Flat warts are small, painless growths caused by the human papillomavirus (HPV) that commonly appear on the face and hands of children. They are usually harmless and disappear within two years, but can be removed for cosmetic reasons. Certain HPV types are associated with flat warts, and dermatologists may suggest over-the-counter creams or prescription ointments for treatment. Cryotherapy and surgical removal are generally discouraged due to the risk of scarring.
Flat warts are small, smooth, painless growths that can arise anywhere on the body, although they are most commonly seen in clusters on the face and hands. Like all warts, they are caused by a human papillomavirus (HPV) infection. Flat warts are common in young children but rarely appear after adolescence. They are almost always harmless and only persist for a few years, although some people choose to remove them for cosmetic purposes.
Researchers have discovered hundreds of different HPV strands that can manifest in many ways. Certain 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 types of warts to appear. The probable reason that children are affected more commonly than adults is that developing immune systems are less effective at suppressing HPV infections.
A typical flat wart is less than 0.2 inch (about five millimeters) in diameter, slightly raised, and lighter in color than the surrounding skin. It is common for warts to appear in clusters, with dozens or hundreds of individual spots clustered tightly together. Most cases are isolated on one cheek, under one eye, or on the forehead. Clusters of flat warts appear less commonly on the backs of the hands, shins and tops of the feet.
Flat warts are usually benign, although 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 take a small skin sample 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 the parents and the patient.
Dermatologists usually don’t suggest aggressive treatment for flat warts, emphasizing that they’re not a cause for concern and will likely go away on their own within about two years. If parents want to shorten the healing time, they can be instructed to try an over-the-counter topical cream containing salicylic acid to irritate and erode 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 types of warts, but doctors generally discourage such measures for flat warts, especially if they’re on the face. The scars from the surgical treatment would persist much longer than the warts themselves.
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