Comparison of Cryotherapy and Topical Salicylic Acid in Common Warts: A Systematic Review and Meta-Analysis

Abstract

Background. Common warts are most common complaint among children and adults caused by human papillomavirus (HPV). Cryotherapy and topical salicylic acid are common therapies. Objective. To compare the efficacy and safety of cryotherapy and topical salicylic acid in common warts. Methods. Randomized controlled trials (RCTs) comparing cryotherapy and topical salicylic acid treatment in patients with common warts were searched by using PubMed, Embase, Google Scholar, and Cochrane Database of Systematic Reviews up to Oct 20, 2021. The keywords were “common warts/verruca,” “cryotherapy,” and “salicylic acid.” The language was restrained to English. No age or gender limitation was conducted. The outcomes were complete remission of all warts at different observation times, recurrence rates, and side effects. Study-specific effect sizes were pooled by using the fixed-effects model and the Mantel–Haenszel method. I2 was used to assess heterogeneity of studies. Results. Seven articles involving 976 patients randomized into the cryotherapy group or salicylic acid group were included. Of whom, 487 patients received cryotherapy, while 489 received salicylic acid treatment. With the fixed-effects model, the pool effect of complete clearance of warts at 12 weeks comparing cryotherapy and salicylic acid was not statistically significant (RR = 0.99 (0.84–1.17), I2 = 0%). Conclusion. Comparable efficacy of cryotherapy and topical salicylic acid was conducted in common wart treatment. More high-quality pieces of evidence with more samples are needed to confirm the results for further recommendations.