Treatment of warts by keratolysis

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.

Formulations

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]

Molecular basis of therapeutic effect

  • 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

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.

References

  1. ^ Lawson EE, Edwards HG, Barry BW, Williams AC (1998). "Interaction of salicylic acid with verrucae assessed by FT-Raman spectroscopy". J Drug Target. 5: 343–51. doi:10.3109/10611869808997862. PMID 9771616.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  2. ^ Tsai J, Chuang S, Hsu M, Sheu H (October 1999). "Distribution of salicylic acid in human stratum corneum following topical application in vivo: a comparison of six different formulations". Int J Pharm. 188: 145–53. PMID 10518670.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  3. ^ Lachapelle JM, Leroy B (January 1990). "Allergic contact dermatitis to colophony included in the formulation of flexible collodion BP, the vehicle of a salicylic and lactic acid wart paint". Dermatol Clin. 8: 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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