Laser Wart Removal: Blast Away HPV Painlessly and Effectively

Let’s call it as it is. Warts annoy the heck out of people. They can ruin your otherwise beach-ready body. And when you try to take them out, they can scar or come back bigger, as if to take revenge!

Warts result from human papillomavirus (HPV) infection of the skin. They’re unsightly, though, fortunately, treatable. Various wart therapies are available, but laser wart removal is one you should try when all else fails. 

Read on if you want to know more before booking an appointment. Here, I explain how lasers work on warts, the treatment’s benefits and risks and what to expect during the process. I also discuss recommendations for keeping these lesions away for good.

What Is Laser Wart Removal and How Does It Work?

Laser wart removal treats warts with powerful light beams. Two types of lasers can accomplish this.

• Ablative lasers burn the wart from the surface. They emit far-infrared light that vaporizes watery cells in the epidermis, the skin’s top layer. The most commonly used ablative lasers are CO2 and erbium (Er:YAG).

The procedure creates an open wound that generally takes 1-2 weeks to heal. One or two sessions are usually enough for ablative laser wart surgery to work. However, it’s risky for patients who tend to scar badly.

• Non-ablative lasers burn the wart’s blood vessels from the inside, causing it to dry up within days. The therapy doesn’t leave behind any open wounds, so the risk of scarring is less. However, a blister can grow on the treated area that may also take 1-2 weeks to scab and fall away. Unroofing the blister may cause infection or scarring.

Vbeam laser treatment is a common procedure that uses yellow laser energy to destroy the red blood pigment hemoglobin. However, the skin’s main pigment, melanin, is also sensitive to yellow light. So, Vbeam treatment may result in post-inflammatory hyperpigmentation (PIH) in skin of color.

The neodymium or Nd:YAG laser is a non-ablative laser that emits near-infrared light. Hemoglobin is less sensitive to it, but melanin is even less so. So, the risk of developing PIH is less with the neodymium laser.

Patients generally need multiple sessions when they go for non-ablative wart treatment. 

Thanks to the diversity of laser devices and modern techniques, we can make laser wart removal safe for any skin type. 

What Are the Benefits of Laser Wart Treatment?

Wart treatments come in many forms. You must have gone through most of them if you’ve been trying to get rid of stubborn warts with little success.

First, there are over-the-counter medications like salicylic acid. Yes, people may buy them without a prescription. However, without proper instructions, they wouldn’t know how to make them work. That’s why these treatments often fail.

Second, we have surgical excision, cryotherapy and other in-office procedures. They’re much more effective than at-home remedies. However, without nifty devices like lasers, their scarring and recurrence rates are all over the place.

You may have also tried homeopathic remedies and realized they don’t work.

Then there are lasers. Where do they fall in this spectrum? Here’s what you need to know:

Laser therapy is one of the most effective wart treatments

Studies consistently show that laser surgery is more effective than other HPV treatments. Manual wart removal surgery has as much as an 85% success rate but up to 30% recurrence rate. Repeated cryotherapy clears up to 69% of non-genital warts after 12 weeks and up to 96% of genital warts after 6 weeks. The recurrence rate is also as high as 30%.

Meanwhile, lasers achieve up to 100% clearance of various non-resistant wart types, though the number of sessions differs by laser type. Ablative lasers can do it after one treatment. Vbeam needs up to six, while neodymium requires two. The recurrence rate after laser wart removal is 6-13%, depending on the laser and treatment protocol used.

Resistant warts respond variably, though combining lasers with other treatments makes it possible to reach >90% clearance.

Laser surgery yields the best cosmetic and functional outcomes

Lasers are precise tools. They rely on the different light spectrum sensitivities of skin tissues to eliminate their targets without affecting the surrounding areas. The Vbeam laser selectively destroying the blood vessels is an example. Lasers are preferred for treating warts in cosmetically sensitive locations like the face and around the nails. 

Meanwhile, other methods indiscriminately injure tissues, so they’re more likely to cause scarring, nerve damage and disfigurement.

