Anonymous on September 20, 2011

How do doctors test for HPV and genital warts?

I have tiny bumps between my anus and vaginal opening that a doctor said are genital warts. I want another opinion with an HPV test, but I don’t know where to go. And also, is an HPV test a culture test like you get for a bacterial infection? My boyfriend and I have been getting things that look like pimples on our stomachs and butts. I’ve been getting them on my legs too...I never get pimples there. What could this be?

answered by Ruthann M. Cunningham, MD on September 20, 2011

I understand your concerns and I’ll give you my best ideas about what might be going on.

It’s true that bumps on your genitals could be cause for concern. It’s hard to tell without examining you, but there are several possibilities of what the bumps could be...including genital warts, herpes, or even syphilis. You can get tested for genital warts at a doctor’s office...and if you want a second opinion, you might consider going to an STD clinic. The test for genital warts is not a culture test ⎼ most doctors diagnose genital warts by examining them. However a doctor may take a small piece of the bump to test for HPV, if necessary. (This isn’t the standard procedure, but it’s possible.) 

Testing for HPV is different than testing for a bacterial infection. For women, there are two available HPV screenings: the Pap test and the HPV test. The Pap test is more common and it’s available through most doctor’s offices. The Pap test looks at cells from your cervix to see if any of them appear abnormal, which could indicate an HPV infection (the type that can cause cervical cancer). 

The HPV test is less common. It looks for genetic material from HPV viruses and uses different technology that isn’t always available at doctor’s offices...but that’s okay because, when it comes to genital warts, most doctors can identify them by examination and prescribe the right treatment.

If a second doctor doesn’t confirm your first diagnosis of genital warts, you might consider talking to your doctor about getting tested for herpes and syphilis. And if you test positive for one of these STDs, you can begin treatment right away. For more information about risks, symptoms, testing and treatment of these and other STDs, see our Expert Guide to STD Basics

Finally, regarding the pimples on your stomachs, buttocks and legs...they could also be a sign of herpes or syphilis, or a symptom of scabies (scabies are tiny mites that can be spread through skin-to-skin contact, and through infected sheets or towels). 

Skin rashes can also happen if you’re allergic to a detergent or if you’ve switched to a different detergent lately, that could be the cause. Or, the rash could indicate that you and your boyfriend both have a skin condition like psoriasis or eczema. 

I encourage both you and your partner to visit a doctor who will be able to examine your rashes and give you a more definite answer. If you do test positive for an STD, you’ll have the peace of mind that you’re doing something about it sooner...rather than later, when more serious complications from untreated STDs can occur.

I wish you both a speedy resolution to your discomfort, and good health going forward. 

Related info:

Ruthann M. Cunningham, MD

Dr. Cunningham is a member of the Analyte Physicans Group. She's also a member of the American College of Emergency Physicians, practicing at both Northwestern Lake Forest Hospital in Illinois and at Wheaton Franciscan All Saints Medical Center in Wisconsin. An ER physician since 2000, she regularly treats patients with STDs. Dr. Cunningham was educated at Wayne State University School of Medicine and completed her Emergency Medicine residency at Cook County Hospital in Chicago, IL.

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