Oral Warts: Symptoms, Diagnosis, and Treatment Options

Oral cauliflower (also known as oral warts or oral papillomas)

I am 16 years old and have developed some strange pink bumps under my tongue, about 10 in total, some are separate and some are connected.
I am concerned because I performed oral sex on a stranger three weeks ago, so I suspect I might have genital warts or something else.
Which department should I consult? I previously visited a general ENT clinic, and they mentioned it could be a salivary gland issue, but I didn't disclose that I had oral sex.
If it is indeed genital warts, how should it be treated? There are many areas in the mouth that are hard to reach; will electrocautery or cryotherapy be effective in completely removing them? Currently, there are no lesions on my genitals or anus.
Will treatment require a surgical procedure?

Niming, 10~19 year old female. Ask Date: 2017/05/02

Dr. Chen Taicheng reply Family Medicine

● If you suspect warts, you may want to consult an otolaryngologist.
If the diagnosis remains uncertain, you can also visit a dermatologist for further evaluation.
● Treatment options for warts include cryotherapy, electrosurgery, laser therapy, topical wart removal medications, and even surgical excision.
You should discuss these options with your physician.
● Generally, treatment can be more complicated, but it is still curable.
If the physician determines that it is not warts, there is no need for excessive concern.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital, Family Medicine Department.

Reply Date: 2017/05/02

More Info

Understanding oral warts, particularly in the context of your symptoms, is crucial for proper diagnosis and treatment. Based on your description of pinkish growths under your tongue, it is essential to consider several factors, including potential sexually transmitted infections (STIs) such as human papillomavirus (HPV), which can cause genital warts and, in some cases, oral warts.

Symptoms of Oral Warts
Oral warts can present as small, raised, pinkish or white lesions in the mouth, including the tongue, gums, and inner cheeks. They may be solitary or clustered and can vary in size. In some cases, they might be asymptomatic, while in others, they can cause discomfort, pain, or difficulty in eating and speaking. Given your recent sexual activity, it is understandable to be concerned about the possibility of HPV or other STIs.

Diagnosis
For an accurate diagnosis, it is advisable to consult a healthcare professional who specializes in oral health or infectious diseases. You may want to see an oral surgeon, a dentist with experience in oral pathology, or a dermatologist. It is essential to be open about your symptoms and any relevant sexual history, as this information can significantly aid in diagnosis.
During the examination, the healthcare provider may perform a visual inspection of the lesions and may suggest a biopsy if there is any suspicion of malignancy or if the diagnosis is unclear. A biopsy involves removing a small sample of tissue for laboratory analysis, which can confirm the presence of HPV or other conditions.

Treatment Options
If the lesions are confirmed to be warts caused by HPV, several treatment options are available:
1. Topical Treatments: Medications such as imiquimod or podophyllin can be applied directly to the warts. These treatments help to stimulate the immune response to fight the virus.

2. Cryotherapy: This involves freezing the warts with liquid nitrogen. It is a common method for removing warts but may require multiple sessions.

3. Electrosurgery: This technique uses electrical currents to burn off the warts. It is effective but may leave scars.

4. Laser Treatment: In some cases, laser therapy may be used to remove warts, especially if they are widespread or resistant to other treatments.

5. Surgical Excision: If the warts are large or persistent, surgical removal may be necessary. This procedure is typically performed in a clinical setting, possibly requiring anesthesia.

Considerations
It is important to note that while treatments can remove visible warts, they do not eliminate the HPV virus from the body. HPV can remain dormant and may cause warts to recur. Regular follow-ups with your healthcare provider are essential to monitor for any new lesions or changes.

Conclusion
Given your age and the nature of your symptoms, it is crucial to seek medical attention promptly. Be honest with your healthcare provider about your sexual history and symptoms, as this will help them provide the best care possible. If you suspect that you have HPV or another STI, early diagnosis and treatment can help manage the condition effectively and reduce the risk of transmission to others. Remember, maintaining open communication with your healthcare provider is key to addressing your concerns and ensuring your overall health.

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