Flat Warts: What Are They, Their Causes, Preventions And Treatment Options

Verruca plana, also referred to as flat warts, is a widespread dermatological disorder caused by the human papillomavirus (HPV) and can affect individuals of any age. However, they are most prevalent among children and young adults. They manifest as small, smooth, flat-topped lesions often found on the face, neck, hands, and wrists. 

Unlike their more conspicuous counterparts, such as common warts or plantar warts, flat warts tend to be less noticeable but can spread more extensively across the skin. Even though these skin growths are benign, they can be rather painful while being tiny and unnoticeable. 

Understanding the nature of flat warts, their causes, preventive measures, and possible treatment options can help manage this condition effectively.

Nature and Appearance of Flat Warts

Flat warts are characterised by their:

  • Size and Shape: They are smaller than other types of warts, typically less than a quarter inch in diameter, with a flat or slightly raised surface.
  • Colour: They can be pink, light brown, or yellowish in colour, blending in more closely with the skin compared to other wart types.
  • Number and Distribution: They often appear in large numbers, sometimes in clusters of 20 to 100 at a time, and can spread through autoinoculation.

Differences from Other Types of Warts

Flat warts differ from other warts in several key aspects:

  • Location: They are most commonly found on the face, back of the hands, and legs, whereas other warts typically appear on the fingers, toes, and soles of the feet.
  • Appearance: Their flat and smooth surface contrasts with the rough and bumpy texture of common warts and plantar warts.
  • Tendency to Spread: They are more likely to spread to other parts of the body and to other people through shaving or scratching.

Causes of Flat Warts

The primary cause of flat warts is an infection with HPV, a virus that penetrates the skin through small cuts or abrasions. Different strains of HPV are responsible for different types of warts. For flat warts, HPV types 3, 10, 28, and 49 are most commonly implicated. Transmission can occur because of:

Direct Contact

Flat warts are extremely infectious and can be transferred from one person to another through physical contact. The risk of transmission rises when people share private objects like towels, razors, or clothing with an infected person. Flat warts can also appear as a consequence of coming into contact with HPV-infected objects or surfaces.

Weakened Immune System

A weakened immune system leaves one susceptible to infections in general, including flat warts. Flat warts are more likely to manifest in those with lowered immunity, such as organ transplant recipients or anyone diagnosed with HIV/AIDS.

Skin-to-Skin Contact

The HPV virus may spread more easily when people participate in activities that require extended skin-to-skin contact, such as contact sports or wrestling. This is especially true if there is direct skin-to-skin contact with an infected person, particularly if they have active flat warts.

Damaged or Abraded Skin

Flat warts are more likely to appear when there are open wounds, scrapes, or scratches on the skin because they serve as entry routes for the HPV virus. When the protection layer is broken, the virus can enter the skin more easily.

Environmental Factors

Flat warts may develop as an outcome of specific environmental causes. Public swimming pools, changing rooms, and shared showers are examples of warm, humid settings that are excellent for the growth of the HPV virus. Infections may result from touching surfaces in these environments.

Prevention of Flat Warts

Even while flat warts are difficult to completely avoid, certain precautions can reduce the likelihood of their appearance. Prevention strategies focus on minimising exposure to the virus and enhancing skin health.

Good Hygiene Practices

The possibility of acquiring the HPV virus can be decreased by regularly washing your hands, refraining from sharing personal objects and maintaining dry, clean skin.

Protecting Damaged Skin

Another way of reducing the likelihood of HPV transmission is by taking steps to protect any wounds, scratches, or open sores on the skin.

Boosting the Immune System

A fit lifestyle consisting of a balanced diet, regular physical activity, proper sleep, and stress regulation can help the body’s immune system to function better and handle illnesses.


There are vaccines available to protect against some HPV strains, including the ones that cause flat warts. To ascertain whether immunisation is appropriate for you or your kids, speak with a medical professional.

Treatment Options for Flat Warts

Treatment may not always be necessary, as flat warts can resolve on their own. However, due to their tendency to spread and their aesthetic impact, many seek treatment. Available options include:

Over-the-Counter Remedies
  • Salicylic Acid: Available in patches, gels, or liquids, it helps peel off the wart layer by layer.
  • Cryotherapy Kits: These kits freeze the wart, similar to professional cryotherapy, but with less intensity.
Prescription Medications
  • Topical Treatments: Retinoids derived from vitamin A or imiquimod can disrupt wart growth.
  • Oral Medications: In severe cases, doctors may prescribe antiviral or immunomodulating drugs.
Medical Procedures
  • Cryotherapy: Professional freezing of the wart with liquid nitrogen.
  • Laser Treatment: Utilising a laser to burn and destroy wart tissue.
  • Electrosurgery and Curettage: Burning the wart with electric current and scraping it off.


Flat warts, while generally harmless, can be a nuisance due to their appearance and the potential to spread. To properly manage and stop the spread of flat warts, it is essential to understand their nature and causes. The chances of catching the HPV virus can be lowered by maintaining good hygiene, preserving injured skin, and boosting their immune systems. 

If you feel you have developed these tiny, flat growths on your skin, see a dermatologist right away. Remember, timely detection and treatment are key factors in managing flat warts.


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