ConditionSkin, hair & nails
Papilloma
A papilloma is a benign (non-cancerous) growth that projects outward from the skin or a mucous membrane in small finger-like fronds, often looking like a wart or a tiny cauliflower. Many papillomas are caused by human papillomavirus (HPV), including common warts, genital warts and oral papillomas. Others, such as intraductal papillomas of the breast, are not linked to HPV. Most are harmless and can be left or removed, but some types can recur, obstruct the airway or, rarely, carry a cancer risk, so new growths should be checked.
Also called: Papillomas, squamous papilloma, papillary growth, wart-like growth
At a glance
- What it is
- A benign growth with finger-like projections on skin or mucous membranes.
- Causes
- HPV for skin, genital, oral and laryngeal papillomas. Non-viral for breast intraductal papillomas and some others.
- Common sites
- Skin, mouth, throat and voice box, breast ducts, nose and sinuses, bladder.
- Risk
- Most are harmless. Inverted sinonasal papillomas, some breast papillomas and laryngeal papillomas need specialist care.
- Treatment
- Observation, freezing, surgical excision, laser, and HPV vaccination for prevention.
When to get help
Call 911 or go to the ER
- Noisy breathing, difficulty breathing or stridor in a child or adult with known throat papillomas
See a doctor within a day or two
- Progressive hoarseness or noisy breathing, especially in a child (possible laryngeal papillomas)
- Bloody nipple discharge from one duct
Book a routine appointment
- A new growth on the skin, mouth, genitals or inside the nose that is growing, bleeding or changing
- A one-sided blocked nose, nosebleeds or facial pressure with a mass in the nose
- Blood in the urine
- Genital growths: get checked and consider STI testing
Usually safe to manage at home
- A small, typical common wart or skin papilloma that is not changing
What a papilloma is
The term describes a shape, not a single disease: a growth with a stalk or base and frond-like projections, covered by surface cells (epithelium). Papillomas can arise wherever there is epithelium.
Types of papilloma
| Type | Location | Cause | Key points |
|---|---|---|---|
| Common and plantar warts | Hands, feet, skin | HPV | Rough, harmless, may resolve |
| Squamous papilloma (skin tag-like) | Skin, eyelids, neck | Often HPV or friction | Benign, removed for comfort or appearance |
| Genital warts (condyloma) | Genitals and anus | HPV 6 and 11 | Sexually transmitted |
| Oral squamous papilloma | Tongue, palate, lips | HPV 6 and 11 | Small, painless, usually benign |
| Laryngeal papilloma (recurrent respiratory papillomatosis) | Voice box and airway | HPV 6 and 11 | Hoarseness, can block the airway, tends to recur |
| Intraductal papilloma | Breast duct near the nipple | Not HPV | Nipple discharge, sometimes a lump |
| Inverted papilloma | Nose and sinuses | HPV in some cases | Can recur and occasionally becomes cancer |
| Urothelial papilloma | Bladder | Not HPV | Blood in urine. Needs cystoscopy |
| Choroid plexus papilloma | Brain ventricles | Not HPV | Rare tumor in young children |
HPV and papillomas
Human papillomavirus has more than 200 types. "Low-risk" types, especially HPV 6 and 11, cause most warts and papillomas. "High-risk" types such as HPV 16 and 18 cause cervical, anal, throat and other cancers, though they are much less likely to produce visible papillomas.
HPV spreads by skin-to-skin contact, including sexual contact. Laryngeal papillomas in children are usually acquired from the mother during birth.
Symptoms
Depend on location:
- skin: a raised, rough or smooth, flesh-colored or slightly darker growth
- mouth: a small painless white or pink cauliflower-like bump
- voice box: hoarseness, noisy breathing, breathlessness
- breast: clear or bloody nipple discharge from one duct, sometimes a small lump near the areola
- nose: a one-sided blocked nose, nosebleeds, reduced smell
- bladder: blood in the urine
Diagnosis
- examination: most skin and oral papillomas are recognized by appearance
- biopsy or excision: confirms the diagnosis and excludes cancer
- laryngoscopy: for voice box papillomas
- mammogram, ultrasound and core biopsy: for intraductal papillomas
- nasal endoscopy and CT or MRI: for sinonasal papillomas
- cystoscopy: for bladder papillomas
Treatment
Skin and oral papillomas
- observation for small, asymptomatic lesions
- cryotherapy (freezing)
- simple surgical excision or laser removal
- salicylic acid for common warts
Genital warts
- topical treatments such as imiquimod or podophyllotoxin
- cryotherapy, excision or laser
Laryngeal papillomatosis
- repeated surgical removal, usually with microdebrider or laser, to keep the airway open and preserve voice
- adjuvant treatments such as bevacizumab in severe cases
- recurrent respiratory papillomatosis can need many procedures
Intraductal papilloma
- surgical excision is often recommended, particularly with atypical cells on biopsy, because a small proportion are associated with cancer nearby. Some small, typical papillomas without atypia may be monitored after specialist review
Inverted sinonasal papilloma
- complete endoscopic surgical removal with long-term follow-up because of recurrence and a small cancer risk
Prevention
- HPV vaccination (recommended at age 11 to 12, catch-up through 26) protects against HPV 6 and 11, which cause most genital warts and respiratory papillomas, and against cancer-causing types
- condoms reduce, but do not eliminate, genital HPV transmission
- avoid picking or shaving over warts to prevent spread
Frequently asked questions
What is a papilloma?
A papilloma is a benign growth that projects outward from skin or a mucous membrane in small finger-like fronds. Many are caused by HPV, including warts and oral and laryngeal papillomas. Breast and bladder papillomas have other causes.
Is a papilloma cancerous?
Most papillomas are benign. However, some types, such as inverted papillomas of the nose, some breast intraductal papillomas and bladder papillomas, are associated with a small risk of cancer and need specialist assessment and follow-up.
What is the difference between a papilloma and a wart?
A wart is a type of papilloma caused by HPV on the skin. "Papilloma" is the broader term for any benign growth with this frond-like structure, which can occur in the mouth, throat, breast ducts, nose or bladder.
How are papillomas removed?
Depending on the location, papillomas can be frozen, cut out, removed with a laser or scraped off. Breast, sinus and laryngeal papillomas are removed surgically by specialists. Removed tissue is usually examined under a microscope.
Can papillomas come back?
Yes. HPV-related papillomas, especially laryngeal papillomas and genital warts, often recur because the virus can remain in surrounding tissue. Inverted sinonasal papillomas also recur if not completely removed.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology (AAD): Warts
- National Cancer Institute: HPV and cancer
- American Cancer Society: Non-cancerous breast conditions (intraductal papillomas)
- American Academy of Otolaryngology-Head and Neck Surgery: Recurrent respiratory papillomatosis
- CDC: Human papillomavirus (HPV)