Efficacy of cryotherapy versus radiofrequency ablation in the treatment of plantar warts

Background: Plantar warts may be refractory to any form of treatment and are associated with pain and a decreased quality of life. There are very few randomized controlled studies that focus on the treatment of plantar warts. Cryotherapy and radiofrequency ablation (RFA) have been used in the treatment of this recalcitrant condition. However, no data exists comparing the efficacy of these treatment options in the treatment of plantar warts. The aim of the study was to compare the efficacy of cryotherapy and RFA in the treatment of plantar warts. Method: Fifty patients with a clinical diagnosis of plantar warts were included in the study. They were randomly divided into two groups of 25 patients. After paring the warts, Group A was treated with cryotherapy with nitrous oxide and Group B was treated by RFA of warts every 2 weeks for a maximum period of 12 weeks. The results of the two groups were compared at the end of 12 weeks. Result: Fifty patients had a total of 212 warts. Eighty four percent (21/25) of the patients receiving RFA experienced subjective benefits within 2 sessions whereas in the cryotherapy group, 72% (19/25) of the patients required three to four sessions to experience subjective benefits (p = 0.00189). Eighty four percent (21/25) of the patients and 91.6% (121/132) of the warts in the RFA group achieved complete clearance by the end of 12 weeks whereas only 32% (8/25) of the patients and 31.25 % (25/80) of the warts receiving cryotherapy achieved complete clearance by the end of 12 weeks (p = 0.00681). Conclusion: Radiofrequency ablation is more effective than cryotherapy in the treatment of plantar warts and gives quicker subjective and objective results.