[Question #4882] small wart on tongue

25 months ago
Dear Doctor,
A couple of months ago I noticed a small round growth on the side of my tongue.
It is pretty much identical to this:
https://fineartamerica.com/featured/tongue-wart-dr-p-marazziscience-photo-library.html
I have experience no symptoms whatsoever and the growth has not gotten bigger. 
Any ideas as to what it may be? Should I be concerned? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
25 months ago
Welcome to the forum. Apologies for the longer than usual delay in responding.

Oral warts are not rare, but not very common either. Having not seen the bump on your tongue, I cannot judge what it is. The photo at the link you have provded may well be a wart, but it also could be something else, such as a fibroma. With only one visibile that isn't enlarging, a wart may be less likely. But the only way for you to know would be to be professionally examined, e.g. your primary care physician, dentist, or an ENT specialist. If it bothers you, probably it can be easily treated, no matter what it turns out to be.

I'd be happy to comment further if you get professionally examined and would like to let me know the diagnosis and what treatmetn is advised. In the meantime, I hope this information is helpful.

HHH, MD
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24 months ago
 Hi Dr. The wart was removed and the biopsy came back as a benign verruca vulgaris. The doctors office said that no further treatment is needed. How did this come about? Is it sexual in nature? Should I worry about infecting other people?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Thanks for the follow-up information. However, I'm afraid I can't help much. Isolated oral warts are not generally considered to be sexually transmitted or acquired, and I am unaware of any research or data on the topic. We don't see this problem commonly in STD clinics, and if we saw a patient like you, we would refer him or her to an ENT specialist and rely on his/her expertise. My general understanding is that your doctor is correct that nothing more need be done and that transmission to other persons is unlikely.

Sorry I can't be more helpful, but let me know if anything else comes to mind.
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24 months ago
thank you doctor! would it be wise to test for HPV anyway and rule out a possible infection? and would you recommend Gardasil in a 35 year old straight male such as myself? I am not particularly promiscuous  but I have had my fair share of bad judgment calls
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
You have HPV and there is no need for a lab test to prove it. All warts are caused by HPV; I thought you understood that -- sorry if the understanding was mine.

Gardasil isn't recommended at your age; the risk of new HPV infections is low, and in any case you probably have already been infected with some or most of the 9 HPV types prevented by the vaccine. 
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Dr. Hook reminded me of the recent approval of Gardasil up to age 45 (formerly up to age 26). I understood that, but the frequency of new HPV infections still is low in most people beyond their mid-20s, and I had in mind your statement of not being "partcularly promiscuous". On the other hand, If you are likely to be sexually active with more than one partner, you could discuss pros and cons of vaccination with your doctor. 

Sorry for any confusion.
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24 months ago
thank you doctor(s)!
now that the wart on my tongue has been removed, is there a next course of action?
should I monitor my tongue, and if so for how long? 
will the HPV infection go away on its own?
should I abstain from sexual contact, particularly oral-genital?


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Hello again. Somehow I missed this last follow-up question. I found it in preparation to close the thread, normally done 4 weeks after the initial question.

You don't need to "monitor" your tongue. If another wart shows up, you'll feel it or see it without having to look closely.

Over time, almost all HPV infections are suppressed or entirely eradicated by the immune system.

You certainly don't need to abstain sexually in terms of genital contact. There are no data on risk of HPV transmission from either overt oral warts or asymptomatic oral HPV infections. Our usual advice about genital warts is that people should either abstain with new partners, or advise potential partners of their infection, for 3-6 months after treatment, then not necessary if no recurrence of the wart. These are not science-based guidelines, just a common sense approach of many STD experts. I can't say how those same experts would judge the issue for oral HPV/warts, but I probably would give pretty much this advice to a patient in my clinic. But none of this applies to current, ongoing partner(s). You can safely assume regular partners have already been repeatedly exposed, and no need or benefit to stopping contact now. That horse is long out of the barn, no use in closing the door now.

In view of my own error, I'll keep this thread open a few more days in case you have another reply or comment. Sorry again about the delayed reply.
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