HPV is a highly common virus. While often associated with genital infections, it can also infect the mouth and throat, a condition known as oral HPV. For the majority of individuals, the immune system effectively clears an oral HPV infection within one to two years, often without causing symptoms. Concern arises when the virus persists or causes visible changes, such as growths or lesions.
Appearance of Low-Risk Oral HPV Lesions
Low-risk types of the Human Papillomavirus are typically responsible for the most visually identifiable growths in the mouth, which are generally benign. These manifestations are commonly referred to as oral papillomas or verrucae, which are essentially common warts found on the mucosal surfaces. The growths are characterized by a distinct outward-projecting, or exophytic, appearance.
The texture of these lesions is often described as rough, bumpy, or having a “cauliflower-like” surface due to numerous small, finger-like projections called fronds. Their color usually matches the surrounding tissue, appearing either flesh-toned or slightly pink, though they can sometimes be white due to a buildup of keratin.
These low-risk growths are typically small, often measuring less than one centimeter. They may be attached to the oral tissue either directly (sessile) or by a small stalk (pedunculated). Common sites include the soft palate, the tongue, and the lining of the lips and cheeks. These wart-like lesions rarely progress to cancer and represent a less concerning category compared to changes linked to high-risk HPV types.
High-Risk HPV and Subtle Oral Changes
The high-risk HPV types, particularly HPV 16, are strongly associated with oropharyngeal cancer (OPC), which affects the back of the throat, including the tonsils and the base of the tongue. Unlike low-risk types that cause visible growths, a high-risk HPV infection is typically asymptomatic and does not produce a visible wart. Instead, the concern centers on the subtle, non-wart-like changes that signal the potential development of cancer.
Signs of developing OPC are often hidden and painless, making them difficult to detect without a professional examination. Serious indicators include persistent, non-healing sores or ulcers in the throat area, or unexplained lumps and masses in the cheek, throat, or neck. These masses often result from the cancer spreading to the lymph nodes, which is a common presentation for HPV-positive OPC.
Other subtle visual changes include persistent white patches, known as leukoplakia, or red patches, known as erythroplakia, particularly on the tonsil or the side wall of the throat. These patches are often painless and may represent precancerous or cancerous changes in the mucosal lining. Functional symptoms that can accompany these subtle tissue anomalies include difficulty swallowing, a persistent sore throat, or hoarseness that does not resolve. These signs reflect cellular changes and tumor growth, not the benign projections caused by low-risk HPV.
Next Steps If You Notice Oral Anomalies
If any anomaly or unusual change is noticed within the mouth or throat, seek a professional evaluation immediately. This includes any persistent lump, sore, or discolored patch, regardless of whether it looks like a wart or a flat lesion. A change that lasts for two weeks or more warrants an appointment with a dentist or physician for a thorough examination.
During an evaluation, the healthcare professional will perform a visual and tactile exam, checking the oral cavity, neck, and throat for any masses or asymmetries. If a suspicious area is identified, the next step is often a biopsy, where a small tissue sample is taken for laboratory analysis. This procedure provides a definitive diagnosis by determining the exact nature of the cells and whether HPV is present and actively driving the growth. Early detection is a significant factor in successful treatment outcomes, making prompt professional attention important.