Images of Flat Wart (9)
Warts are growths of the skin and inside the mouth that are caused by a virus known as the human papillomavirus (HPV). The virus causes thickening of the top skin layer. Flat warts tend to be small but can be plentiful. They are usually painless and go away on their own, sometimes taking a few months or up to a couple years to resolve.
Warts are usually acquired from person-to-person contact. The virus is not highly contagious but can cause an infection by entering through a small break in the skin. In the same way, warts can be spread to other places on your own body (autoinoculation). The virus can sometimes be transferred by touching an object used by an infected person.
Who's At Risk?
Warts can affect people of any age, but they are most common in children between the ages of 12 and 16 years. It is estimated that 20% of schoolchildren and about 10% of the general population have warts. Warts can affect people of any race / ethnicity. People with HIV, organ transplants, or who are taking chemotherapy medication have a higher incidence of warts because of their weakened immune system.
Signs & Symptoms
The most common locations for flat warts include the:
- Face, especially in children.
- Legs, especially in those who shave their legs.
- Beard area, especially in those who shave their face.
- Backs of the hands.
Flat warts are very slightly raised, flat-topped, smooth, round or oval papules (small, solid bumps) ranging in size from 1-3 mm. In lighter skin colors, flat warts may be pink, skin-colored, or yellowish-brown. In darker skin colors, flat warts may be whitish, pink, purple, or brown.
There are often numerous flat warts, and they may appear in a line due to autoinoculation from scratching or shaving.
Because warts can go away on their own, it is not necessary to treat all warts. Additionally, treating warts may not always destroy them, nor will it necessarily keep other warts from appearing. Treatment can be painful, cause scars, and might need to be repeated, so treatment should only be done in cases where the warts are highly bothersome or interfere with daily life.
- Over-the-counter wart removers have a high percentage of salicylic acid and work by dissolving away the layer of skin infected with the virus. This needs to be used daily and can sometimes be irritating to skin around the warts.
- Duct tape applied daily to the affected area of the face can help remove warts. The tape should be very sticky and kept on for a few days at a time.
- Over-the-counter freezing medications are available but have not been found to be very effective.
- Coupled with the above therapies, the wart should be soaked in warm water, and any loose skin should be removed every few days with a mild abrasive, like a pumice stone.
- Household members should avoid sharing personal items such as towels.
Once you have been diagnosed with flat warts, your medical professional may try one or more of the following treatments:
- Freezing with liquid nitrogen (cryosurgery).
- Application of imiquimod, tretinoin, or fluorouracil, especially for flat warts on the face.
- Burning with an electric needle (electrocautery).
Make an appointment with a medical professional if you have:
- Painful or bleeding warts.
- Warts on your face.
- Rapidly spreading or multiplying warts.
- Warts that interfere with daily life and are not responsive to self-care.
Bolognia J, Schaffer JV, Cerroni L. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018.
James WD, Elston D, Treat JR, Rosenbach MA. Andrew’s Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2019.
Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology. 9th ed. New York, NY: McGraw-Hill Education; 2019.
Last modified on December 7th, 2023 at 3:05 pm
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