Human papillomavirus (HPV) is a remarkably common virus, especially known for its role in causing genital warts and certain cancers. Yet many are surprised to learn that it can also infect the throat, mouth, larynx, and tonsils. This form of infection is often referred to as oral HPV or HPV-related oropharyngeal disease.
1. Often No Obvious Symptoms
One of the most striking aspects of oral HPV infection is its capacity to remain silent. Most people carrying the virus in the throat or mouth do not experience any noticeable symptoms. The virus can exist quietly for months or even years without any outward signs — which means someone might spread it without ever realizing they have it.
2. Wart-Like Growths (Papillomas)
In less common cases, visible warts or benign growths may appear within the throat. These may manifest on:
- The back of the throat
- The base of the tongue
- Tonsils
- Soft palate or vocal folds
These small, smooth, flesh-colored or white bumps are usually painless but can occasionally cause discomfort, especially if they multiply or interfere with swallowing or breathing. In children, this condition is known as laryngeal papillomatosis, and it can affect vocal quality or even obstruct the airway if the growths increase in size or number. In adults, these warts tend to grow more slowly, with fewer immediate risks, though medical monitoring is still essential.
3. Throat Discomfort or Soreness
While more typical of other throat infections, in some cases oral HPV may be associated with mild throat pain, hoarseness, or a scratchy sensation at the back of the throat. These symptoms are often mild and intermittent, which is why they are frequently mistaken for routine throat irritation or seasonal allergies.
4. Swollen Neck Lymph Nodes or Neck Lump
A persistent or enlarged lump in the side of the neck is often the most noticeable sign of a more serious HPV-related condition. This could be a swollen lymph node reacting to infection, or more concerningly, an indication of HPV-positive oropharyngeal cancer. Unlike infections, these neck lumps typically do not hurt and may appear suddenly. Individuals often discover them unexpectedly while dressing or washing up.
5. Voice Changes or Hoarseness
This can occur if HPV causes lesions on the vocal cords or growths in the larynx. The result is often a persistent hoarseness or change in voice quality. Even when throat pain is absent, voice alterations may tip a person off to an underlying issue and warrant evaluation by an ear, nose, and throat specialist.
6. Difficulty Swallowing or Sensation of Something Stuck
Some people may feel that food or liquid is sticking in the throat—especially if growths are located near the tonsils or tongue base. While typically subtle, when swallowing becomes persistently uncomfortable, it should be medically investigated.
7. Ear or Jaw Pain
Though less common, persistent earaches or pain along the side of the jaw can be associated with nerve involvement from deeper throat lesions. In HPV-related throat cancers, these pains may emerge even when none of the classic throat symptoms are present.
8. Unexplained Weight Loss or Loss of Appetite
In cases where HPV infection leads to oropharyngeal cancer, systemic effects can include lack of appetite and unintentional weight loss. Chronic fatigue may also occur. These symptoms are usually accompanied by other local symptoms, like a neck lump or persistent sore throat.
9. White or Red Lesions (Erythroplasia/Leukoplakia)
Even before cancer develops, premalignant patches may appear as red, white, or mixed red-and-white lesions in the mouth or throat. These areas can be flat or slightly raised and resistant to prompt healing. They serve as warning signs that require biopsy to rule out early malignant transformation.
10. Rarely, Persistent Coughing Up Blood
Although extremely rare, this is a critical symptom and requires immediate medical attention. It may indicate advanced disease involving blood vessel erosion and should never be ignored.
If you notice any of the following signs, it’s important to seek medical evaluation from an ENT specialist or your primary care provider:
- A neck lump or swelling that lasts more than two weeks
- Persistent hoarseness or voice changes
- Sore throat that doesn’t clear up in 2–3 weeks
- Difficulty swallowing or feeling something stuck
- White or red patches in the mouth/throat that don’t heal
- Ear pain that is otherwise unexplained
- Unintentional weight loss or loss of appetite
Doctors diagnose oral or throat HPV through thorough examination, possibly using a mirror or endoscopy to view the throat’s interior. If any suspicious growths or lesions are found, biopsy samples may be taken. Imaging tests such as CT or MRI scans can help determine the extent of growths or tumors.
Treatment depends on the findings:
- Benign warts (papillomas) may be removed surgically or via laser to restore airway function and voice quality.
- Premalignant patches may require targeted removal or close monitoring with repeat biopsies.
- HPV-positive oropharyngeal cancer is usually treated through a combination of surgery, radiation therapy, and sometimes chemotherapy. These cancers, caused by high-risk strains like HPV-16, tend to respond well to treatment, especially when caught early.
The HPV vaccination offers highly effective protection against several high-risk HPV strains (notably types 16 and 18) that account for the majority of throat cancers. The vaccine also covers low-risk strains (6 and 11) that cause warts and benign growths. Safe sexual practices, including the use of barrier protection during oral sex, can reduce but not entirely eliminate transmission risk.
Although oral HPV can be quiet and unassuming, persistent or unusual throat symptoms should not be ignored. With proper awareness and timely medical attention, many HPV-related throat conditions, including early-stage cancers, can be effectively treated. Remaining vigilant and proactive is crucial—early detection greatly improves outcomes.
