your doctor is still uncertain, even if it is warts, it may also resolve on its own.
Please do not worry too much.

Respectfully, Dr.
Li-Cheng Lu, Taoyuan General Hospital.

Reply Date: 2014/01/14

More Info

The concerns you have regarding HPV and the results of your acetic acid test are quite valid, and it's important to clarify these points to alleviate your worries. Let's break down your questions and provide a comprehensive understanding of the situation.

1. Acetic Acid Test and Its Implications: The acetic acid test, often used in gynecological examinations, is a method to visualize areas of potential HPV infection. When acetic acid is applied to the cervix or vaginal area, abnormal cells, particularly those affected by HPV, can turn white. This is due to the acetic acid causing dehydration of the abnormal cells, making them more visible. However, it is crucial to note that not all white areas indicate HPV or genital warts (condylomata acuminata).
In your case, the appearance of a white line or scar-like area after the application of acetic acid could indeed be due to a previous injury or irritation rather than an active HPV infection. If there was a minor tear or abrasion in the area, the acetic acid could react with the damaged tissue, leading to a white appearance. Therefore, it is possible that what you observed is not necessarily indicative of HPV-related lesions.

2. Symptoms and Sensations: The sensation of pain or discomfort following the application of acetic acid can also be attributed to the sensitivity of the area. If there was any underlying irritation or minor trauma, the acetic acid could exacerbate that sensation. The raised, scar-like appearance you described could be a result of healing tissue rather than an active infection.
3. Doctor's Assessment: Your doctor’s assessment that there is no need for immediate treatment may stem from the fact that not all HPV infections lead to visible warts or require intervention. Many HPV infections are transient and resolve on their own without treatment. If your doctor observed no significant lesions or signs of active infection, they may have deemed it unnecessary to pursue aggressive treatment at this time.
It's also important to understand that while some types of HPV can lead to genital warts, others are associated with cervical dysplasia or cancer. Regular monitoring and follow-up Pap smears or HPV testing are crucial for managing your health in this context. If your doctor did not express concern about visible warts or lesions, it may indicate that they believe the risk is low at this moment.

4. Next Steps: If you continue to have concerns about the appearance of the area or if you experience any new symptoms, it would be prudent to follow up with your healthcare provider. They may recommend further evaluation, such as a biopsy or a more detailed examination, to rule out any significant issues.
5. Preventive Measures: Regardless of the current findings, maintaining regular gynecological check-ups is essential. Discussing HPV vaccination with your healthcare provider can also be beneficial, as it can help prevent the types of HPV that are most commonly associated with cervical cancer and genital warts.

In conclusion, while the acetic acid test can provide useful information, it is not definitive for diagnosing HPV or genital warts. The appearance of white areas can have multiple explanations, and your doctor’s reassurance suggests that they do not see an immediate cause for concern. However, if you remain anxious or if your symptoms change, do not hesitate to seek further evaluation. Your health and peace of mind are paramount.

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