Removal of viral warts via laser
The term wart includes various skin conditions
The so-called common wart (verruca vulgaris) is characterized by hyperkeratosis and is caused by the human papiloma virus (HPV). Therefore, it is considered an infectious disease. Warts on the sole of the foot are also called plantar warts or, if they become confluent, mosaic warts. Warts on the hands are typically called common warts. If they appear very flat, they are also called plane warts.
Therapeutic options:
A broad array of therapeutic options exists to remove warts:
- The conservative approaches include application of medicated bandages, curretage and typical treatment with specific solutions (e.g. Verrumal).
- Also destructive methods such as removal by application of electric current or chemocaustic application of solutions such as Solcoderman can be employed.
- Further methods comprise cryotherapy (with liquid nitrogen) or laser therapy. Two different laser therapeutic approaches can be distinguished:
- Abrasive laser therapy with the CO2 laser or the erbium:YAG laser. Hereby the wart is burned from the skin causing a defect that may leave a scar in healing.
- Therapy with selective vascular lasers, for example the pulsed-dye laser. This treatment aims at inducing coagulation of the feeding blood vessels to the wart to cause subsequent necrosis of the wart. Several treatment sessions are required, treatment is painful, but does not cause scarring.
- As warts are infectious skin diseases, all locally destructive methods are not suitable for permanent removal of warts. Recurrences occur in the treated areas or adjacent to these areas. Therefore all therapies that lead to the formation of scars should be avoided as patients will be left with a scar in addition to a potentially recurrent wart.
- The so-called spontaneous remission of warts occurs without specific treatment and can sometimes be initiated by suggestive therapy. Especially in children, who suffer from warts at a higher percentage, spontaneous remission is the rule. Therefore surgical interventions should be avoided if possible. Spontaneous remission nowadays is explained by the initiation of an adequate immune response by the patient.
- Currently, new substances exist to induce immune reactions to eliminate warts. For example, topical application of Aldara cream (Imiquimod) works as an immuno-stimulant and may help in the induction of the resolution of warts.
- As mentioned above, laser surgical or electrosurgical removal of warts should be reserved for rare exceptions and not employed in children as these therapies do not treat the underlying condition, i.e. the viral infection.
