<s>[INST] Good afternoon doctor, I m a 27 year old XXXXX female who just recently went to get a GYN check up. However, my doctor discovered several small bumps around the external vaginal region and she said it maybe hpv , but there was no history of abnormal pap smear test. She told me that it can be hyperkeratosis because there are no signs of itching, bleeding or irritation in that area. My doctor also told me check myself once a month to see if there are any changes. So far everything has been the same and I had a follow up appointment with her and she told me based on my history and most recent STD blood test that I have hyperkeratosis. I just need to know will this effect my health in the future and is it cancerous? [/INST] You have not mentioned whether you did get a PAP smear done or not and if it was normal. If not, get one done. If it is normal then all you need to do is regular follow up with your gynecologist. Hyperkeratosis without any atypical features does not increase the risk of having cancer later on. It also does not affect your fertility or libido. However it does need to be kept under observation to look for any atypical changes that might occur. </s>