The facial flat wart (verruca plana) is not only a contagious viral disease, but also causes a disturbing cosmetic problem. Because 5-aminolevulinic acid photodynamic therapy has successfully treated human papilloma virus-related diseases, we employed 20% 5-aminolevulinic acid and a light emitting diode on three recalcitrant facial flat wart patients. Most lesions achieved complete remission after three or four sessions. However, a few non-elevated lesions did not respond to this method. An ablative therapeutic mode is required in addition to 5-aminolevulinic acid photodynamic therapy in such lesions. Therefore, we utilized an Er:YAG laser and 20% 5-aminolevulinic acid photodynamic therapy for one session and achieved an excellent result. Patients should be informed of the possible side-effects of this treatment, such as erythema, exfoliation and post-inflammatory hyperpigmentation, and the requirement for sun protection.