Do HPV Vaccines Protect Against All Warts?

HPV as the cause of warts and the uses for the HPV vaccine

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What Is HPV?

The Human Papilloma Virus is a very common virus, and nearly all individuals are infected with this DNA virus at some point in their lives. HPV infects epithelial cells, cells that cover the body surface. There are over 100 different HPV types, and some have a preference for mucous membranes like those found in the genitals, whereas other types prefer cornified areas or areas of the skin like those on the hands and feet.[1]

 

How Is it Spread?

Depending upon the strain of virus, the HPV virus can be spread by skin to skin contact and during sexual intercourse to result in genital HPV lesions. For warts present on the skin, HPV can be spread via surfaces such as non-slip surfaces in showers or swimming pool areas.[2] Although most HPV infections can be cleared by the immune system, certain strains have been correlated with the development of benign, precancerous, and cancerous lesions such as:

  • Cervical, Vaginal, Vulvar Cancer
  • Penile Cancer
  • Anal Cancer
  • Oropharyngeal Cancer
  • Cutaneous and Genital Warts

High-risk strains are linked to the development of pre-cancers and cancers, whereas the low-risk strains result in cutaneous and genital warts.

 

How Does HPV Relate to Warts?

Warts are caused by one of the many different types of HPV and appear as small growths on the body. Based on their location, they can be characterized as common, palmoplantar, flat, or genital. The most common warts are those presenting on the hands and feet caused by HPV type 1,2,4, 27 and 57, whereas genital warts are caused by low-risk HPV types 6 and 11.[3] These lesions can be difficult to treat, often requiring the combination of several treatments. Nearly 80% of warts regress spontaneously within 2 years, however, this time period may vary depending upon the immune status of the HPV infected individual, the type of HPV they are infected with, the amount of time they have had warts, and the number of warts they have.[4]

 

What Is the HPV Vaccine?

The HPV vaccine comes in different forms that are currently approved in the US to protect against specific low and high-risk strains of HPV. The nonvalent HPV vaccine protects against nine different HPV strains, whereas the quadrivalent HPV vaccine offers protection against four HPV strains. There is no live virus in the vaccine, there are only parts of the virus so that you cannot become infected with HPV following administration of the vaccine. This vaccine is indicated in females and males age 9 through 26 as a 2 or 3 dose series to prevent against the development of the pre-cancerous and cancerous lesions that can develop from HPV.[5]

 

Benefits of the HPV Vaccine

The HPV vaccine is the first preventative vaccine against cancer. In the United States, more than 30,000 people are affected yearly by cancer caused by human papillomavirus. [5] The recommendation for HPV vaccination began in 2006, and since this time infections with HPV have been significantly reduced. As of 2017, the only HPV vaccine available in the United States is Gardasil-9 which protects against HPV types associated with the development cancers of the cervix, vagina, vulva, anus, throat, and penis in addition to genital warts.

Gardasil-9 is composed of HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58 which are HPV types that cause around 90% of cervical cancer, the second most common cancer in women worldwide.[6] In addition, these HPV types also cause approximately 95% of HPV-related cancers in men and 90% of genital warts in both men and women.[7]

Although the vaccine is composed of only nine specific types of HPV, some researchers think that one of the HPV vaccine benefits is that that administering the vaccine leads to an immune response that can lead to cross-protection against several other HPV strains.[2] This means that the HPV vaccine may protect against more types of HPV than included in the vaccine, but this is still considered just a hypothesis. It is important to note that the vaccine offers protection as a preventative measure, and therefore is not used as a treatment for genital warts, precancers, or cancers.

 

Does the HPV Vaccine Protect Against All Warts?

No, the HPV does not protect against all warts. This vaccine is only intended as a preventative measure against the development of warts caused by HPV types 6 and 11, which are responsible for genital warts.[7] Nevertheless, there is some evidence to suggest the HPV vaccine may have a curative potential in treating non-genital warts. In several studies, researchers have reported clinical cure of warts that were difficult to treat in several patients after receiving the HPV vaccine. [8-17] Although there are only a few of these cases, the results appear promising and further studies on more patients are required to see if the HPV vaccine can be used as an alternative treatment for non-genital warts.