Laser wart removal can help you avoid severe side effects

The side effects of lasers are generally milder than other wart treatments. Vbeam, for example, is well-tolerated among children. However, as mentioned previously, side effects also differ between various laser types. In our practice, we work with our patients to see which kind can treat their lesions quickly but is also tolerable for them.

Non-ablative lasers require minimal downtime

Ablative lasers can clear warts after only one session. However, the wounds they create, though superficial, may cause burning pain in patients with low pain tolerance. The aftercare regimen is also time-consuming.

Non-ablative lasers require multiple treatments but won’t cut the skin. The recovery period is usually not as tough, except when a big, painful blister forms as a side effect.

Laser wart removal treatment doesn’t always require anesthesia

Wart procedures require pain control. Ablative lasers and traditional surgical treatments like excision usually need local or general anesthesia. Anesthetics have a small risk of causing allergies and other side effects.

On the other hand, skin cooling—by a cold mist spray, for example—usually suffices during non-ablative laser surgery, sparing patients from anesthesia. However, very young children and people with pain anxiety may still require sedatives and anesthetics.

These benefits make laser wart removal a top choice for many people. However, getting the best outcomes requires more than choosing the best treatment option. You must also entrust the procedure to a bona fide laser specialist and stick to the aftercare regimen religiously.

What Are the Drawbacks of Laser Wart Surgery?

The biggest downside of laser wart removal is the cost. Laser treatment may be one of the best against warts, but it’s also one of the most expensive. 

The other potential disadvantages of this procedure are the following:

• Although the chance is significantly lower than the other wart therapies, relapse after laser treatment is possible, as previously mentioned.
• Laser plumes have viable wart virus DNA, which may spread the infection in the treatment room. However, my BHSkin Dermatology colleagues and I, being board-certified dermatologists, are trained to avoid this.
• An expert must perform the procedure to ensure effectiveness and safety. Although we perform laser therapy routinely in our Glendale and Encino clinics, not all geographic locations have a laser specialist.
• Eye problems may emerge if you don’t wear eye protection during laser therapy. At our clinics, we ensure to give each patient eye protection before starting their session.

Laser wart removal has its risks, but they can be avoided or minimized, especially if a licensed specialist performs the procedure. In my experience, the benefits of laser therapy far outweigh its risks. 

What Can You Expect During the Laser Wart Treatment Process?

Your therapeutic journey starts when you consult a dermatologist about your skin condition. At our clinic, we give each patient a full medical evaluation to make sure that laser surgery is right for them. If it is, we explain the treatment plan and schedule them for their first session. If it’s not, we discuss their best alternatives.

Here’s what you can expect from each phase of the laser treatment experience:

Before the Appointment

Good preparation helps avoid complications. We typically advise our patients to do the following before their session:

• Avoid blood thinners and immunosuppressants like steroids for a few days.
• Abstain from drinking and smoking.
• Take cold sore medication.
• Use topical tretinoin or hydroquinone. 

I recommend these measures to most patients to help them recover quickly and spare them from unwanted side effects like PIH. If a patient has a pre-existing medical condition for which they need blood thinners or immunosuppressants, I advise them to secure medical clearance before the procedure.

During the Appointment

On appointment day, I ask my patients to wash the site of the lesion and keep it clean before checking in. Additionally, I advise them to wear comfortable outfits if their lesions are hidden underneath clothes or footwear. 

After finishing the required paperwork, a medical assistant leads the patient to the treatment room. The patient is then asked to change into a patient gown and wear eye protectors.

Once comfortable, I start cleaning the target area. I then treat the wart with the laser device. Non-ablative instruments like Vbeam and neodymium have built-in cooling mechanisms that reduce patient discomfort during the procedure. Meanwhile, ablative laser treatment requires anesthesia, which I apply or inject 15-30 minutes before using the instrument on the patient’s skin. 

Once done, I clean up the treated area and apply an ointment and bandage. The whole session can take a few minutes to 2 hours, depending on the severity of the condition and whether or not the patient needs anesthesia.

After the Appointment

After the session, I send the patient home with aftercare instructions. I remind them to gently cleanse the area, moisturize it and protect it from the sun. Elevating the site during rest periods helps prevent swelling.

