HPV In Children: Causes, Symptoms, Diagnosis, And Treatment

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Human papillomavirus (HPV) infection is a condition that may cause children to be affected by warts. An infection from HPV in kids can spread through skin-to-skin contact and affect boys and girls alike.

About 200 kinds of HPV have been discovered based on DNA sequences, including low-risk HPVs that may not cause disease or warts. However, high-risk HPVs, such as HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68, may result in wart formation and various types of cancer later in life. Among these, HPV 16 and 18 are associated with most HPV-related cancers.

Read this article to know about the symptoms, causes, complications, treatment, and prevention of HPV infection in children.

Causes And Risk Factors For HPV In Children

Although HPV is a sexually transmitted infection (STI), it can also be transmitted through non-sexual routes. Children may get HPV infection in the following ways.

  • Skin-to-skin contact such as hand-to-hand contact can spread HPV, and having a cut in the skin may increase one’s risk.
  • Mothers with HPV infection can transmit it to the child during vaginal delivery or even before
  • A weakened immune system due to immune-suppressing medications after transplant or other conditions, such as HIV/AIDS, can increase the risk for HPV infection in children.
  • Using towels used by an infected person
  • Genital HPV infection in children may occur during a diaper change, that is, it can be spread from the hands of someone with HPV

Teens who are sexually active at an early age may have an increased risk for HPV. In some cases, sexual abuse can also be a risk factor for children. A medical examination is recommended to identify the exact cause since children can get HPV, including genital warts, in many other ways.

Signs And Symptoms Of Human Papillomavirus Infection

Warts, which are tiny, fleshy, noncancerous bumps on the skin, are common symptoms of HPV infection. However, many children can be asymptomatic. The following are the different types of warts.

  • Genital warts may appear as tiny, cauliflower-like bumps, flat lesions, or small stem-like protrusions. Boys may have genital warts on the scrotum, penis, or around the anus, while girls may notice them on the vulva, cervix, vagina, or in the anal region. Although some children may experience itching and tenderness, genital warts rarely cause pain and discomfort.
  • Plantar warts are hard and grainy and usually appear on the heels and balls of the feet. These might often cause discomfort and may be difficult to treat.
  • Flat warts are flat lesions or slightly raised lesions. Although flat warts may appear anywhere in the body, children tend to get them on the face, and sometimes on the hands and lower arms.
  • Common warts are rough, raised growths that often appear on the hands and fingers. They can be painful and cause bleeding.
  • Recurrent respiratory papillomatosis is a rare disorder characterized by small, wart-like growth in the air passages due to HPV. They are commonly seen in the voice box (larynx) and called laryngeal papillomatosis.

Anogenital warts in children may warrant clinical evaluation as there could be a possibility of sexual abuse. Symptoms such as pain, bleeding, or swollen glands are often seen if HPV develops into cancer. However, it is rare in children.

What Cancers Are Caused By HPV Infection?

HPV infection can cause certain types of cancers decades or years after infection. There is no way to predict who may develop HPV-related cancer. However, long-lasting HPV infection of high-risk types may cause cancer in the cervix, oropharynx, vagina, vulva, penis, and anal area, which are the parts of the body where the HPV infects the cells.

According to the National Cancer Institute, HPV causes

  • Almost all cases of cervical cancers
  • 90% of anal cancer
  • Most throat cancers
  • 75% of vaginal cancer
  • 70% of vulvar cancer
  • More than 60% of penile cancer

Based on the data from the Centers for Disease Control and Prevention, 3% of all cancers in women and 2% of all cancers in men are caused by high-risk HPV types in the US each year. Nearly 45,000 new cancers are seen in parts of the body where HPV is common, and among these, 36,000 are caused by HPV.

Further, approximately 5% of all cancers worldwide are caused by HPV, with an estimated 570,000 women and 60,000 men getting HPV-related cancers each year.

Diagnosis Of HPV Infection In Children

Blood tests aren’t effective for confirming HPV in children. However, the appearance of warts can help in the diagnosis. HPV DNA tests can help identify the genetic material of HPV in samples.

Other tests such as the Pap test, which involves collecting samples from the cervix for microscopic examination, and colposcopy, which uses instruments with light to view the cervix may be done at later ages. Application of vinegar solution may help see the abnormal cells better in colposcopy.

Treatment For HPV In Children

The following treatments are given for warts in children.

  • Topical medicines: Imiquimod cream is prescribed to treat warts in children. This is also approved for genital warts This should be applied on every alternate night, that is, three days in a week, and washed off in the morning. Be careful to apply it using an ear bud so that the medicine does not touch normal skin.
  • Freezing with liquid nitrogen: The dermatologist may apply liquid nitrogen to warts to freeze them. This may cause skin irritation, discomfort, or pain for a day or two.

It is recommended to seek medical care and get prescription medication for children with warts. Applying acids or any other chemicals on warts at home is not recommended. Unapproved remedies may increase the risk of abnormal changes in warts, hence should be avoided.

HPV Vaccines In Children

HPV vaccines can protect more than 90% of HPV-related cancers in later life. Vaccination may prevent cervical cancer, vaginal cancer, and vulvar cancer in girls and anal cancer and genital warts in both girls and boys, and may also prevent certain throat and mouth cancers linked to HPV infection.

The Centers for Disease Control and Prevention recommends HPV vaccine for preteens, both boys and girls, at age 11 or 12. They can receive two doses of HPV vaccine six to 12 months apart. However, the vaccination can be started as early as nine years of age.

Only two doses are recommended for children who receive vaccines from age nine through age 14. Teens and young adults who start later, 15 to 26 years, require three vaccine doses. Three doses are also needed for children with a weakened immune system and those receiving vaccines with less than a five-month gap.

It is best to get vaccinated in the preteen years to be protected before being exposed to HPV since vaccines are less beneficial and may increase the risk for new HPV infection in adults.

HPV infection may go unnoticed for years since most children may not develop warts. You may seek medical care if you find warts in your child’s hands since they can be spread to the genital area and other parts of the body. Never hesitate to vaccinate your child and give proper sex education for teenagers to prevent HPV and related complications in later life.


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Dr. Anuradha Bansal

Dr. Anuradha Bansal is a pediatrician and neonatologist working as assistant professor in the Department of Paediatrics at PIMS Jalandhar. She has done her MBBS and MD Pediatrics at GMCH, Chandigarh. Thereafter, she polished her skills as senior resident at MAMC, Delhi. She has also done IAP Fellowship in Neonatology at GMCH, Chandigarh and obtained the membership of the prestigious... more

Dr Bisny T. Joseph

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made... more