Energy-Based Devices for the Treatment of Cutaneous Verrucae: A Systematic Review

Warts are one of the most common benign neoplasms caused by human papillomavirus infection and often pose a therapeutic challenge.To summarize the current evidence on the safety and efficacy of laser and energy-based devices for the treatment of cutaneous verrucae.A comprehensive systematic review of the literature on laser and energy-based devices for the treatment of cutaneous verrucae was performed.A total of 904 unique studies were identified, of which 109 were included in this review. The most commonly used lasers as a single treatment modality for verrucae included the long-pulsed Nd:Yag (n = 20) and pulsed dye (n = 18) lasers. Other modalities included the CO2 ablative laser (n = 10), photodynamic therapy (n = 11), local hyperthermia (n = 11), microwave therapy (n = 2), and nanopulse stimulation (n = 1). Other studies combined energy-based modalities with additional treatments, such as retinoids, imiquimod, and intralesional bleomycin. Overall, such devices were generally well-tolerated, with only a mild side effect profile.Overall, the use of laser and energy-based devices is a safe and well-tolerated option for cutaneous verrucae that is relatively less invasive than surgical interventions. Future studies using more consistent outcome assessment tools will be valuable to help clinicians develop device-specific protocols and treatment regimens to ensure replicable and effective outcomes.