Destructive therapies for cutaneous warts: A review of the evidence

Area of Science:

• Dermatology
• Dermatologic Surgery
• Infectious Disease

Background:

• Non-genital warts are benign skin growths caused by human papillomavirus (HPV).
• While often self-resolving, warts can cause discomfort and social distress, prompting patient-led treatment seeking.
• This review focuses on chemical and physical destructive therapies for wart management.

Purpose of the Study:

• To systematically review high-quality studies on the efficacy of various destructive therapies for non-genital warts.
• To evaluate the evidence base for commonly used chemical and physical wart treatments.

Main Methods:

• A comprehensive literature review was conducted using MEDLINE and Embase databases up to June 2021.
• Systematic reviews, randomized controlled trials (RCTs), cohort studies, and case series investigating destructive wart therapies were included.
• Studies focusing on chemical or physical destructive treatment modalities were prioritized.

Main Results:

• Fifteen distinct therapies were evaluated, encompassing chemical agents (e.g., salicylic acid, phenol, acids) and physical modalities (e.g., cryotherapy, laser, surgery, electrocautery).
• A significant limitation identified is the scarcity of randomized controlled trials (RCTs) evaluating the efficacy of most investigated treatment options.
• The review identified a broad range of treatments but highlighted a gap in high-level evidence for many.

Conclusions:

• Effective wart treatment requires considering wart location, supporting evidence, and potential adverse effects.
• Adoption of hygienic practices is crucial to prevent transmission alongside any chosen therapeutic intervention.
• Further high-quality research, particularly RCTs, is needed to establish definitive evidence for the efficacy of various destructive wart therapies.