Comparative Efficacy and Safety of Trichloroacetic Acid and Electrocautery in the Treatment of Verruca Vulgaris: A Systematic Review

Ali Kasgriah; Taheri Adjie; Nugrohoaji Babaei

doi:10.22475/jca.v1i1.29

Authors

Ali Kasgriah Department of Infectious Diseases, Faculty of Medicine, AJA University of Medical Sciences, Tehran
Taheri Adjie Department of Dermatology, Faculty of Medicine, AJA University of Medical Sciences, Tehran
Nugrohoaji Babaei Faculty of Medicine, AJA University of Medical Sciences, Tehran

DOI:

https://doi.org/10.22475/jca.v1i1.29

Keywords:

Verruca vulgaris, Trichloroacetic acid, Electrocautery, Treatment efficacy, Safety

Abstract

Verruca vulgaris (VV) is a common benign skin condition caused by human papillomavirus (HPV) infection, often requiring treatment due to physical discomfort and cosmetic concerns. This systematic review aimed to compare the efficacy and safety of trichloroacetic acid (TCA) and electrocautery as commonly used destructive therapies for VV. A total of eligible studies published within the last decade were analyzed. The findings indicate that electrocautery provides higher and more consistent cure rates (75–100%) compared to TCA, which shows more variable outcomes depending on concentration and protocol. However, electrocautery is associated with higher recurrence rates and more severe adverse effects, including pain, scarring, and delayed wound healing. In contrast, TCA offers a safer and more accessible treatment option with generally milder side effects, such as pain and burning sensation, although requiring a longer treatment duration. Overall, treatment selection should be individualized based on patient characteristics, lesion factors, and resource availability. Further high-quality studies with longer follow-up periods are needed to establish optimal management strategies.

References

Asgari, A. A., Taheri, A. T., & Babaei, A. B. (2023). A Comparison of Two Treatment Methods, Trichloroacetic Acid, and Laser Therapy, in the Wart Treatment: A Randomized Double-Blind Clinical Trial in a University Hospital in Tehran, Iran. Annals of Military and Health Sciences Research, 20(4), e134671. https://doi.org/10.5812/amh-134671

Hyder Osman Mirghani, Bader M. Alghamdi, Alnami, R., Alshehri, M., Alanezi, N., Alshahrani, N., Alnoumani, A., Asiri, A., Alalmaie, O., Alsubaie, B., Alshehri, S., & Basel H. Bakhamees. (2024). Cryotherapy vs Laser for Genital Warts Management: A Systematic Review. Saudi Medical Horizons Journal, 4(2), 97–108. https://doi.org/10.54293/smhj.v4i2.107

Jiang, W., Wang, X., Li, S., Li, N., Ai, F., & Dou, J. (2024). Progress in the treatment of Cutaneous warts. International Journal of Public Health and Medical Research, 1(1), 117–121. https://doi.org/10.62051/ijphmr.v1n1.13

Kamilah, L., Adjie, S. P., & Dharmawan, N. (2025). Systematic review of the advantages of trichloroacetic acid and electrocautery therapy in verruca vulgaris. JKKI: Jurnal Kedokteran Dan Kesehatan Indonesia, 410–422. https://doi.org/10.20885/jkki.vol16.iss3.art8

Karrabi, M., Kheirkhah, M., Shahrestanaki, E., Thomas, S., & Sahebkar, M. (2020). Comparison of 40% trichloroacetic acid and cryotherapy for the treatment of plantar warts: A single-blind, randomized clinical trial. Dermatologic Therapy, 33(4), e13559. https://doi.org/10.1111/dth.13559

McDevitt, J. L., Collard, M. D., Murphy, R. P., Sutphin, P. D., Yopp, A. C., Singal, A. G., & Kalva, S. P. (2020). Comparison of radiofrequency and microwave ablation and identification of risk factors for primary treatment failure and local progression. Clinical Imaging, 67, 146–151. https://doi.org/10.1016/j.clinimag.2020.06.014

Mohta, A., Chand Ghiya, B., Dutt Mehta, R., Soni, P., Khokhar, R., Sharda, P., & Ranga, Z. (2022). Skin needling with 100% trichloroacetic acid vs. Needling with bleomycin in the treatment of recalcitrant cutaneous warts. Clinical and Experimental Dermatology, 47(4), 730–734. https://doi.org/10.1111/ced.14968

Osman Mirghani, H., Bader M. Alghamdi, Alnami, R., Alshehri, M., Alanezi, N., Alshahrani, N., Alnoumani, A., Asiri, A., Alalmaie, O., Alsubaie, B., Alshehri, S., & Basel H. Bakhamees. (2024). Cryotherapy vs Laser for Genital Warts Management: A Systematic Review. Saudi Medical Horizons Journal, 4(2), 97–108. https://doi.org/10.54293/smhj.v4i2.107

Ringin, S. A. (2020). The effectiveness of cutaneous wart resolution with current treatment modalities. Journal of Cutaneous and Aesthetic Surgery, 13(1), 24–30. https://doi.org/10.4103/JCAS.JCAS_62_19

Takigawa, M., Kitamura, T., Martin, C. A., Fuimaono, K., Datta, K., Joshi, H., Constantin, M., Bourier, F., Cheniti, G., Duchateau, J., Pambrun, T., Denis, A., Derval, N., Sacher, F., Cochet, H., Hocini, M., Haïssaguerre, M., & Jaïs, P. (2021). Temperature- and flow-controlled ablation/very-high-power short-duration ablation vs conventional power-controlled ablation: Comparison of focal and linear lesion characteristics. Heart Rhythm, 18(4), 553–561. https://doi.org/10.1016/j.hrthm.2020.10.021