Human papillomavirus (HPV) is a very common sexually transmitted infection that can cause warts on different parts of the body. There are over 100 types of HPV, with some low-risk types causing common warts on hands and feet. However, high-risk HPV types can lead to genital warts or precancerous lesions that may develop into cancers over time.
Genital warts affect around 1% of sexually active adults and are spread through vaginal, anal, or oral sex with someone infected with HPV. They can develop weeks or months after sexual contact with a partner who has HPV. Small, soft, pink or flesh-colored bumps usually appear in the genital area but can also occur elsewhere.
HPV infections often clear up on their own, but sometimes the virus persists and genital warts reappear after treatment. Recurrence is common, which can be stressful and frustrating for those trying to get rid of HPV warts. This article examines why HPV warts return after removal and what to do to lower the chances of recurrence.
Do HPV warts come back after being removed?
Unfortunately, yes, HPV warts often return after being removed or treated. One study found that within 3 months, warts reoccurred in 50-73% of patients who had them removed.[1] The recurrence rate at 12 months was even higher at 77%.
Some key reasons why HPV warts frequently come back include:
HPV remains inactive in surrounding skin
The virus that causes warts may still be present in normal-looking skin near the treated wart. Removing the visible wart does not get rid of the underlying HPV infection. The virus remains dormant and can become active again, causing warts to reappear.
Incomplete removal of warts
Sometimes warts grow deep into the skin in clusters with invisible root-like structures underneath. If the wart is not removed entirely, including all the roots, the remaining HPV virus will regrow the wart.
Reinfection from a partner
HPV is highly contagious, and many people get reinfected by an untreated partner. Having sex with someone with genital warts makes recurrence more likely.
Low immunity against HPV
Those with weaker immune systems are more prone to recurrent HPV infections and wart outbreaks. Conditions like HIV/AIDS and use of immunosuppressant drugs after an organ transplant can increase the risk.
Warts developing from surrounding HPV-infected skin
Even if a wart is successfully destroyed, new warts can develop from adjacent skin also infected with HPV. The virus remains active in the area and causes new warts to form.
Failure to eliminate the HPV infection
HPV can hide deep in the layers of the skin or be present in other areas of the body. Since the infection is not wiped out, the virus continues to produce warts.
| Reason for Recurrence | Explanation |
|---|---|
| HPV remains in surrounding skin | Virus stays dormant and reactivates |
| Incomplete removal | Wart roots remaining regrow warts |
| Reinfection from partner | Sex with infected person causes reinfection |
| Low immunity | Weak immune system cannot suppress HPV |
| Warts from infected skin | New warts form from HPV in area |
| HPV infection persists | Virus hides deep and keeps producing warts |
How long does it take for HPV warts to come back?
Genital warts can recur in a few months or up to several years after removal. Warts often reappear within the first 6 months. One study found the median time to recurrence was 4.3 months.[2]
However, warts can return much later, even after 1-2 years. One review reported genital warts recurred after an average of 8.5 months.[3] The longer someone has carried the underlying HPV infection, the more likely the warts will eventually reappear after treatment.
Factors influencing the timing of recurrence include:
Type of HPV
The strain of HPV causing the infection impacts recurrence risk. Warts reappear sooner with high-risk HPV types 16 and 18 compared to low-risk types 6 and 11.
Site of warts
Warts around moist areas like the anus or vagina return faster than those in dryer spots. The environment favors HPV survival.
Severity of infection
Extensive warts emerging in clusters have a greater tendency to come back than single warts. More HPV is present and able to reactivate.
Treatment method
How warts are removed affects the duration before recurrence. Aggressive treatments like laser surgery reduce regrowth risk temporarily.
Immune status
People with weakened immunity like those with HIV are likely to see a quicker recurrence of warts. A poor immune response cannot suppress the HPV virus.
Partner’s HPV status
Having an untreated infected partner leads to reinfection and earlier return of warts.
Do warts ever go away permanently?
It is possible for HPV warts to go away permanently, but there is always a chance of recurrence. The key is for the immune system to gain the upper hand against the virus.
In most healthy people, an HPV infection clears within 1-2 years. Only 10% still carry the virus after 2 years.[4] The warts disappear and do not return when the body’s defenses succeed in eliminating the infection entirely.
Ways warts can permanently resolve include:
Spontaneous clearance
The immune system sometimes overcomes an HPV infection without treatment. Antibodies and cell-mediated immunity destroy the virus until it is gone from the body.