For patients who’ve had an ablative laser treatment, I also give them instructions for proper wound care. Patients who have had plantar wart removal are advised to use loose footwear and crutches during recovery.

In the first few days after a laser session, patients may see signs of inflammation, which is a normal body reaction to any procedure. Mild, transient pain, swelling and redness are common. I recommend icing the treated skin or taking acetaminophen for relief, but expect these symptoms to resolve after a few days.

If they’ve had ablative laser treatment, I advise them to keep the wound moist with ointment throughout the day. This prevents scabbing while the wound heals. It takes two weeks or less for the epidermis to grow back completely, and downtime is as long. Healing in the deeper skin layers may continue for months to years.

Meanwhile, most patients who have had non-ablative laser therapy see the wart drying up without significant inflammation or discoloration. Hence, the short downtime. Some blistering or bruising occasionally happens, lasting 1-2 weeks. But more often than not, the treated area heals like a mild skin injury.

What Are the Side Effects of Laser Wart Removal?

The most common side effects of laser surgery are pain, redness and swelling. Again, these are normal body reactions to the procedure. Bruising, blistering and crusting may occur in vulnerable patients. The symptoms are more pronounced after ablative surgery.

The complications of laser treatment include the following:

• Burns
• Pigmentation problems
• Infection
• Scarring
• Eye injury
• Hypersensitivity to the materials used during and after treatment

However, these events are more likely to occur if an inexperienced provider performs the procedure. That’s why choosing a good laser dermatologist is important.

Treatment failure or relapses may happen in patients with poor immunity and those who let their lesions spread extensively before getting treated.

What Are the Contraindications of Laser Wart Surgery?

Laser treatment is safe and effective, but it’s not for everybody. The following are contraindications to the procedure:

• Ongoing oral isotretinoin treatment
• Bad scarring history
• Chronic inflammatory skin conditions like psoriasis and collagen disorders
• Bacterial superinfection of the site
• Recent UV light exposure
• Recent treatments that can make the skin laser burn-prone, such as chemical peeling

These conditions can produce complications during the post-treatment period. Your provider may postpone your laser session or recommend an alternative treatment in their presence.

How Much Does Laser Wart Removal Cost?

Many factors affect the treatment’s cost—the provider’s expertise, the clinic’s geographic location, the type of procedure, the extent of the lesion and others. Your best source of pricing information is your provider’s clinic, so call. Health insurance pays for medically necessary procedures like wart removal, though coverage varies by plan.

If you call our Glendale or Encino clinic, our medical assistants will be more than glad to answer cost-related questions for you.

Can Warts Grow Back After Laser Treatment?

Decades of research have given us an arsenal of wart treatments, but the struggle to eliminate them continues. Laser wart removal is highly effective, as studies show. But even healthy patients may see a recurrence if they have habits that make them HPV-prone.

How Do You Stop the Recurrence of Warts?

You can keep warts from coming back with some simple tweaks to your habits.

• Practice good hygiene.
• Don’t share personal items. Warts are slow to grow, and some people may be unsuspecting infectious carriers.
• Avoid walking barefoot in public pools and showers.
• The virus loves to invade broken skin. Moisturize regularly to strengthen the skin barrier. Protect areas with open wounds.
• Sanitize communal equipment in the workplace, gym and other places you frequently go to.
• Avoid touching warts to stop spreading the infection.
• Get vaccinated against HPV.

Preventing wart recurrence can spare you from spending any more on treatment. However, if the lesions still pop back despite your best efforts, see a doctor right away.

Laser Wart Removal—The Takeaway

Laser surgery is one of the best treatments against warts. It has excellent clearance rates, low recurrence rates and mild side effects. The cosmetic results are also superior to other in-office procedures. It’s costly but may well be worth every penny. To keep warts away for good, developing healthy habits and HPV vaccination can help.

If you’re looking for a laser wart removal expert in LA, don’t look any further. BHSkin has some of California’s leading laser dermatologists. Their results are phenomenal, but you’ll love them more for the way they care for their patients.

Book your appointment today!

Sources:

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Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online