The aim of this study was to evaluate red light-emitting diode (LED) therapy to assist wound healing and pain attenuation following Er:YAG ablation of plantar verrucae. Over the past two-and-a-half years, the principal author (MAT) has treated 141 cases of plantar warts under local anesthesia in 133 patients with Er:YAG laser ablation followed by red light therapy to assist wound healing. The Er:YAG laser (29 J/cm
2, 2.0 J/pulse, 350 μs pulsewidth, 3 mm collimated handpiece) is used first to precisely ablate the verrucous tissue till normal architecture is seen. Immediately after treatment a red LED therapy system is applied (633 nm, 20 min, 126 J/cm
2) to the wound and surrounding area. LED therapy at the same parameters is repeated on postoperative days 2, 3, 6 and 10. A representative plantar verruca case is presented. Following precise and clean ablation of the plantar verrucae with clear margins into normal skin architecture with the Er:YAG system, minimal secondary thermal damage is seen: the LED system is then immediately used at the above parameters. After the first treatment session, patients are usually able to walk normally without any pain, even those who have bilateral verrucae, and no exudate is usually seen from postoperative day 3 and thereafter, which is in the authors’ experience completely different from cases treated with laser ablation only, whether CO
2 or Er:YAG. By postoperative day 6 the wounds have shrunk noticeably and are filled with healthy granulation tissue, and by day 15 they have usually completely healed with minimal scarring. At the 12-month follow-up recurrence rates have been less than 8% (11/141). From the authors’ experience in 141 cases, visible red LED therapy has given excellent and pain-free healing in these difficult-to-treat lesions with very low recurrence rates following Er:YAG laser precise and speedy ablation of plantar verrucae with minimal thermal damage to surrounding tissue.
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