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Viral Wart

Effectiveness of Laser Treatment for Common Warts

Common warts, that is, cutaneous warts that can arise on any part of the body, make up 70% of all diagnosed warts. Their treatment, however, has stymied practitioners because no monotherapy has achieved complete remission in every case. The most common treatments are salicylic acid (SA) and cryotherapy. Other treatments include chemical agents, chemotherapeutics, contact sensitizing agents, surgical excision, curettage, and laser therapy.

A recent systematic review study sought to determine the effectiveness of various laser treatments for the treatment of nongenital cutaneous warts. The authors compared 35 studies published between 1989 and 2015 that comprised an aggregate of 2149 patients and four different laser treatments (CO2, Er:YAG, PDL, or Nd:YAG lasers).

The results showed that historically, CO2, PDL, and Nd:YAG are the laser modalities most studied for wart treatment, and of these PDL has the most favorable adverse effect profile. For simple and recalcitrant warts treated with lasers, clearance rates ranged from 47%to 100%.  Comparisons of lasers to nonlaser treatment modalities are limited, but a few studies suggest that PDL and conventional therapies such as cryotherapy or cantharidin are comparable in efficacy.

The authors point out that proper safety precautions including gloves, smoke evacuation, and face masks should be used during laser treatment of warts. The authors conclude that lasers are an effective treatment option. However, there is a lack of evidence to provide clear guidelines for selection of laser device for different warts and there is inadequate evidence to provide specific laser setting recommendations. The authors note that future studies should be designed to compare laser modalities to each other and to nonlaser treatment options, to establish optimal treatment protocols.


Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: November 14, 2016

Source: JAMA
Adapted from the original article.

[Image: Dermnet New Zealand]

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