2940nm Erbium:YAG (Er:YAG) laser effectively removes persistent or recalcitrant warts by vaporizing infected tissue layer-by-layer
2940nm Erbium:YAG (Er:YAG) lasereffectively removes persistent or recalcitrant warts by vaporizing infected tissue layer-by-layer. Highly absorbed by water in skin cells, this highly precise ablative technology minimizes thermal damage to surrounding healthy tissue, greatly reducing the risk of scarring compared to traditional CO₂ lasers.
- Anesthesia: Due to the sensitivity of vaporizing wart-infected tissue, the dermatologist will first apply a numbing cream (like EMLA) or inject a local anesthetic.
- Ablation: The laser is used to systematically ablate the wart, often extending slightly into the adjacent healthy tissue to ensure complete viral removal.
- Combined Therapy:To prevent recurrence, dermatologists often use the 2940nm Laser alongside other procedures. For example, theFotona laser system utilizes a secondary Nd:YAG wavelength to coagulate the blood vessels feeding the wart, essentially cutting off its nutrient supply.
Advantages
- Reduced Collateral Damage: The 2940nm wavelength is absorbed by water roughly 10 times better than CO₂ lasers. This means less heat is transferred to the surrounding skin, minimizing healing times and discoloration.
- High Precision: It allows the operator to control the exact depth of ablation, which is particularly beneficial for deep plantar warts or periungual warts.
- Low Complication Rate: It is a tissue-sparing method that provides clean ablation craters with exceptional healing outcomes.
- Where on the body is the wart located?
- How long have you had it, and have you tried other treatments (like freezing or creams)?
Background: Viral warts are the result of keratinocyte infection caused by the human papillomavirus (HPV), usually represent as benign growths of epithelial tissue. Those afflicted often experience a notable decline in their quality of life due to these lesions, which can also lead to functional issues and physical discomfort. Laser technology has introduced novel approaches in treating viral warts, especially ablative lasers such as CO2 and Erbium-YAG (Er:YAG) lasers. Er:YAG laser gained recognition as a safe and effective method for addressing viral warts. Nevertheless, different recurrence rates have been reported in medical literature following treatment using Er:YAG laser, ranging from 24% to 71%. This study aimed to evaluate the recurrence rate and the risk factors that might affect it following successful treatment of warts using an Er:YAG laser.
Methods: A retrospective chart review analysis of all 245 patients who underwent an Er:YAG laser wart removal between January 2019 and July 2023 was conducted. The main outcomes measures were response rate and number of sessions required to get complete clearance.
Results: There was an overall complete resolution rate of 71.6% at 12 months follow-up. Four parameters were found to affect the response rate: the number of sessions until complete response, duration of the wart present before the laser treatment, smoking, and periungual wart location.
Conclusion: Er:YAG laser is an effective method for treating recalcitrant warts, and different risk factors were proven to effect its efficacy.
