Abstract:Objective: To investigate the efficacy of CO2 fractional laser pretreatment combined with photodynamic therapy in patients with facial flat warts. Methods: A total of 109 patients with facial flat warts who visited our hospital from May 2020 to March 2023 were randomly divided into a control group (55 cases, 2 cases were excluded, and 53 cases were finally completed) and an observation group (54 cases, 1 case was excluded, and 53 cases were finally completed) using a random number table method. The control group was treated with photodynamic therapy alone, and the observation group was treated with photodynamic therapy after CO2 fractional laser pretreatment. The total effective rate and recurrence rate at 6 months follow-up were compared between the two groups. The changes in inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and interferon-γ (INF-γ)] and lesion symptom scores before and after treatment were observed in the two groups. Results: The overall efficacy of the observation group was higher than that of the control group (P<0.05). There was no difference in inflammatory factors between the two groups before treatment (P>0.05). The inflammatory factors decreased after treatment in both groups, and the difference in inflammatory factors before and after treatment in the observation group was greater than that in the control group (P<0.05). There was no difference in lesion symptom scores between the two groups before treatment. The number, size, color, thickness, itching degree, and isomorphic reaction scores of lesions decreased after treatment in both groups, and the difference in lesion symptom scores before and after treatment in the observation group was greater than that in the control group (P<0.05). After 6 months of follow-up, the recurrence rate in the observation group was 3.701% (1/27 cases) compared with 25.00% (4/16 cases) in the control group, which was not statistically significant (P>0.05). Conclusion: CO2 fractional laser pretreatment combined with photodynamic therapy can reduce inflammatory response, alleviate symptoms, and improve the efficacy in patients with facial flat warts.