Treatment of warts by keratolysis

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Two viral warts on a middle finger, being treated with a mixture of acids to remove them. A white precipitation forms on the area where the product was applied.

Keratolysis is the removal of dead surface skin cells and is a treatment for several types of wart. The most common keratolytic treatment of warts available over-the-counter involves salicylic acid. These products are readily available at most drugstores and supermarkets. There are typically two types of products: adhesive pads treated with salicylic acid or a bottle of concentrated salicylic acid. Removing a wart with this method requires a strict regimen of cleaning the area, applying the salicylic acid, and removing the dead skin with a pumice stone or emery board. It may take up to 12 weeks to remove a stubborn wart.[citation needed]

Formulations

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Some formulations are:

  • alcoholic solution containing glycerol
  • collodion which dries to a celluloid film / Duofilm
  • simple ointment
  • absorption ointment
  • oil in water cream

The amount of salicylic acid reaching the wart varies substantially depending on the formulation used.[1] Brands in the UK include Bazuka (Dendron), Scholl (SSL International), Compound W, Cuplex gel, Duofilm (Stiefel), Occlusal (Alliance), Salatac Gel, Salactol Paint, and Verrugon (Ransom).[1][2][additional citation(s) needed]

Molecular basis of therapeutic effect

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  • Salicylic acid reaches warts; lactic acid and collodion do not.[2] Therefore, these additional components have only an indirect role in therapy.
  • The molecular structure of the skin is altered at the centre of the wart.[3]
  • Experiments indicated that salicylic acid bonding within the human papillomavirus-containing verruca tissue is more likely than simple acid dissociation upon dissolution in water within the tissue.[4]

Complications

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Some cases of allergic contact dermatitis have been observed when using collodion formulations.[5] This was found to be due to rosin in the collodion.[citation needed]

References

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  1. ^ J Drug Target. 1998;5(5):343-51. PMID 9771616
  2. ^ Int J Pharm. 1999 Oct 25;188(2):145-53. PMID 10518670
  3. ^ Dermatol Clin. 1990 Jan;8(1):143-6. PMID 2302853
  1. ^ "Bazuka extra strength gel". Netdoctor. Retrieved 9 January 2012.
  2. ^ Nathan, Alan (2010-06-17). "Verrucas". Non-Prescription Medicines. Pharmaceutical Press. p. 286.
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