Cryotherapy best for warts

LuckyLisfranc · Sep 14, 2010

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Cryotherapy best for warts

by Michael Woodhead

Cryotherapy is superior to self-administered topical salicylic acid as a treatment for common warts and much more effective than a ‘wait and see’ approach, a general practice study has shown.

In a prospective trial in 240 patients presenting to GP with common or planter warts, those randomised to cryotherapy showed a 49% cure rate for common warts (mostly of the hand) at 13 weeks compared to 15% for salicylic acid and 8% for patients allocated to a wait-and-see group.

Cryotherapy was associated with more frequent and severe adverse effects than salicylic acid application, but nevertheless it had the highest satisfaction rates among patients.

The findings from the Dutch study, published in the Canadian Medical Association Journal (online 13 Sept) also showed that there was no difference between treatments in cure rates for plantar warts. However, there was a suggestion that the active treatments were more effective than the wait-and-see approach at 26 weeks, suggesting that the effects of treatment are delayed, or treatment may need to be more aggressive in this type of wart because of the overlying callosity.

They found cure rates for plantar were higher for children, at around 50%, whereas they were lower for adolescents, at around 5%.

The authors say their study has answered an important question because earlier studies had favoured salicylic acid application over cryotherapy for the treatment of warts. Until now most of the evidence for treatment of warts has been contradictory and come from small trials or trials in specialist dermatology settings, they note.

14 September 2010
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NewsBot · Sep 15, 2010

Press release:
Dutch Study: Cryotherapy Most Effective for Warts

On Monday, a group of researchers from Netherlands published a new study in the Canadian Medical Association Journal, revealing that patients, who have been diagnosed with warts since a duration of more than six months, might have less chances of survival, than those diagnosed earlier.

Moreover, the study showed that Cryotherapy with liquid nitrogen is considered as the most practical and effective treatment for common cases of warts. Cryotherapy offers the patients an 83% chance of full recovery.

The study dealt with data from 240 participants from Netherlands, with their ages ranging between 4 and 79 years old.

Dr. Sjoerd Bruggink, a Professor at the Leiden University Medical Centre and the co-author stated that despite the fact that 90% of the people get warts, it is one of the fields where the information is not really abundant. Therefore, he also said that he is pleased to participate in such a study.

He said, "We did another study in which, in primary schools, one-third of children had warts somewhere. So it's a very common problem. They ... can also irritate on the feet or on hands. So it's harmless, but annoying".

He added that these kind of studies do not require a large amount of money.
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NewsBot · Sep 15, 2010

Cryotherapy with liquid nitrogen versus topical salicylic acid application for cutaneous warts in primary care: a randomized controlled trial
Sjoerd C. Bruggink, Jacobijn Gussekloo, Marjolein Y. Berger, Krista Zaaijer, Willem J.J. Assendelft, Margot W.M. de Waal, Jan Nico Bouwes Bavinck, Bart W. Koes, and Just A.H. Eekhof
Can. Med. Assoc. J., Sep 2010; doi:10.1503/cmaj.092194

Background: Cryotherapy is widely used for the treatment of cutaneous warts in primary care. However, evidence favours salicylic acid application. We compared the effectiveness of these treatments as well as a wait-and-see approach.

Methods: Consecutive patients with new cutaneous warts were recruited in 30 primary care practices in the Netherlands between May 1, 2006, and Jan. 26, 2007. We randomly allocated eligible patients to one of three groups: cryotherapy with liquid nitrogen every two weeks, self-application of salicylic acid daily or a wait-and-see approach. The primary outcome was the proportion of participants whose warts were all cured at 13 weeks. Analysis was on an intention-totreat basis. Secondary outcomes included treatment adherence, side effects and treatment satisfaction. Research nurses assessed outcomes during home visits at 4, 13 and 26 weeks.

Results: Of the 250 participants (age 4 to 79 years), 240 were included in the analysis at 13 weeks (loss to follow-up 4%). Cure rates were 39% (95% confidence interval [CI] 29%–51%) in the cryotherapy group, 24% (95% CI 16%–35%) in the salicylic acid group and 16% (95% CI 9.5%–25%) in the wait-andsee group. Differences in effectiveness were most pronounced among participants with common warts (n = 116): cure rates were 49% (95% CI 34%–64%) in the cryotherapy group, 15% (95% CI 7%–30%) in the salicylic acid group and 8% (95% CI 3%–21%) in the wait-and-see group. Cure rates among the participants with plantar warts (n = 124) did not differ significantly between treatment groups.

Interpretation: For common warts, cryotherapy was the most effective therapy in primary care. For plantar warts, we found no clinically relevant difference in effectiveness between cryotherapy, topical application of salicylic acid or a wait-and-see approach after 13 weeks.
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admin · Sep 15, 2010

NewsBot said: ↑

For plantar warts, we found no clinically relevant difference in effectiveness between cryotherapy, topical application of salicylic acid or a wait-and-see approach after 13 weeks.
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That bit is worth repeating.

saluja · Sep 15, 2010

No mention of imiquimod?

Mark_M · Sep 16, 2010

The study should of included professionally applied salycilic acid. Im not suprised a self administered treatment is not as effective.

LuckyLisfranc Well-Known Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

admin Administrator Staff Member

saluja Welcome New Poster

Mark_M Active Member

cryotherapy/radiofrequency ablation, sclerosing or PRP injection for neuroma?

cryotherapy for plantar fibroma, ganglion

Use of cryotherapy to identify cutaneous warts

Needling versus liquid nitrogen cryotherapy for the treatment of pedal warts

Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae)

Cryotherapy for neurovascular heloma?

Cryotherapy dosage for VP's?

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