Effectiveness of the cryotherapy spray technique in improving treatment outcomes of plantar warts: A comparative study from Saudi Arabia

Plantar warts are challenging to treat and often recur despite standard therapies. While cryotherapy is effective for their treatment, data on cryotherapy spray techniques are limited, especially in Saudi Arabia. We assessed the efficacy of cryotherapy spray techniques for treating plantar warts, emphasizing cure rates, treatment duration, and side effects. In this single-center comparative before-after study, patients with plantar warts treated using a standardized cryotherapy spray protocol in a dedicated cryotherapy clinic (case group) were compared with a historical control group treated with nonstandardized cryotherapy methods before implementation of the protocol. Control patients were retrospectively identified from medical records and met the same inclusion and exclusion criteria as the case group. We compared cure and recurrence rates, treatment duration, number of treatment sessions, and adverse effects between groups. The standardized cryotherapy spray technique achieved a cure rate of 96.8% and a recurrence rate of 6.5%, compared with 87.9% and 18.2%, respectively, in the control group. Although cure and recurrence rates were numerically more favorable in the case group, these differences were not statistically significant in this small sample. In contrast, the standardized technique was associated with a significantly shorter treatment duration (P = .001), fewer treatment sessions (P < .001), and a lower incidence of pain and erosion (P = .035) than the nonstandardized methods used in the control group. Cryotherapy treatment sessions should be based on the recommended technique in this study, which is a safer, evidence-based method for treating plantar warts, with shorter treatment durations and lower recurrence rates compared to using uncertain cryotherapy methods. Larger, controlled studies are needed to confirm these findings and further define the optimal cryotherapy technique for plantar warts.