When does photodynamic therapy become necessary or worthwhile to treat flat warts?

Doctor's Answer

Flat warts are also known as plane warts (verruca plana). These warts are smaller, rounder and smoother than the other types and it grows in batches. It may appear as yellowish-brown or skin coloured bumps. The bumps commonly grows onto areas such as the face, legs, back of the hands or areas that are often exposed to the sun.

There are many treatment options for plane warts.

Some commonly used treatment options include:

  • Topical creams e.g. tretinoin cream and imiquimod
  • Cryotherapy (liquid nitrogen treatment)
  • Electrosurgical ablation

If the plane warts are persistent or do not respond to conventional treatments, photodynamic therapy (PDT) is an option. Photodynamic therapy is mainly approved for the treatment of actinic keratosis and some early skin cancers.

There are some studies that show that PDT can be effective for the treatment of plane warts but this is an off label indication. I would consider PDT treatment if the traditional options have failed or are contraindicated.

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