Viral Warts: Treatment with a Higher Concentration of Salicylic Acid

Take Home Message: Viral Wart treatment with higher doses of Salicyclic Acid are as effective as cryotherapy and have fewer side effects (Study from Malaysia)

Comments
This study compares 2 treatments against viral warts:

1. Salicyclic Acid
-It is often used as topical treatment at a concentration of 10%. The goal is to dissolve the cornified layer of the skin so that a couple of hours later, the dead skin can be removed before a new application is done.
-In this study salicylic acid 20% is used. This dosage is normally used for corns and callosities daily until the skin becomes sensitive. It is important not to apply these concentrations on the surrounding skin as erosions can occur.

2.Liquid Nitrogen (Cryotherapy)
-This treatment is of common usage against viral warts. After paring, the affected are is frozen which kills the basal cells of the epidermis (which are infected by the virus). It can result in the formation of blisters which can be painful.
To read more on cryotherapy, click HERE

-To read more on Viral Warts, click HERE
-To read all our articles on Viral Warts, click HERE
Abstract
–Introduction: Cryotherapy and salicylic acid ointment are the two most common treatments used for treating plantar warts.
–Objective: The aim of this study is to compare the clearance rate of plantar warts at 12 weeks between liquid nitrogen cryotherapy and 20% salicylic acid ointment.
–Methods: Patients with plantar warts were randomized into cryotherapy and 20% salicylic acid groups. Patients randomized into cryotherapy group received a maximum of four treatments given two weeks apart. Patients randomized into 20% salicylic acid group were instructed to apply the salicylic acid ointment onto the wart nightly and to cover the treated area with a hypoallergenic plaster. Both groups were also provided with a personal foot file to file down the surrounding callus daily at home. Digital pictures were taken at first visit and 12 weeks after enrolment to assess the resolution of plantar wart.
–Results: Eighty patients with plantar warts were included. Thirty nine patients were randomized into cryotherapy group and forty one patients were randomized into 20% salicylic acid ointment group. Thirteen (33.3%) patients were completely cleared of their plantar warts with cryotherapy whereas eleven (26.8%) patients were completely cleared of their plantar warts with topical 20% salicylic acid ointment (P = 0.526). Nine patients were lost to follow-up. With cryotherapy, two patients reported blister formation and one patient developed hyperpigmentation. No side effects were reported with 20% salicylic acid ointment.
Conclusion: There is no difference in effectiveness between cryotherapy and 20% salicylic acid ointment in the treatment of plantar wart.

Reference: RCD16-0213 Cutaneous Infections. Regional Congress of Dermatology (RCD) 2016 – Singapore CRYOTHERAPY VERSUS 20% SALICYLIC ACID OINTMENT FOR THE TREATMENT OF PLANTAR WARTS – A RANDOMIZED TRIAL S.R. Syed Nong Chek1, R. Ridzwan2, N.Z.A. Mohd Ali Azizan1 1Hospital Kuala Lumpur, Dermatology, Kuala Lumpur, Malaysia 2Hospital Selayang, Dermatology, Selangor