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CO2: carbon dioxide OVC: oral verrucous carcinoma PDT: photodynamic therapy INTRODUCTION Verrucous carcinoma is a rare variant of welldifferentiated squamous cell carcinoma with locally aggressive and minimal metastatic potential. Oral verrucous carcinoma (OVC) is themost common type of verrucous carcinoma in the head and neck regions and accounts for 55.9% of 2350 such cases. The overall 5-year survival rate for OVC is approximately 50% in a retrospective cohort study. The risk factors for OVC include chronic inflammation induced by chemical carcinogenesis associated with betel quid chewing, smoking, human papillomavirus infection, and immunosuppression. The treatment of OVC remains in debate and is challenging. Many options, including surgery, radiation, chemotherapy, cryosurgery, laser ablation, photodynamic therapy (PDT), systemic retinoid, and recombinant a-interferon, either in combinations or alone, are reported with varied success rates. Radiotherapy is controversial because anaplastic transformation after irradiation has been reported, whereas other reports show OVC to be radiosensitive. Surgical excision with adequate margins seems to have the lowest recurrence rate. However, tumor removal usually leads to disfigurement or loss of function of the oral cavity. Our report concerns a patient with OVC of the lips who, refusing wide excision after failed nonsurgical treatments, was successfully treatedwith systemic acitretin after tumor debulking with a carbon dioxide (CO2) laser.