Carbon dioxide laser versus erbium: YAG laser in treatment of epidermal verrucous nevus: a comparative randomized clinical study

Background: A verrucous epidermal nevus (VEN) is a skin disorder that has been treated using different treatment modalities with varying results. Ablative lasers such as carbon dioxide laser (CO2) and erbium: yt-trium-aluminum-garnet (Er:YAG) laser have been considered as the gold standard for the treatment of epidermal nevi. Objective: To evaluate and compare the efficacy, postoperative wound healing and side effects of pulsed CO2 laser and Er: YAG laser for the treatment of verrucous epidermal nevi. Materials and methods: Twenty patients with localized VEN were randomly divided into two groups. Group 1 was administered CO2 laser and group 2 underwent Er: YAG laser treatment. A blinded physician evaluated the photographs and dermoscopic photomicrographs for the efficacy and possible side effects. All patients received one treatment session and were followed up over a 6-month period. Results: Both lasers induced noticeable clinical improvement, but there were no significant differences between two lasers in treatment response, patient satisfaction, duration of erythema and side effects. The average time to re-epithelialization was 13.5 days with CO2 and 7.9 days with Er:YAG laser (p< .0005). No scarring was observed in Er: YAG laser group and no lesional recurrence was detected in CO2 laser group since treatment. Conclusion: Apart from re-epithelialization, both lasers showed equivalent outcomes with respect to treatment response, patient satisfaction, side effects and complications.