Flat warts, also known as juvenile warts, are small, smooth, and flat-topped bumps the size of pinheads. These warts can be either flesh-colored or brownish-yellow.
They are hardly noticeable but are commonly found on the face, back of the hands, or legs. Flat warts are mostly found in children and young adults. The warts are caused by a contagious virus but are benign and are usually not painful.
Warts can be round or oval to face, ranging from 1-3 millimeters in diameter. They can grow in groups of 20 to 200 warts. The warts typically appear around a scratch or break in the skin.
They may be present in the beard area of men due to shaving sticks. Women, on the other hand, may get warts on their legs for the same reason.
If you are concerned or unsure about a bump on the skin, you must contact a doctor to determine if the lumps are flat warts or something else.
Causes and Risk Factor for Flat Warts
Flat warts, like most warts, are primarily caused by the HPV virus. People with an impaired or weakened immune system are at risk of contracting the virus directly or indirectly.
Causes of flat warts include:
- HPV Virus: Many strains of HPV virus exist, and only about three are responsible for the development of flat warts; HPV-3, HPV- 10, and HPV- 28. The virus is also associated with the development of cervical cancers, although only a few strains are responsible for this. For warts to occur, HPV enters the body via the epidermal layer of the skin or the respiratory tract. Once inside, the virus irritates the keratinocytes – cells beneath the skin responsible for creating keratin. Excess production of keratin can result in tough lumps of skin appearing on your face, arms, or feet, which vary in size and color.
- Impaired Immune System: HPV viruses thrive on those with an immature or weakened immune system. The virus that causes flat warts often targets the young and those who cannot respond appropriately to the threat of the virus. This usually includes children and teenagers. The disease, however, is not limited to children. It can also affect people with diseases of the immune system such as HIV and those suffering from conditions like hypothyroidism.
- Poor Nutrition: Diet plays an essential role in supporting the immune system and maintaining health and wellbeing. It is important to be conscious of what you eat, especially if you are young or suffer from an existing health condition. Indulging in foods high in refined sugars and processed fat may take a toll on your health and stress your immune system. This causes it to be unable to identify and combat pathogens like the HPV virus effectively.
- Indirect Contact: Physical contact with infected objects or surfaces is one of the most common ways to contract the HPV virus. Flat warts often appear in the beard area, and this is sometimes due to how men shave. Shaving irritates and weakens the skin around the jaw, making it easier for the virus to penetrate the skin. Infected skin cells shed while shaving can linger on the razor or nearby surfaces until it comes in contact with another victim. It is not advisable to share personal effects like razors and towels to reduce the risk of infection.
- Direct Contact: HPV virus can be spread through direct contact with an infected person. Spending a continuous amount of time with someone that has been infected with the virus may increase your risk of being infected.
Signs and Symptoms of Flat Warts
Flat warts can be identified and located in the following areas:
- Face, especially in children
- Jaw and beard area in men
- Legs, especially in women
- Back of hands
When to see a doctor
Make an appointment with a dermatologist if you have:
- Warts on the face
- Painful or bleeding warts
- Rapidly spreading or multiplying warts
- Warts that interfere with everyday life and are not responsive to self-care
Flat warts do not often require treatment and usually disappear on their own.
Some people may want to get rid of them sooner for cosmetic or aesthetic reasons.
Over-the-counter treatments are available, and they can also be purchased online.
A doctor can remove most warts using specific removal techniques; however, some of these procedures can cause warts to spread. Removal methods include:
- Burning the wart is using a laser
- Excision involving the cutting or scraping away the wart with a scalpel
- Cryotherapy, which involves freezing the wart with liquid nitrogen until it falls off
- Cantharidin application, a chemical that causes a blister to form under the wart and lift it from the skin
If the flat warts are present on a person’s face, hands, or another sensitive area, gentler treatments may be used to avoid scarring.
Instead, a doctor may prescribe a topical cream designed to irritate the skin so that the wart can be peeled away. These may include retinoic acid or benzoyl peroxide creams.
HPV is a highly contagious virus. Therefore people with warts should take steps to avoid spreading the virus.
They can do this by:
- Washing hands after touching warts, even to apply a cream
- Refraining from scratching, rubbing, or picking at warts
- Keeping the skin clean and dry
- Cleaning toys properly
- Not sharing towels or other items that touch the skin
Avoid contracting HPV by:
- Refraining from touching another person’s warts
- Wearing flip-flops or shower shoes in public pools and locker rooms
- Avoiding using the towels or other items of a person with the virus
While proper hygiene and the precautions above can help, a person may not avoid contracting HPV.