Use of long-pulsed neodymium-doped yttrium-aluminium-garnet (LP-Nd:YAG) laser provides similar overall therapeutic effects to those of cryotherapy, results of a recent study have shown. However, laser appears more effective against recalcitrant warts and results in shorter time to warts clearance.

In this single-centre study, the investigators determined whether LP-Nd:YAG laser was superior to cryotherapy for cutaneous warts. They equally randomized 150 adult patients to receive laser or cryotherapy every 3 to 4 weeks, for a maximum of four sessions.

Cure rates at 16 weeks and 6 months were the primary outcomes, while secondary ones included time to warts clearance and treatment-related adverse effects.

No statistically significant difference was seen in the cure rate between laser and cryotherapy at 16 weeks (54.1 percent vs 46.7 percent) and 6 months (59.5 percent vs 57.3 percent). However, laser treatment (p=0.04) tended to have shorter time to warts clearance than cryotherapy (p=0.08).

In post hoc analyses, LP-Nd:YAG laser demonstrated a significantly higher cure rate than cryotherapy in three subgroups of human papillomavirus 2/27/57-induced recalcitrant warts, but not in their counterpart subgroups. Of note, more mild adverse effects occurred in the laser group.

This study was limited by its single-centre design.

“Observational studies have shown promising therapeutic effects of LP-Nd:YAG laser on warts,” the investigators said.