ConditionSkin, hair & nails
Flat Warts (Verruca Plana)
Flat warts (verruca plana) are small, smooth, slightly raised bumps caused by human papillomavirus (HPV), usually types 3 and 10. They are 1 to 5 mm across, skin-colored, pink or light brown, and often appear in clusters of dozens on the face, back of the hands or shaved legs. They are most common in children and teenagers. Flat warts are harmless and often clear on their own within 1 to 2 years, but treatments such as topical retinoids can speed things up.
Also called: Verruca plana, plane warts, juvenile warts
At a glance
- What they are
- Small, smooth, flat-topped HPV growths.
- Where
- Face, forehead, beard area, backs of hands, shins (especially after shaving).
- Who
- Mostly children and teens; adults too, especially with weakened immunity.
- Contagious?
- Yes, mildly, by skin contact and especially by shaving or scratching.
- Treatment
- Often none needed; topical retinoids, imiquimod, 5-fluorouracil, gentle freezing or other in-office treatments.
When to get help
See a doctor within a day or two
- A single lesion that is growing, bleeding, ulcerated or changing color, especially in an adult
Book a routine appointment
- Warts that are spreading rapidly or numerous, or that appear in adulthood without clear cause
- Hundreds of flat warts, or warts in someone with HIV, an organ transplant or on immune-suppressing medicines
- Warts on the genitals or around the anus
- Warts causing distress or not improving after a few months of home treatment
Usually safe to manage at home
- A few typical flat warts on a child's face or hands that are not bothering them
What flat warts look like
- small, round or oval bumps 1 to 5 mm across
- smooth, flat tops, unlike the rough, cauliflower-like surface of common warts
- skin-colored, pinkish, yellowish or light brown
- often in groups of 20 to 100 or more
- sometimes in a line, where scratching or shaving spread the virus along the skin (the Koebner phenomenon)
- usually painless, occasionally itchy
What causes flat warts
HPV infects the top layer of skin through tiny cuts or abrasions. The types that cause flat warts (mainly HPV 3, 10, 28 and 41) are different from those causing genital warts or cervical cancer.
They spread through:
- direct skin contact
- shaving the face or legs, which carries the virus along the skin
- scratching or picking
- shared towels or razors
The incubation period can be weeks to months, so new warts may appear long after exposure. People with weakened immune systems are more likely to have many, persistent flat warts.
Flat warts vs similar spots
| Condition | How it differs |
|---|---|
| Flat warts | Smooth, flat-topped, clustered, often in shaving lines |
| Molluscum contagiosum | Pearly, dome-shaped bumps with a central dimple |
| Acne (closed comedones) | Small white bumps with a blocked pore; come and go |
| Lichen planus | Purple, flat-topped, very itchy bumps, often on wrists |
| Seborrheic keratoses | Waxy, "stuck-on" spots in older adults |
| Syringomas | Small skin-colored bumps around the eyes in adults |
A doctor can usually diagnose flat warts by looking. A biopsy is rarely needed.
Treatment
Many flat warts go away on their own within 1 to 2 years as the immune system recognizes the virus. Treatment is optional for children with a few warts. When treatment is wanted, gentle methods are preferred, especially on the face, to avoid scarring.
Over-the-counter options
- salicylic acid preparations, used carefully on the hands and legs; generally avoided on the face because they irritate
- duct tape occlusion has mixed evidence
Prescription creams
- topical retinoids (tretinoin, adapalene): cause peeling that removes warts over weeks; a common first choice for the face
- imiquimod cream: stimulates the immune system against the virus
- 5-fluorouracil cream: effective but causes irritation
- cantharidin, applied in the clinic
In-office treatments
- cryotherapy (freezing) with light applications to reduce scarring and color changes
- laser therapy or electrocautery for stubborn warts
- immunotherapy with injections of candida antigen in resistant cases
Recurrence is common, as the virus can remain in normal-looking skin.
Preventing spread
- avoid picking, scratching or shaving over warts
- use an electric razor, or shave around affected areas, and do not share razors or towels
- wash hands after touching warts
- keep skin moisturized to prevent tiny cracks
Frequently asked questions
What causes flat warts on the face?
Flat warts on the face are caused by certain types of HPV that infect the skin through tiny breaks. Shaving, scratching and touching spread them, which is why they often appear in clusters along the beard area or forehead.
Are flat warts contagious?
Yes, mildly. They spread by skin-to-skin contact, shared razors or towels, and by spreading the virus across your own skin through shaving or scratching. Avoid shaving over them and do not share personal items.
How do you get rid of flat warts?
Many disappear on their own within 1 to 2 years. Treatments include prescription retinoid creams, imiquimod, 5-fluorouracil, gentle freezing and laser. Facial warts are treated carefully to avoid scarring. A dermatologist can suggest the best option.
Why do I get flat warts on my legs after shaving?
Shaving creates tiny nicks and drags the virus along the skin, seeding new warts in lines. Switching to an electric razor, shaving less often, or avoiding areas with warts helps stop the spread while they are treated.
Are flat warts dangerous?
No. Flat warts are harmless and do not turn into cancer in healthy people. Rarely, very widespread flat-wart-like lesions can be a sign of an immune problem or epidermodysplasia verruciformis, which needs specialist assessment.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Warts - Diagnosis and Treatment
- American Academy of Dermatology: Warts - Who Gets and Causes
- DermNet: Viral warts
- MedlinePlus: Warts
- NHS: Warts and verrucas