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23-09-2010 | Article

Freezing beats topical treatment for common warts


Free abstract

MedWire News: Freezing may be a more effective treatment for removing common warts than applying a topical treatment, study results suggest.

At 13 weeks, 39% of warts treated by freezing (cryotherapy) had cleared compared with just 24% of those treated with topical salicylic acid, making cryotherapy 1.62 times more likely to cure common warts in this instance than salicylic acid.

There has been ongoing controversy over which treatment is superior, with evidence to date favouring salicylic acid, note Sjoerd C Bruggink, from Leiden University Medical Center in The Netherlands and colleagues. These new findings therefore contest this evidence.

The researchers compared cryotherapy using liquid nitrogen, with topical application of salicylic acid, and a wait-and-see approach in 250 patients with warts, of whom 116 had common warts (on the hands or elsewhere) and 124 had plantar warts (on the soles of the feet).

The salicylic acid preparation contained 40% salicylic acid in petroleum jelly and was self-applied. The preparation was stronger than over-the-counter formulations, which were all the patients in the wait-and-see group were allowed to use.

After 13 weeks, warts had cleared in 24% of patients receiving cryotherapy compared with 16% of those using salicylic acid and 16% of those the wait-and-see group.

The superior efficacy of cryotherapy was mainly due to its benefit in treating common warts, with 49% of patients with this type of wart cured with cryotherapy compared with 15% with salicylic acid and 8% in the wait-and-see group.

There were no significant differences among the treatments for plantar warts.

The researchers note in the CMAJ that cryotherapy was associated with more unwanted effects than salicylic acid, including pain, blistering, and skin irritation. However, overall patient satisfaction was much higher among patients receiving cyrotherapy, at 69% compared with 24% for those using salicylic acid and 22% for the wait-and-see group.

"For common warts, cryotherapy was the most effective therapy in primary care," the researchers conclude.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Lucy Piper