Liquid Nitrogen Cryotherapy Versus 20% Salicylic Acid Ointment for the Treatment of Plantar Warts – A Randomized Trial

ABSTRACT

Introduction: Cryotherapy and salicylic acid ointment are the two most common treatments used for treating plantar warts. The aim of this study is to compare the clearance rate of plantar warts at 12 weeks between liquid nitrogen cryotherapy and 20% salicylic acid ointment. Methods: Patients with plantar warts were randomized into cryotherapy and 20% salicylic acid groups. Patients assigned into cryotherapy group received a maximum of four treatments given two weeks apart. Patients recruited into 20% salicylic acid group were instructed to apply the salicylic acid ointment onto the wart nightly and to cover the treated area with a hypoallergenic plaster. Both groups were also provided with a personal foot file to thin out the surrounding callus daily at home. Digital pictures were taken at first visit and 12 weeks after enrolment to assess the resolution of plantar wart. Results: Eighty patients with plantar warts were included. Thirty-nine patients were randomized into cryotherapy group and forty-one patients were randomized into 20% salicylic acid ointment group. Thirteen (33.3%) patients had a complete clearance of the warts with cryotherapy whereas eleven (26.8%) patients had a complete clearance of the warts with topical 20% salicylic acid ointment (p=0.526). Nine patients were lost to follow-up. With cryotherapy, two patients reported blister formation and one patient developed hyperpigmentation. No side effects were reported with 20% salicylic acid ointment. Conclusion: There is no difference in effectiveness between cryotherapy and 20% salicylic acid ointment in the treatment of plantar wart.