Sexually Transmitted Diseases/Is this HPV?

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Question
Image of blisters
Image of blisters  
QUESTION: Hello,
My name is Anabel and I am a 21 year old female from the United States.
About 3 days ago i woke up to my vagina being incredibly itchy, i examined it and discovered white/yellowish cottage cheese like discharge. I did some research and came to the conclusion that I may have a yeast infection. I wasnt able to see a doctor right away (i will see one august 25th) so i decided to purchase a yeast infection 3 day treatment (clotrimazole) I have finished using the treatment now but 2 days into my yeast infection I was feeling pain a specific spot while wiping my self. I examined it and what i appeared to see were blister like bumps. At this point I have no clue what those bumps are or what caused them but I am freaking out that I may have something more serious than a yeast infection. I have never had sex, however i do have a bf and he has touched me mostly on my clit never in my vagina. I am not sure if i possibly got an STD from somewhere else with out having sex. I am going nuts here and any help would be appreciated. I will attach a few photos. The blister that hurts the most is the redish pink one, the other ones that are the color of my skin dont really hurt but still greatly worry me. I worry its HPV but i don't know how i could have gotten it.

ANSWER: Hello Anabel,
Clotrimazole used to be an effective treatment for vaginal yeast (candida), however many yeast infections are resistant to this medication now, so you may need something a bit more effective, such as the prescriptive topical cream medications miconazole or terconazole or the oral pill fluconazole. The "blisters" you think you have really look more like squamous papillomatosis, which are normal variations in the vulva and vagina. These are totally UNRELATED to HPV/warts, or herpes (HSV), but may be mildly irritating such as what you are experiencing.  

An actual examination by your health care provider will help to identify it more accurately and provide peace of mind.

Good luck!
--mark


---------- FOLLOW-UP ----------

QUESTION: Hello,
Thanks a lot for your response. I have been reading up on squamous papillomatosis and some web pages say that it is a type of HPV? Some of the people state that they are doctors so I am not sure what to  think?
Also I previously only had painful possible "squamous papillomatosis" only one side of my labia minora however now the other side has painful ones too. Before the pain I noticed that i had several growths on both sides, is there anything I can do for the pain before i see a doctor? If it is somehow hpv could i have gotten it without having sex? What causes these horrible little things?

Answer
Hello Anabel,
HPV can sometimes produce a velvety texture similar to squamous papillomatosis, but I'm in the camp that believes it is a normal variation.  It may be confused with early HPV infection, and the problem is that if the tissue is biopsied and genetically tested for HPV, the virus is frequently be present, even in the absence of warts. That's the controversy.  But didn't you say that you've never been sexually active, therefore where can you get HPV from? (Your mother probably delivered you through a vaginal delivery, and you might have from her, but this too is somewhat controversial source of HPV, and the virus would have had to remain viable for decades without expressing itself as active HPV lesions!)

HPV can be very prevalent, but may not be associated with disease or pathology, much like skin germs and intestinal germs are ever present, yet they too rarely cause real disease, just sort of lurking in the shadows, "waiting" for a change in the immune system (such as during pregnancy, cancer or organ transplant chemotherapy, severe immunodeficiency states like AIDS, etc.) to grow and proliferate, causing warts or precancers.

The question to now answer is why part of your vulva has a painful area.  This is known as "vulvodynia" and can be due to chronic irritation, rubbing, a neuropathy (dysfunction of nerve), an abscess from a bacterial infection, etc. HPV by itself usually is NOT related to localized vulvar pain.

Hope this makes some degree of sense. It points to your seeing a knowledgeable family medicine or gynecology specialist who can figure out exactly what is wrong.  

Good luck!
--mark  

Sexually Transmitted Diseases

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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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