Flat Warts ICD-10: B07.8
Often searched as: small flat bumps on face, smooth bumps on forehead, clusters of tiny bumps on skin, flat warts on legs, warts from shaving, HPV skin bumps, small smooth bumps on hands, warts on face treatment…
Clinical urgency level
Systems Affected
Severity Levels
mild
A few flat warts in a limited area, not spreading, causing no discomfort — can be monitored or treated with over-the-counter options.
moderate
Multiple warts spreading across the face, legs, or hands; spreading after shaving; causing cosmetic distress.
severe
Extensive or rapidly spreading warts, especially in immunocompromised individuals where HPV infections can become widespread and resistant to treatment.
Red Flags
- Rapid spread of dozens of new warts in a short time
- Warts appearing in a child or adult with no improvement after many months
- Warts on the face spreading after shaving
- Warts in an immunocompromised person (HIV, transplant recipient) — can be extensive
- Any wart that changes color, bleeds, or grows unusually fast — needs evaluation to rule out other lesions
Clinical Presentation
Flat warts (verruca plana) — multiple smooth small papules on the face
Source: Wikimedia Commons (CC BY-SA 3.0 )
Flat warts image gallery — DermNet NZ
View gallery on DermNet NZ (image gallery reference)When to See a Doctor
See a dermatologist if flat warts are spreading rapidly, affecting visible areas like the face, or not responding to home treatment after several months. Warts in people with weakened immune systems always warrant professional evaluation. Any lesion that bleeds, changes rapidly, or doesn't look like a typical wart should be examined.
Differential Diagnosis
- Sebaceous hyperplasia (enlarged oil glands on face)
- Milia (tiny white cysts)
- Epidermal nevi
- Lichen planus (flat-topped papules)
- Molluscum contagiosum (small, dome-shaped bumps with central dimple)
- Syringoma (small benign sweat duct tumors under eyes)
- Acne comedones (on face)
Comorbidities
- Immunosuppression (HIV, organ transplant — higher wart burden)
- Atopic dermatitis (skin barrier disruption increases HPV entry risk)
- Epidermodysplasia verruciformis (rare genetic condition with widespread HPV-related lesions)
Prognosis
Flat warts in children and immunocompetent adults often resolve spontaneously within 1–2 years as the immune system clears the HPV infection. However, they can persist for years and spread if not addressed, particularly through shaving. Treatment options include topical retinoids, salicylic acid, cryotherapy, or laser — all with good outcomes. Recurrence is possible if the HPV strain persists in the skin.
Detailed Overview
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