Question: In immunocompetent children and adults, at what rate do commonly used local treatments lead to complete disappearance of the treated wart?

Objective: To assess the evidence for the efficacy of local treatments for cutaneous warts.

Methods: Systematic review of randomized controlled trials.

Main Outcome Measures: Total clearance of warts and adverse effects such as irritation, pain, and blistering.

Study Selection: Randomized controlled trials of any local treatment for uncomplicated cutaneous warts. All published and unpublished material was considered, with no restriction on date or language.

Results: Fifty trials provided generally weak evidence because of poor methods and reporting. The best evidence was for topical treatments containing salicylic acid. Data pooled from 6 placebo-controlled trials showed a cure rate of 75% (144 of 191) in cases compared with 48% (89 of 185) in controls (odds ratio, 3.91; 95% confidence interval, 2.40-6.36). Some evidence for the efficacy of contact immunotherapy was provided by 2 small trials comparing dinitrochlorobenzene with placebo. Evidence for the efficacy of cryotherapy was limited. No consistent evidence was found for the efficacy of intralesional bleomycin, and only limited evidence was found for the efficacy of topical fluorouracil, intralesional interferons, photodynamic therapy, and pulsed dye laser.