The Efficacy of Immunocryosurgery with Combined 2% Niosomal Zinc Sulfate Suspension and Cryotherapy in the Treatment of Verruca vulgaris

Topical zinc sulfate application has lower efficacy in comparison with intralesional usage, due to less penetration of ionic drug within the epidermis. Niosomes introduce new method of drug delivery with improved penetration and sustained release of medicaments within epidermis. On the other hand, combined cryotherapy with topical immunomodulators can increase the efficacy of cryotherapy with less recurrence rate. In this study, we compared the efficacy of 2% niosomal zinc sulfate suspension with cryotherapy versus combined conventional 2% zinc sulfate and cryotherapy in the treatment of Verruca vulgaris.

This is a triple-blind randomized clinical trial on 60 patients. Patients were randomized in 2 groups including combined 2% niosomal zinc sulfate suspension with cryotherapy versus combined 2% conventional zinc sulfate suspension combined with cryotherapy. The efficacy of treatment was evaluated during the treatment sessions until 12 weeks. Patients were followed for 3 months after the end of the treatment to evaluate recurrence rate. We used chi-square test to evaluate the efficacy of treatment and side effects. Mean number of treatment sessions was evaluated by t-test.

Mean number of the treatment sessions for complete remission was 3.66±0.92 and 4.63±0.66, in niosomal group and conventional group, respectively (P=0.001). The rate of complete remission was higher at the 6th and 8th weeks of the treatment in niosomal group compared to conventional group (P=0.001).

This study demonstrated significant rapid remission of wart lesions treated with cryotherapy plus 2% niosomal zinc oxide suspension in comparison with cryotherapy plus 2% conventional zinc oxide suspension.