Cryotherapy vs trichloroacetic acid 90% in treatment of common warts

J Cosmet Dermatol. 2019 Apr;18(2):608-613. doi: 10.1111/jocd.12805. Epub 2018 Oct 24.


Introduction: Common warts are hyperkeratotic, benign cutaneous growths caused by types 1, 2, and 7 Human papilloma viruses. Different modalities are available to treat warts. Cryotherapy is one of the most common and effective treatments for common warts. Trichloroacetic acid (TCA), in high concentrations, can be used as a therapeutic modality.

Objectives: The aim of this study is to compare the efficacy and safety of cryotherapy using liquid nitrogen (spray method) versus trichloroacetic acid 90% in treatment of common warts.

Patients and methods: Thirty-five patients with 414 common warts, from the Dermatology outpatient clinic, Assiut University Hospital, were enrolled in this study. We used two techniques for the treatment of common warts. The lesions in each patient were divided into two groups (A and B), group A treated by cryotherapy while group B treated by trichloroacetic acid (TCA) 90%.

Results: There was significant decrease in the size of the warts in both groups. There were statistically significant better results among group A than group B regarding the mean percentage of improvement (90.11 ± 27.92 vs 26.19 ± 42.93, respectively; P < 0.001) and grade of improvement, where good response was obtained in 89.2% in group A compared with 26.2% in group B (P < 0.001). Complete cure was significantly higher in group A (83.1%) than group B (21.3%; P < 0.001). However, side effects were significantly higher among group A than group B.

Conclusion: Cryotherapy is more effective than TCA 90% in treatment of common wart. TCA 90% has lesser complications than cryotherapy.

Keywords: common warts; cryotherapy; trichloroacetic acid.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Caustics / administration & dosage*
  • Caustics / adverse effects
  • Cryotherapy / adverse effects
  • Cryotherapy / methods*
  • Female
  • Humans
  • Male
  • Treatment Outcome
  • Trichloroacetic Acid / administration & dosage*
  • Trichloroacetic Acid / adverse effects
  • Warts / therapy*
  • Young Adult


  • Caustics
  • Trichloroacetic Acid