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Warts are small, raised bumps on the skin. They occur on the upper layer of the skin surface known as the epidermis and are caused by human papillomavirus (HPV) infections.
Warts are fairly common in children and teenagers; some studies claim that more than 30% of this age group is affected by the condition. On the other hand, less than 5% of adults suffer from warts.
Flat warts are a type of warts that are most commonly found in children. They are small, pinkish-red, and smooth. Flat warts tend to occur in clusters and can be found on the back, neck, arms, and legs. (1)(2)
Take a deeper look at the causes, risk factors, and treatment options available for flat warts.
What Are the Causes and Risk Factors of Flat Warts?
HPV infections usually spread via direct skin-to-skin contact with an affected person’s warts, but some factors that can increase your risk are:
- Injuries or cuts to the skin
- Other skin infections that cause scarring or damage to the skin surface
- Excess sweating, particularly on hands and feet
- Biting nails
- Scratching the warts
- Swimming in public pools
- Working with raw meat a lot
- Being immunocompromised and weak immunity in older people or children
- Skin conditions such as dermatitis or eczema (3)
What Are the Symptoms of Flat Warts?
Some common symptoms of flat warts are:
- Round, pink, or light yellowish-brown bumps
- Flat or smooth bumps that occur in clusters
- Benign bumps that generally do not cause pain
What Are the Treatments for Flat Warts?
Some cases of flat warts tend to go away on their own after a while and do not require intervention.However, if your warts do not seem to disappear and are causing you discomfort or pain, your doctor may physically remove the warts or prescribe some medications for you.
Common treatment plans for flat warts include the following.
1. Topical creams
Creams containing retinoic acid, salicylic acid, and imiquimod may be prescribed by the doctor to soothe the inflammation and help heal the skin. (4)
Cantharidin is another topical treatment for warts. Cantharidin is a compound extracted from beetles that can help remove warts. It forms a blister around the wart when applied.
Cover the area with a bandage after applying it. After a few days, you can peel away the bandage, and the wart will be removed along with it. (5)
3. Trichloroacetic acid
A concentration of 50% to 100% of trichloroacetic acid is usually used to apply to the warts, which will eventually necrose and fall off.
4. Other medicines
Your doctor may give you bleomycin injections that can help your body fight the HPV infection and “kill” the warts. (6)
Some vaccines such as the MMR vaccine can also be injected into big warts, which will help in developing antibodies against the wart and ultimately eliminating the wart.
5. Minor surgery
Minor surgery is performed by the doctor for stubborn warts that are causing significant pain or disfigurement in the patient. The warts are removed using an electric needle or freezing technique.
Cryotherapy (freezing) is performed by the dermatologist to freeze the wart. The wart will blister and fall off within a couple of weeks. (6) Radiofrequency is done on small warts on the face, scalp, or hands. The warts are cauterized using an electrocautery or radiofrequency probe.
How Are Flat Warts Diagnosed?
If you or your child has any of the above mentioned symptoms, it is important to consult a doctor at the earliest to determine whether they have flat warts or any other skin condition.
Your doctor can diagnose flat warts based on physical examination, medical history, and results of diagnostic tests. Skin biopsy is one of the tests your doctor may order. The doctor will remove the wart and send it to the lab for testing. (7)
When to See a Doctor
Consult a doctor immediately if you notice any of the following:
- Pain or inflammation in the warts.
- Swelling, redness, or a warm feeling in the affected area.
- You are immunocompromised (you have diabetes, AIDS, etc.), are pregnant, or below 10 years of age
Flat warts are benign and usually disappear on their own in healthy, young individuals. Treatment is usually prescribed only when the warts cause pain or are not healing on their own even after a couple of weeks.
Other skin conditions may appear similar to flat warts (such as dermatitis). Thus, it is necessary to get a proper medical checkup from a dermatologist to ensure you receive the correct treatment.