Flat Warts: Causes, Symptoms, and Treatment Options

Flat warts?

I am a 33-year-old unmarried male with no history of inappropriate sexual behavior.
Several years ago, I developed a flat wart the size of a fish scale on my scrotum.
Although it has not noticeably enlarged, it often itches.
What kind of skin condition is this? How should it be treated? Thank you for your response!

Mr. Li, 30~39 year old female. Ask Date: 2000/08/22

Dr. Jin Lianchun reply Dermatology

Dr.
Jin Lian-Chun from Pingtung Hospital's Dermatology Department responds: Hello Mr.
Li, based on your description, there are several possible diagnoses: (1) Common warts: These are caused by a viral infection and can be treated with cryotherapy using liquid nitrogen or carbon dioxide laser treatment.
(2) Genital warts: These are also caused by a viral infection, typically transmitted through sexual contact.
Treatment options include cryotherapy with liquid nitrogen, electrosurgery, or carbon dioxide laser treatment.
It is also advisable for your sexual partner to undergo a gynecological examination for any symptoms.
(3) Seborrheic keratosis or skin tags: These are benign proliferative lesions, and treatment options are the same as above, or they may not require treatment and can simply be monitored.
(4) Angiokeratoma: These lesions are typically red-black in color and are benign vascular proliferations.
They usually occur in multiple numbers and can be observed or surgically excised if necessary.
(5) Soft fibromas: These can be treated with cryotherapy using liquid nitrogen, electrosurgery, or surgical excision.
I recommend that you visit a nearby dermatology clinic as soon as possible to obtain the most accurate diagnosis.

Reply Date: 2000/08/22

More Info

Flat warts, also known as verrucae planae, are a common type of wart caused by the human papillomavirus (HPV). They typically appear as small, smooth, flat-topped bumps on the skin and can vary in color from flesh-toned to slightly darker. These warts are often found on the face, neck, hands, and legs, but they can also occur in other areas, including the genital region, as you mentioned with your experience on the scrotum.

Causes
Flat warts are primarily caused by HPV, which is a virus that infects the skin. There are many different strains of HPV, and some are more likely to cause warts than others. The virus can enter the skin through small cuts or abrasions, which is why warts can sometimes appear after minor injuries. Flat warts are contagious and can spread through direct skin-to-skin contact or indirectly through contaminated surfaces.

Symptoms
The most common symptoms associated with flat warts include:
- Small, flat-topped bumps that may be slightly raised.

- The warts can be skin-colored or slightly darker.

- They may be itchy, which you have experienced.

- Flat warts can appear in clusters and may be more prominent in areas where the skin is frequently shaved or irritated.

Treatment Options
While flat warts are generally harmless and may resolve on their own over time, treatment is often sought for cosmetic reasons or if the warts are causing discomfort. Here are some common treatment options:
1. Topical Treatments: Over-the-counter treatments containing salicylic acid can help to gradually peel away the wart. These treatments may take several weeks to be effective.

2. Cryotherapy: This involves freezing the wart with liquid nitrogen, which causes the wart to fall off. This treatment is usually performed by a healthcare professional.

3. Electrosurgery: This method uses electrical currents to burn off the wart. It is typically done in a doctor's office.

4. Laser Treatment: In some cases, laser therapy may be used to remove warts, especially if they are resistant to other treatments.

5. Immunotherapy: This approach involves stimulating the immune system to fight the HPV infection. This can be done through topical medications or injections.

6. Surgical Removal: In persistent cases, a healthcare provider may recommend surgical excision of the wart.

Recommendations
Given your description of the flat wart on your scrotum, it is advisable to consult a dermatologist or a healthcare professional for an accurate diagnosis and appropriate treatment plan. Self-treatment can sometimes lead to irritation or infection, especially in sensitive areas like the genital region.
In the meantime, avoid picking at the wart, as this can lead to further irritation or spread of the virus. Maintaining good hygiene and avoiding sharing personal items like towels can help prevent the spread of HPV.

Conclusion
Flat warts are a common skin condition caused by HPV, and while they can be bothersome, there are effective treatment options available. It’s important to seek professional advice to ensure the best course of action for your specific situation. If you notice any changes in the wart or if it becomes painful, make sure to seek medical attention promptly.

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