* This Website is for general skin beauty, wellness, and health information only. This Website is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. The information provided on this Website should never be used to disregard, delay, or refuse treatment or advice from a physician or a qualified health provider.

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References

  1. Lipke MM. An armamentarium of wart treatments. Clin Med Res.2006;4(4):273-293; PMID: 17210977 Link to research.
  2. Vlahovic TC, Khan MT. The Human Papillomavirus and Its Role in Plantar Warts: A Comprehensive Review of Diagnosis and Management. Clin Podiatr Med Surg.2016;33(3):337-353; PMID: 27215155 Link to research.
  3. Gibbs S, Harvey I, Sterling JC, et al. Local treatments for cutaneous warts. Cochrane Database Syst Rev.2003;10.1002/14651858.CD001781(3):CD001781; PMID: 12917913 Link to research.
  4. Sterling JC, Gibbs S, Haque Hussain SS, et al. British Association of Dermatologists' guidelines for the management of cutaneous warts 2014. Br J Dermatol.2014;171(4):696-712; PMID: 25273231 Link to research.
  5. CDC Vaccine Information Sheet. Human Papillomavirus. Available from: Link to research. PMID:
  6. Arbyn M, Xu L, Simoens C, et al. Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors. Cochrane Database Syst Rev.2018;5:CD009069; PMID: 29740819 Link to research.
  7. Gardasil [package insert] Whitehouse Station: Merck Sharp & Dohme Corp., NJ. 2011PMID:
  8. Abeck D, Folster-Holst R. Quadrivalent human papillomavirus vaccination: a promising treatment for recalcitrant cutaneous warts in children. Acta Derm Venereol.2015;95(8):1017-1019; PMID: 25824471 Link to research.
  9. Daniel BS, Murrell DF. Complete resolution of chronic multiple verruca vulgaris treated with quadrivalent human papillomavirus vaccine. JAMA Dermatol.2013;149(3):370-372; PMID: 23552967 Link to research.
  10. Ferguson SB, Gallo ES. Nonavalent human papillomavirus vaccination as a treatment for warts in an immunosuppressed adult. JAAD Case Rep.2017;3(4):367-369; PMID: 28795126 Link to research.
  11. Kreuter A, Waterboer T, Wieland U. Regression of cutaneous warts in a patient with WILD syndrome following recombinant quadrivalent human papillomavirus vaccination. Arch Dermatol.2010;146(10):1196-1197; PMID: 20956677 Link to research.
  12. Landini MM, Borgogna C, Peretti A, et al. Identification of the skin virome in a boy with widespread human papillomavirus-2-positive warts that completely regressed after administration of tetravalent human papillomavirus vaccine. Br J Dermatol.2015;173(2):597-600; PMID: 25639663 Link to research.
  13. Landis MN, Lookingbill DP, Sluzevich JC. Recalcitrant plantar warts treated with recombinant quadrivalent human papillomavirus vaccine. J Am Acad Dermatol.2012;67(2):e73-74; PMID: 22794819 Link to research.
  14. Martin JM, Escandell I, Ayala D, et al. Spontaneous Remission of Recalcitrant Warts in Girls After Human Papillomavirus Vaccination. Actas Dermosifiliogr.2016;107(6):533-535; PMID: 27006016 Link to research.
  15. Moscato GM, Di Matteo G, Ciotti M, et al. Dual response to human papilloma virus vaccine in an immunodeficiency disorder: resolution of plantar warts and persistence of condylomas. J Eur Acad Dermatol Venereol.2016;30(7):1212-1213; PMID: 25871452 Link to research.
  16. Venugopal SS, Murrell DF. Recalcitrant cutaneous warts treated with recombinant quadrivalent human papillomavirus vaccine (types 6, 11, 16, and 18) in a developmentally delayed, 31-year-old white man. Arch Dermatol.2010;146(5):475-477; PMID: 20479293 Link to research.
  17. Silling S, Wieland U, Werner M, et al. Resolution of novel human papillomavirus-induced warts after HPV vaccination. Emerg Infect Dis.2014;20(1):142-145; PMID: 24378072 Link to research.