13.7 Preparations for warts and calluses
Click here for anogenital warts
|Most warts resolve without treatment |
Encourage self-care with OTC products as appropriate
|1st choice||Occlusal® cutaneous solution, (salicylic acid 26%)||Dose:|
For common and plantar warts, apply daily
|Salactol ® paint (salicylic acid 16.7%, lactic acid 16.7%)||Dose:|
For warts, particulary plantar warts, verrucas, corns and calluses, apply daily
|Salatac® gel (salicylic acid 12%, lactic acid 4%)||Dose:|
For warts, verrucas, corns and calluses, apply daily
- Most warts resolve without treatment within months and treatment is required only if the warts are painful, unsightly, persistent, or cause distress.
- Treatments are available over-the-counter from pharmacies and many patients can be encouraged to self-care.
- These preparations are suitable for all cutaneous warts except facial and genital warts.
- Formaldehyde gel may be useful for persistent plantar mosaic warts.
- Wart removing preparations are keratolytic. They can cause irritation, therefore application to normal or broken skin should be avoided. Surrounding skin to the wart can be protected by applying soft paraffin.
- Rub the wart surface gently with a file or pumice stone once weekly; treatment may need to be continued for up to 3 months.
Anogenital warts – General notes
- The treatment of anogenital warts should be accompanied by screening for other sexually transmitted diseases.
- Patients with a limited number of external warts or keratinised lesions may be better treated with cryotherapy or other forms of physical ablation.
|1st choice||Podophyllotoxin 0.5% solution (Warticon®, Condyline®)|
|2nd choice||Imiquimod 5% cream (Aldara®)|
- Surrounding skin should be protected when treating anogenital warts.
- Podophyllotoxin cream is not recommended for use by either women or men as it soaks into underwear and is less effective than the solution which dries into the skin.
- Podophyllotoxin solution may be used for soft, non-keratinised external anogenital warts.
- Imiquimod is relatively expensive and should only be used when other treatments have failed.
- Imiquimod cream should be rubbed in and allowed to stay on the treated area for 6-10 hours; then washed off with mild soap and water. The cream should be washed off before sexual contact. Imiquimod may damage latex condoms and diaphragms.
- Imiquimod is the only drug licensed for perianal warts.
- Podophyllotoxin and imiquimod should not be used during pregnancy.