Efficacy of Nd:YAG laser therapy for the treatment of verrucae: a literature review

Abstract

Verrucae are benign epithelial proliferations, characteristically 1-20 mm in diameter, caused by human papilloma virus (HPV) infection occurring on the skin and mucosa (Photomed Laser Surg 33(6):338-42, 2015; Lasers Med Sci 29(3):1111-6, 2014). Prevalence of verrucae is 5-20% in children and young adults with peak incidence reported during teenage years (Lasers Med Sci 29(3):1111-6, 2014; J Am Acad Dermatol 22(4):547-66, 1990; J Korean Med Sci 24(5):889-93, 2009). Patients often express significant displeasure with quality of life due to this cosmetic insecurity, as well as functional problems and physical discomfort when they occur on palms of hands and soles of feet. Traditional therapeutic options for warts, such as topical salicyclic acid, topical imiquimod, bleomycin injections, cryotherapy, surgical excision, and electrocautery, have proven somewhat effective but often lead to high recurrence rates or scarring (Photomed Laser Surg 33(6):338-42, 2015). Laser therapy offers an alternative solution by employing selective tissue destruction with minimal risks. We performed a broad literature search in PubMed to obtain all available published articles that studied the treatment of verrucae on the skin with 1064-nm neodymium-doped yttrium aluminum garnet laser. This laser is specifically suited for verruca treatment due to its deeply penetrating 1064-nm wavelength and relatively low risk of pigmentation changes in dark skin types (Photomed Laser Surg 33(6):338-42, 2015). Laser therapy is effective in the treatment of verrucae and has enabled clinicians to provide direct, targeted treatment of warts.

Blue photobiomodulation LED therapy impacts SARS‐CoV‐2 by limiting its replication in Vero cells

“…Remarkably, PBMT at infrared wavelengths is already exploited for the treatment of viral ailments, such as the warts caused by human papillomavirus (HPV) [22], or herpetic oral lesions induced by herpes simplex virus 1 [23].…”

Identification of Immunodominant T-lymphocyte Epitope Peptides in HPV 1, 2 and 3 L1 Protein for Novel Cutaneous Wart Vaccine

“…These risks have led many physicians to opt for a wait-and-see approach, leaving patients with cosmetic insecurity and physical discomfort. Others have turned to alternative techniques such as laser therapy and oral isotretinoin, but issues over recurrent infection remain [17–19]. Evidently, there is a need for a prophylactic, nondestructive wart treatment.…”

Wart removal without anesthesia using long‐pulse 1064‐nm Nd:YAG laser

“…Extracutaneous lesions occur on orificial mucous membranes and include oral common warts, oral condylomata acuminata, focal epithelial hyperplasia, oral florid papillomatosis, nasal papillomas, conjunctival papillomas, laryngeal papillomatosis, and cervical warts 3 . Patients often express a significant reduction in quality of life due to this cosmetic nuisance, as well as functional problems and physical discomfort when they occur on the palms of the hands and soles of the feet 5 . Therefore, cutaneous warts are one of the most common pathologies treated by the clinical dermatologist 6 .…”

“…The Nd:YAG laser is preferred over other laser treatment alternatives for its deeper penetrating 1064-nm wavelength, which enables direct contact with warts while lowering the risk of pigmentation in dark skin types 5 , but is a relatively painful therapeutic option, so topical or infiltrative anesthesia is usually used 1,2,4,10,13,14 . However, direct, perilesional injections of anesthetic can lead to more local skin and tissue damage as reported by Smith 15 , and also seen firsthand at our center.…”

“…ZORMAN ANd KORON warts. 3 Patients often express a significant reduction in quality of life due to this cosmetic nuisance, as well as functional problems and physical discomfort when they occur on the palms of the hands and soles of the feet 5 . Therefore, cutaneous warts are one of the most common pathologies treated by the clinical dermatologist 6 .…”