[1] The causative agent of the disease is believed to be Chelonid alphaherpesvirus 5 (ChHV-5), a species of virus in the genus Scutavirus, subfamily Alphaherpesvirinae, family Herpesviridae, and order Herpesvirales.

[1] FP is most often found externally around the armpits, genitals, neck, eyes, and tails of turtles, but also occur in and around the mouth, and rarely in internal organs or on the carapace.

[9] The tumours appear to be benign and can be present for many years, but if large, can mechanically hamper sight, swallowing, and swimming, which may ultimately be fatal.

[1] Long-term studies found no signs of the disease on Florida's Atlantic coast in the 1970s, but during the 1980s FP was recorded in incidences varying from 28 to 67%.

The reason for this belief is because nearly all tissue samples tested from turtles with lesions carry genetic material of this herpesvirus, varying between 95 and 100% depending on different studies and locations.

[6][11] Possible factors include some parasites, bacteria, environmental pollutants, UV-light, changing water temperatures and biotoxins.

[1] Again, causality has not been concluded, but an association seems to exist between the distribution of especially the dinoflagellates and the occurrence of FP, and as they are found on weeds, they can be ingested by foraging green sea turtles.

[15] The strongest association with FP is with habitat type, especially increased anthropogenic activity causing high-nitrogen footprints in a surrounding environment where green sea turtles are found.

[8] Even so, observations support the hypothesis that near-shore habitats have a strong correlation with the disease, as newly recruited individuals from the pelagic life phase have never been found with tumours,[6] and when migrating to more shallow ocean zones, such as the neritic zone, individuals still remain free from FP, but when entering lagoon systems, turtles may become infected.

[15] Turtles are known to be robust to physical damage, but are surprisingly very susceptible to biological and chemical contaminants caused by anthropogenic activity.

[15] As the turtles forage on invasive macroalgae in nutrient-rich waters, they can ingest environmental nitrogen in the form of arginine, which is known to regulate immune activity, promote herpesviruses, and contribute to tumorigenesis.