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 involve 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 creamThe amount of salicylic acid reaching the wart varies substantially depending on the formulation usedref|Tsai1999.

Molecular basis of therapeutic effect

* Salicylic acid reaches warts; lactic acid and collodion do notref|Lawson1998. Therefore, these additional components have only an indirect role in therapy.
* The molecular structure of the skin is altered at the centre of the wartref|Lawson1998.
* 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 tissueref|Lawson1998.

Complications

Some cases of allergic contact dermatitis have been observed when using collodion formulationsref|Lachapelle1990. This was found to be due to colophony in the collodion.

References

# J Drug Target. 1998;5(5):343-51. PMID 9771616
# Int J Pharm. 1999 Oct 25;188(2):145-53. PMID 10518670
# Dermatol Clin. 1990 Jan;8(1):143-6. PMID 2302853

External links

* [http://www.drugs.com/cons/Duofilm.html List of brand names in US and Canada]