Medical Technology

Comparative Effectiveness of Cryotherapy and Salicylic Acid for Wart Removal

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"Comparative Effectiveness of Cryotherapy and Salicylic Acid for Wart Removal"
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Warts are benign skin growths appearing over certain parts of the body and are considered to be caused by the human papilloma virus (HPV). They appear within a short period of time and can be present for months or even years. However, in most instances, the warts will disappear after several months without any active interventions.

Why do warts need treatment?

In most instances, the necessity to treat warts would be because of its disfiguring appearance, pain and its interference with the person’s activities. However, not all persons treated with wart removal therapy would reap benefits as its effectiveness can vary from one person to another.

What are the treatment methods available for wart removal?

Among the available treatment options, local application of salicylic acid would be the commonest to use. The method would involve using an applicator to touch over each wart after socking it with salicylic acid. As soon as it is applied, the surface of the wart would become white and in most instances, it would not cause any pain. However, touching the normal skin could cause burning feeling or irritation at the site and therefore you should avoid using on sensitive skin and over areas of thin skin.

The second commonest method of removing warts would be cryotherapy. This involves extreme freezing of the wart to minus 50 degrees Celsius or even up to minus 196 degrees Celsius.  However, the latter temperatures could only be achieved using liquid nitrogen and it is used primarily by trained health care professionals and would not be available as an over-the-counter treatment modality.

Although there are several other formal and informal treatment methods available for treating warts, they may not be as effective as the first two methods.

Which one is better? Salicylic acid or cryotherapy?

As mentioned earlier, both methods have been used in clinical practice although salicylic acid would be the commonest method and the most easiest to use. At the same time, many studies point towards the effectiveness of salicylic acid over cryotherapy although it is an argument challenged from time to time.

What is the scientific evidence supporting such claims?

The evidence towards establishing the superiority of cryotherapy over salicylic acid application came from a recently published article in the Canadian Medical Association Journal. The randomized control trial made use of 250 patients from several family practice clinics in Netherlands and offered them three types of treatment options. These included the application of salicylic acid, cryotherapy, and wait-and-see approach.

At the same time, the researchers divided the group into two, based on the type of wart which is either a ‘common wart’ or a ‘plantar wart’.

After 13 weeks following offering the treatment, family health nurses assessed these patients using signs of cure. These signs included disappearance of the warts, inability to feel the warts, appearance of normal skin color, and the returning of normal skin lines.

Based on the assessment, the researchers concluded that, the overall cure rate with cryotherapy was 39% while it was only 24% with salicylic acid. The ones who opted to wait and see achieved a cure rate of 16% at the end of 13 weeks. However, this was not the same with patients treated for plantar warts and the significant between different treatment modalities were negligible.

From the gathered evidence, the researchers argued that, cryotherapy is far superior to salicylic acid in treating common warts.


Bruggink SC, et al. Cryotherapy with liquid nitrogen versus topical salicylic acid application for cutaneous warts in primary care: randomized controlled trial. CMAJ. 2010 Oct 19;182(15):1624-30. Epub 2010 Sep 13.

More about this author: Dr Pandula Siribaddana

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