Three Examples of Papillomatous Growths

While many skin growths look similar at first glance, they often have very different “blueprints” under the surface. In dermatology, the term papilloma covers three distinct examples of growths that may appear alike but behave differently because of their unique biological causes.

Understanding these differences helps you and your doctor determine whether a growth is a result of friction, a common virus, or simple skin cell overgrowth.

Acrochordons: The “Friction” Growth

Commonly known as skin tags, acrochordons are biologically classified as fibroepithelial polyps ^[1]. Rather than being a simple overgrowth of the top layer of skin, they are made of a core of loose connective tissue, collagen fibers, and tiny blood vessels ^[1].

These growths are most common in areas where skin rubs against skin or clothing, such as the neck, armpits, and groin ^[2][3]. Several factors are associated with their development:

• Mechanical Friction: Constant rubbing (trauma) in skin folds is believed to trigger the growth of these small, soft stalks ^[4].
• Hormonal Changes: Many people develop skin tags during pregnancy. This may be linked to elevations in estrogen and progesterone that facilitate development ^[4].
• Metabolic Health: There is an observational association between multiple skin tags and metabolic features. This includes obesity, impaired glucose regulation, and dyslipidemia ^[5][6]. Having skin tags does not prove you have diabetes, but multiple tags may prompt a clinician to consider routine metabolic-risk assessment ^[5].

Viral Papillomas: The “Infection” Growth

Commonly known as cutaneous warts, these are caused by the Human Papillomavirus (HPV) ^[7]. Unlike skin tags, which are made of connective tissue, warts are an infection of the cells at the very bottom of your skin’s surface layer ^[7].

The virus “reprograms” these cells to multiply rapidly, creating a hard, rough growth. Because they are viral, they have specific characteristics:

• Contagious Spread: Warts can spread through direct skin-to-skin contact or if you accidentally spread the virus from one part of your own body to another ^[8]. You can reduce spread by practicing good hand hygiene, not picking or shaving over warts, and not sharing towels, razors, or nail tools.
• Spontaneous Regression: In most healthy people, the immune system eventually recognizes the virus and clears the infection. While it can take a few years, the majority of these warts will eventually disappear on their own without treatment ^[9][10].
• Location: While they can appear anywhere, viral papillomas are most common on “exposed” or high-contact skin, such as the hands and feet ^[8].

Squamous Cell Papillomas: The “Structural” Growth

A squamous cell papilloma is a benign (non-cancerous) overgrowth of the flat cells that form the outermost layer of your skin and the linings of your mouth and throat ^[11].

Under a microscope, these growths are famous for their finger-like projections ^[12]. These tiny “fingers” of skin cells grow outward, each supported by its own central core of blood vessels ^[11].

• Location: While they can appear on the skin, they are most frequently found on mucous membranes, such as the tongue, the roof of the mouth, or the gums ^[13][14]. Note that a genital condyloma is not synonymous with every squamous papilloma.
• The HPV Debate: While some squamous papillomas are linked to strains of HPV, others appear to develop spontaneously without a clear viral cause ^[13][15].

Summary of Differences

Although these three growths may all be called “papillomas” because they grow outward, their biology tells a different story.