HPV after diagnosis in children

Overview

HPV (human papillomavirus) is a very common virus that can cause warts on the skin or in moist areas like the mouth, throat, or genitals. In children, HPV usually causes common skin warts or, less often, warts in the genital area or the voice box. Most children with HPV have no symptoms and the virus goes away on its own.

Yes, HPV is very common. Almost everyone gets it at some point in their life. In children, common skin warts affect about 10–20% of school-age kids.

HPV can affect children of any age, but skin warts are most common in children aged 5–15. Genital HPV in children is rare and may raise concerns about possible abuse. Respiratory papillomatosis (warts in the voice box) is uncommon and usually affects children under 5.

Symptoms

Common symptoms

• Small, rough bumps on the skin (common warts on hands or fingers)
• Flat warts on the face or legs
• Plantar warts on the soles of the feet (may look like calluses)
• Genital warts (soft, flesh-colored bumps in the genital or anal area)
• Hoarseness or breathing trouble (if warts grow in the voice box)

Symptoms in children

• Most children have no symptoms at all.
• Skin warts may appear, often painless or slightly tender.
• Genital warts may be itchy or uncomfortable, but often painless.
• Respiratory papillomatosis can cause a weak cry, hoarse voice, or noisy breathing.

Symptoms in older adults

• Genital warts may recur or persist.
• Persistent high-risk HPV infection can lead to abnormal Pap smears and cervical cancer.
• Older adults may also develop skin warts, but these are less common.

Causes

Main causes

• HPV viruses – there are over 100 different types.
• Direct skin-to-skin contact with someone who has HPV (e.g., touching a wart, sexual contact)
• Sharing towels, socks, or shoes can sometimes spread plantar warts.
• A child can get genital HPV from a caregiver during birth (rare) or from sexual abuse (needs careful evaluation).

Risk factors

• Having a weakened immune system (e.g., from illness or medication)
• Skin injuries (scratches or cuts) make it easier for the virus to enter
• Walking barefoot in public places like swimming pools or locker rooms
• Not being vaccinated against HPV

When to see a doctor

See a doctor urgently if:

• If your child has trouble breathing or a very hoarse voice
• If genital warts appear and you suspect abuse

Book a routine appointment if:

• Skin warts that don’t go away after several months
• Warts that are painful, bleed, or spread quickly
• Any wart in the genital area for evaluation

Diagnosis

A doctor can usually diagnose HPV-related warts just by looking at them. For genital warts or respiratory papillomatosis, the doctor may do a closer exam or take a small sample (biopsy) to check the cells.

Tests that may be done

• Visual exam of the skin or genital area
• Biopsy (removing a tiny piece of the wart for lab testing)
• Sometimes a vinegar solution (acetic acid) to make genital warts more visible
• For respiratory symptoms: laryngoscopy (looking into the voice box with a small camera)

What to expect at your appointment

The doctor will ask about symptoms, exposure to warts, and any concerns. The exam is usually quick and not painful. If a biopsy is done, a numbing cream is used first.

Treatment

Many HPV warts in children go away without treatment. If treatment is needed, options include medicines applied to the wart or procedures like freezing or laser. Genital warts and respiratory papillomatosis often need treatment to prevent discomfort or breathing problems.

Self-care at home

• For common skin warts: apply over-the-counter salicylic acid products as directed
• Cover warts with a bandage to prevent spreading
• Do not pick or scratch warts
• Keep feet clean and dry, wear flip-flops in public showers

Medical treatments

Doctors may prescribe topical medicines like caustic solutions, creams that boost the immune system, or cryotherapy (freezing the wart). For genital warts, they may use special creams or procedures like electrosurgery. Respiratory papillomatosis is treated with surgery to remove the warts, sometimes followed by antiviral medicine.

When is surgery considered?

Surgery is used when warts are large, cause symptoms like bleeding or trouble breathing, or do not respond to other treatments. For respiratory papillomatosis, repeated surgeries may be needed over time.

Living with this condition

Most children with HPV warts can live a normal life. Warts may take months to go away, but they are not dangerous. Keep the wart covered so it doesn’t spread to others.

Lifestyle tips

• Encourage good handwashing to prevent spreading warts
• Avoid sharing towels, razors, or socks
• If your child has genital warts, talk to your doctor about how to handle school and activities

Diet and exercise

A healthy diet rich in fruits and vegetables supports the immune system in fighting the virus. Normal exercise is fine, but avoid activities that could injure the wart (like rough sports).

Mental health and emotional wellbeing

Children with visible warts may feel embarrassed or self-conscious. Reassure them that warts are common and will go away. If they are teased, talk to their teacher or school counselor. Genital warts can be emotionally difficult; seek counseling if needed.

Prevention

Yes, many HPV infections can be prevented with the HPV vaccine. The vaccine is recommended for all children aged 11–12 years, but can be given as early as age 9. It protects against the most harmful types of HPV that cause genital warts and cancers.

Vaccines

The HPV vaccine is given as a series of shots (usually 2 doses for children under 15). It is safe and effective. Ask your child’s doctor about getting vaccinated.

Screening programmes

For children, routine screening for HPV is not needed. For girls and women starting at age 25, cervical screening (Pap smear) checks for changes caused by HPV. Boys and men do not need routine screening.

Complications

If left untreated

• Skin warts may spread to other parts of the body or to other people
• Genital warts may grow larger or become more numerous
• Respiratory papillomatosis can cause voice changes or breathing problems if not treated
• Rarely, persistent high-risk HPV in adults can lead to cancer (but this takes many years)

Long-term outlook

The outlook for children with HPV is very good. Most warts go away on their own or with simple treatment. With the HPV vaccine, the risk of serious complications later in life is greatly reduced. If your child has genital warts or respiratory papillomatosis, early treatment helps prevent problems and supports their long-term health.

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