Assessment and Comparison of Efficacy and Safety of Monotherapy With Topical 50% Urea Cream and Combination Therapy With Topical 50% Urea Cream and Carboxytherapy in Treatment of Recalcitrant Common Wart: A Randomized, Single-Blinded, 2-Split Clinical Trial
In brief
Carboxytherapy plus 50% urea cream speeds wart clearance compared with urea alone
In a split-body trial of 20 patients with stubborn common warts, adding weekly carboxytherapy to twice-daily 50% urea cream shrank lesions more and achieved complete resolution faster than urea cream alone, while both regimens were safe and showed no recurrences at six months. The study suggests a modest benefit of the combination, but larger trials are needed to confirm its advantage.
- Journal
- Journal of medical virology (Q1)
- Published
- 1 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Nooshin Bagherani, Mohammad Rafiei, Bruce R Smoller, Reza Yaghoobi, Rahmatollah Moradzade, Mina Mirnezami, et al.
- PMID
- 42541394
- DOI
- 10.1002/jmv.71061
Why clinicians should know about it
- Picked for Dermatology (top studies of the week, 11 October 2026): Urea cream vs urea + carboxytherapy for recalcitrant common warts
Abstract
The treatment of common warts can occasionally be a challenge in recalcitrant cases, either recurrent ones or non-responders to treatment. In the current study, the efficacy and safety of monotherapy with topical 50% urea cream and combination therapy with topical 50% urea cream and carboxytherapy were assessed and compared in the treatment of recalcitrant common wart. Twenty subjects with recalcitrant common warts in the extremities (excluding the plantar surface) were selected. For the lesions of one side of the body, topical 50% urea cream was used 2 times a day (group A), while for the other side, combination of topical 50% urea cream and carboxytherapy was administered (group B). Carboxytherapy was done weekly, and both treatments were continued until complete resolution. The lesion count and size were assessed until 2 weeks after the fifth session of carboxytherapy. Recurrence rate was evaluated 6 months after complete resolution. Regarding the lesion count, no statistically significant difference was seen between the 2 groups. In group B, decrease of lesion size was significantly greater than that in group A. The time for complete resolution was significantly shorter in the group B. No significant adverse event was reported in either treatment group. No recurrence of lesions was reported 6 months after complete resolution in either group. Our findings demonstrated that both monotherapy with topical 50% urea cream and combination therapy with topical 50% urea cream and carboxytherapy were effective in the treatment of recalcitrant recurrent common warts, although the effectiveness of combination therapy was statistically more.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.