Warts

The pulsed dye laser is an alternative treatment to traditional methods used against warts.

Harmless but unsightly and sometimes painful, warts still represent today a therapeutic challenge. As an alternative to local or surgical care, laser offers new perspectives for treatment of warts.

Generally, the treatment of warts remains difficult. Even though they can disappear spontaneously after a long time, warts can spread and make other warts. Long-term monitoring is necessary to prevent recurrence. The pulsed dye laser is well accepted by patients and particularly efficient against warts.

What are warts?

Warts are harmless lesions of the skin and of the mucous membranes that can appear on any part of the body. These common lesions (estimated at about 10% in children and young adults) are caused by an infection with the Human Papilloma Virus. The transmission of this virus typically occurs following micro trauma (warts on the hands) or in the case of plantar warts, infected areas such as public swimming pools.

The type of plantar warts

• Deep, painful, and defined lesions with a hyperkeratotic edge
• Lesions with a mosaic shape that are superficial and painless

Ordinary warts

• Tough and rough papules with an irregular surface. Typically located on the face, the hands, and the neck, they are painless.
• Subungual warts which are generally recurrent and very painful and which can generate a malformation of the nails

The wart treatments

Based on a physical destruction of the keratinocytes, the treatment can be local or surgical:

• A salicylic acid preparation used in different concentrations, a painful and prolonged procedure
• Intra lesional bleomycin : hardly ever performed
• Electro surgery: quick and efficient, but painful. With a high risk of  scars
• Ablation by the use of the CO2 laser: usually used for the recurrent warts. A difficult and painful procedure

The pulsed dye laser as an efficient alternative:

The exact mechanism of the Pulsed Dye laser in the treatment against warts (but also in the treatment against scars and tattoo removal) is based on the elimination of the dermal vessels with an indirect effect of destruction of infected keratinocytes. Oxyhemoglobin contained in the dilated and congested blood vessels in the warts is targeted by the Pulsed Dye laser. The treatment is carried out by selective photo-thermolysis and photo-coagulation. By focusing on a very specific area, the laser treatment can treat the local infection (the wart) but also its extension to reduce the chance of recurrence. This painless laser treatment appears to be very efficient.