Viral Wart Removal Using Lee-Chan Radiofrequency Ablation-Intense Pulsed Light Technique: Case Series and Literature Review

Background: Viral warts, also known as verrucae, are common benign epithelial proliferations caused by human papillomavirus (HPV) infection. Although benign, viral warts frequently cause significant physical discomfort, functional impairment, and psychological distress for patients. Radiofrequency ablation has emerged as an effective method for viral wart removal due to its precision and hemostatic properties, but may result in post-inflammatory hyperpigmentation, which poses an additional aesthetic challenge particularly in patients with darker skin types. Intense pulsed light therapy is an established treatment modality for post-inflammatory hyperpigmentation management. This case series and literature review aims to evaluate the efficacy and safety of radiofrequency ablation for viral wart removal followed by intense pulsed light therapy for post-inflammatory hyperpigmentation management. Methods:Three patients with clinically diagnosed viral warts were treated using radiofrequency ablation. Post-treatment, they were monitored for the development of post-inflammatory hyperpigmentation. For patients who developed post-inflammatory hyperpigmentation, intense pulsed light therapy was administered (Lee-Chan RFA-IPL technique). The outcomes were assessed based on the resolution of viral wart lesions, the degree of post-inflammatory hyperpigmentation, and patient satisfaction. A comprehensive literature review was conducted to contextualize the findings within the broader field of viral wart treatment and post-inflammatory hyperpigmentation management. Results: Three patients underwent radiofrequency ablation for viral wart removal. Complete removal of viral wart lesions was achieved in all cases without significant complications. However, all three patients developed varying levels of post-inflammatory hyperpigmentation within two to three weeks post-ablation. These patients received intense pulsed light therapy starting at four weeks post-radiofrequency ablation, administered in a series of seven sessions at three-week intervals. The post-inflammatory hyperpigmentation significantly improved in 100% (3/3) of patients after intense pulsed light therapy, evidenced by marked reduction in hyperpigmentation and high patient satisfaction rates. Both radiofrequency ablation and intense pulsed light procedures were well-tolerated with minimal adverse effects. Conclusions:The combination of radiofrequency ablation and subsequent intense pulsed light therapy (Lee-Chan RFA-IPL technique) appears to be an effective and safe strategy for managing viral wart lesions and associated post-inflammatory hyperpigmentation. Radiofrequency ablation successfully removes viral wart lesions with high efficacy and minimal risk, while intense pulsed light effectively mitigates post-inflammatory hyperpigmentation, enhancing cosmetic outcomes and patient satisfaction. This case series underscores the potential of integrating these modalities in clinical practice, offering a promising approach to optimize cosmetic results in patients with post-inflammatory hyperpigmentation. Further large-scale studies and randomized controlled trials are warranted to affirm these findings and refine treatment protocols.