Successful treatment
Removing all infected tissue including wart roots and surrounding affected skin can eradicate HPV from the area so warts fade permanently.
Strengthened immunity
Improving immune function helps some people clear recurrent HPV infections and any warts also disappear for good.
Virus becomes dormant
The HPV may stop causing cell changes but remain inactive in the body. Warts are no longer produced, but the virus is not vanquished.
Change in environment
Altering the genital skin environment through pH, hormones, or bacteria may prevent dormant HPV from reactivating.
Unfortunately, there are no guarantees that warts or the underlying HPV infection will permanently disappear. But immune strengthening and lifestyle habits can improve the chances of long-term remission.
Treatments to remove HPV warts
There are many options to get rid of visible HPV warts, although recurrences are likely. Common medical treatments include:
Cryotherapy
Freezing warts with liquid nitrogen or another cryogenic agent. Repeated freezing can destroy wart tissue.
Salicylic acid
Applying this chemical peel to warts causes a blister underneath, gradually peeling away layers of the wart.
Cantharidin
This topical blistering agent applied to warts causes them to separate from healthy skin.
Electrocautery
Burning off warts using an electrical current through a small probe. A local anesthetic is first used.
Excision
Surgically cutting out warts with a scalpel or scissors. Stitches may be required to close the wound.
Laser surgery
Using a focused laser beam to destroy and vaporize wart tissue.
No single treatment is superior, and sessions are often repeated every 1-2 weeks until the warts are gone. However, removing visible warts does not eliminate the underlying HPV infection. While temporary clearance of warts may occur, recurrences are common without clearing the virus.
Tips to prevent recurrence of HPV warts
Although difficult, there are some tips to lower the risk of HPV wart reappearance after removal:
Strengthen immune function
Leading a healthy lifestyle with good diet, exercise, sleep, and stress management helps the immune system keep HPV suppressed.
Consider immune-boosting supplements
Medicinal mushrooms, zinc, vitamin C, and probiotics support antiviral immunity and may aid HPV clearance.
Stop smoking tobacco
Smoking weakens the immune response against HPV, increasing persistence of the virus and recurrence risk.
Use condoms
Barrier protection limits exposure to new or ongoing HPV infections from sexual partners. However, condoms are not 100% effective as HPV can spread from skin contact.
Get partner treated
Having any sexual partners evaluated and treated for HPV will prevent reinfection leading to more warts.
Get vaccinated
The HPV vaccine protects against strains most linked to warts and cancers. It is recommended for ages 9-45.
Repeat wart removal methods
Consistently removing any recurring warts as soon as they appear may ultimately clear the local HPV infection. Freezing or excision methods work best.
Try complementary therapies
Options like homeopathy, herbs, green tea extract, and zinc ointment may support HPV and wart clearance. Evidence is limited but positive.
Allow time for virus to clear
It takes 1-2 years for most healthy people to develop immunity and overcome HPV naturally. Avoiding reinfection during this time allows the infection to run its course.
The emotional impact of recurrent HPV warts
Having HPV warts return again and again after removal attempts can take a psychological toll. Common feelings those with recurrent warts experience include:
- Frustration, anger, and resentment
- Depression and lowered self-esteem
- Embarrassment about condition
- Anxiety over infecting current or future partners
- Fear of cancer risk
- Hopelessness that warts will ever clear
- Guilt over transmission to a partner
Seeking emotional support is important when dealing with repeat occurrences of HPV warts. Consider joining a support group, seeing a therapist, or sharing your feelings with trusted loved ones. Being patient with treatment and focusing on overall well-being and immunity helps counter the frustration of recurrences.
Conclusion
Unfortunately, the recurrence of genital warts after removal treatment is quite high due to HPV remaining invisibly dormant in the skin or reinfection by a partner. Warts often reappear within the first year after removal, but may return much later. Persistent HPV infections can lead to repeat occurrences of warts over several years or even decades in some cases.
While frustrating, there are treatments that can remove visible warts temporarily. However, clearing the underlying HPV infection that causes them is key to long-term elimination. Some people do overcome the virus and have warts disappear permanently through their immune response. Boosting overall health, avoiding reinfection, managing warts promptly, and getting vaccinated are beneficial strategies to reduce recurrences. Supporting emotional health also helps cope with the unpredictability of HPV wart recurrence.