Flat Warts ICD-10: B07.8

Viral skin infection

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

lowmediumhigh

Systems Affected

skin

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

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

Causes, Symptoms, and When to Take Action Flat warts are benign, smooth, small bumps on the skin. They are flatter and smaller than other wart types, often appearing in groups, especially in children and teens. How It Looks Texture: Smooth surface, very slightly raised or almost flush with skin Color: Skin-colored, yellowish-brown, pink, or slightly brown depending on skin tone Shape: Round or oval; many in one area (clusters of dozens to around a hundred) Location: Common on face, back of hands, neck, legs; may spread after shaving in beard area or other shaved skin Why Does It Appear? Caused by infection with specific strains of human papillomavirus (HPV) Virus enters through small breaks, cuts, or abrasions Warm, moist skin and skin trauma (e.g., shaving or scratches) may increase risk Weakened immune response or hygiene factors may also contribute Should You Be Concerned? Flat warts are not dangerous and often disappear on their own, though it may take many months or years. Concern is justified if: Warts spread extensively They are persistent and do not improve They cause cosmetic distress or affect quality of life They become irritated or show changes in appearance Can You Prevent It? Avoid scratching, shaving over warts, or skin trauma that might spread virus Wash hands and skin after touching warts Avoid sharing personal items that contact skin (e.g. towels) Keep skin clean and dry 👉 How Piel AI Can Help Piel AI allows you to track flat wart appearance over time via regular images. While not diagnostic, it helps you notice changes in number, clustering, or spread, and aids discussions with healthcare providers. Summary Flat warts are small, benign skin bumps caused by HPV, often appearing in clusters. They are smooth, slightly raised, and vary in color according to skin tone. Usually harmless and self-resolving, but can persist for long periods. Preventive hygiene, avoiding skin trauma, and monitoring are helpful.

Tags

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