What are Flat Warts?

D. Jeffress

Flat warts are small, smooth, painless growths that can arise anywhere on the body, though they are most commonly seen in groupings on the face and hands. Like all warts, they are caused by a human papillomavirus (HPV) infection. Flat warts are frequently seen in young children, yet they rarely manifest after adolescence. They are almost always harmless and only persist for a few years, though some people choose to have them removed for aesthetic purposes.

Cryotherapy is the most reliable way to remove warts.
Cryotherapy is the most reliable way to remove warts.

Researchers have discovered hundreds of different strands of HPV that can manifest in any number of ways. A few specific strands, namely HPV types 3, 10, and 28, are associated with the development of flat warts. These types only rarely become malignant or cause other kinds of warts to appear. The likely reason why children are affected more commonly than adults is that developing immune systems are less effective at suppressing HPV infections.

Freezing warts with liquid nitrogen often causes blisters to form where the treatment was performed.
Freezing warts with liquid nitrogen often causes blisters to form where the treatment was performed.

A typical flat wart is less than 0.2 inches (about five millimeters) in diameter, slightly raised, and lighter in color than surrounding skin. It is common for warts to appear in clusters, with dozens or hundreds of individual spots grouped closely together. Most cases are isolated to a cheek, underneath an eye, or on the forehead. Clusters of flat warts appear less commonly on the backs of the hands, the shins, and the tops of the feet.

A dermatologist can confirm if a flat wart is benign.
A dermatologist can confirm if a flat wart is benign.

Flat warts are normally are benign, though they should still be inspected by a doctor to rule out the possibility of a more serious skin condition. A dermatologist can inspect the warts and collect a tiny sample of skin for laboratory analysis to confirm the presence of an active HPV infection. After making a diagnosis, the doctor can explain the physiology of the condition and discuss treatment options with parents and the patient.

Smokers are more susceptible to HPV infection.
Smokers are more susceptible to HPV infection.

Dermatologists do not usually suggest aggressive treatment for flat warts, pointing out the fact that they are not a reason for concern and will likely go away on their own within about two years. If parents want to decrease healing time, they may be instructed to try an over-the-counter topical cream containing salicylic acid to irritate and erode the affected skin. A high-strength ointment containing retinoic acid may be prescribed for persistent or recurring warts. Cryotherapy and surgical removal are options for many kinds of warts, but doctors generally discourage such measures for flat warts, especially if they are on the face. Scarring from surgical treatment would persist for much longer than the warts themselves.

Warts may require surgical removal.
Warts may require surgical removal.
In some cases, laser treatments may be used to remove warts on the forehead or under the eye.
In some cases, laser treatments may be used to remove warts on the forehead or under the eye.
A high-strength ointment containing retinoic acid may be prescribed to treat persistent warts.
A high-strength ointment containing retinoic acid may be prescribed to treat persistent warts.

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Discussion Comments

zeak4hands

@Jacques6 - Yes, you can pass a flat wart on. Just make sure that no one kisses you on the cheek and you should be fine. It has to be direct contact. Just like plantar warts, do not scratch it. It can spread.

As for home flat wart treatments – your options are limited to whatever rumors are floating around on the web. A lot of people swear that caster oil removes all kinds of warts, while other people say that it does nothing.

I know that castor oil works on plantar warts – it's what I used – but I haven't found anyone who said that it worked on flat warts yet. You might have to ask your doctor about flat wart removal.

Jacques6

I have a flat wart on my cheek and I was hoping to get rid of it before the holidays roll around. My family always takes a lot of pictures and I don't want the wart to be there.

I have two questions that I was hoping somebody could answer for me. One, are flat warts contagious? The last thing I want to do is pass it on! Two, are there any home treatments for flat warts? I would like to avoid a doctor bill just for a wart.

Any recipes for flat wart remover? Maybe a over-the-counter treatment?

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