Sexually Transmitted Diseases/Scared of HPV.

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Question
The bumps.
The bumps.  
Suspicious skin.
Suspicious skin.  
QUESTION: Greetings, Mr. Behar.

I'm a 22 year old male. I'm gonna tell you my whole story so you can understand where I'm coming from and why I'm so paranoid about this. I've been with my partner for about 4 years. We've never had sex but we've had "skin to skin" sexual contact.  The last time I've had a sexual contact with my partner was on November the 1st. A month later I had folliculitis in my pubic area. Because of my lack in knowledge, at first I thought the folliculitis was herpes so I took 5 herpes blood tests. (at first I had an IgG test for HSV type 2, then  after 2 months I had 2 IgG and IgM tests for both types) they all came back negative. I started to examine my genital area and found two papule-like bumps on my shaft. They're not rough and when I squeeze them nothing come out of them. I thought they were warts, which made me more paranoid and scared. Two months ago I went to a venereal and dermatology consultant. He treated the folliculitis and when I showed him the bumps, he literally told me "all men have those bumps" then he scheduled a follow up appointment after two weeks. 2 days before my follow up apt I went to a venereal and dermatology specialist at some polyclinic and he said those bumps are warts and they could get bigger (they haven't changed size since I've seen them though), he said I better burn them off (he didn't prescribe any creams like aldara...etc). On my follow up, I told the consultant what the specialist had told me, he took a look at them again and he said they do not look like warts, they're just normal bumps and all men have them and I shouldn't think about them. Couple of weeks later I read about the vinegar test, so I applied the solution on the bumps and they didn't turn white, I'm not sure if I done it the right way. Anyways, a month later I went to another venereal and dermatology consultant and  he took a look at the bumps and the genital area and he said, what I have is an "insignificant change to the skin of the penis" and he also told me to not think about the bumps.

My question for you sir, do these bumps look like any STDs or warts? Or are they just normal bumps that all men have?



Ps. I masturbate heavily since I was 14, I've never used lube and I'm assuming the hand to penis friction damaged the skin and caused those bumps.


Thank you.

ANSWER: Hello Adele,
The photos do NOT look like warts (human papilloma virus, HPV). They do look like the normal bumps that many men have; I agree with the other STD experts that you consulted. The only real way to know for certain, is to take a biopsy specimen for a microscopic and DNA analyses-- this is hardly worth the discomfort.  If your anxiety is that overwhelming, than you need to get help from a therapist. This has nothing to do with how frequently or vigorously you masturbate!

Good luck!
--mark


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QUESTION: Thank you so much, sir, for your answer. I'll probably schedule a biopsy soon. However, I want to be relieved about this so I'd like to show you two more pictures of what I suspect are flat warts from two different angles.

Answer
Hi Again, Adele,
The question to ask yourself is what will you derive from the results of a possible biopsy of the skin? If it is positive for a particular strain of HPV, what then?? There are no effective treatments other than cryo therapy, trichloroacetic acid, imiquimod, podophyllin, and perhaps a few others. The actual biopsy removes a portion of skin, but does not remove the underlying HPV. I think you are unnecessarily stressing yourself out!

Good luck!
--mark  

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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