Compounded Wart Treatment Options

Warts are growths caused by the human papilloma virus (HPV) and can occur anywhere on the body. Up to 10% of the population is affected by warts. Though typically benign, they can be transmitted by direct or indirect contact to other parts of the body or to other people. While about 40% will spontaneously regress within two years, warts are unsightly, sometimes painful, and can spread if left unchecked. They can be difficult to treat, but compounded medications provide a number of treatment options, such as flurouracil/glycolic acid, DNCB, podophyllum and trichloroacetic or bichloroacetic acid. If you suffer with warts, you may want to talk to your doctor about one of these treatment options:

Fluorouracil (5FU) & Glycolic Acid
5FU is an antimetabolite antineoplastic agent that hinders DNA and RNA synthesis to interrupt growth and initiate apoptosis. Glycolic acid acts as a skin peeling agent to help remove the dead cells. Common dose is 2.5-5% 5FU and 25-50% glycolic acid in an ointment base applied by toothpick or cotton swab twice daily, then covered with duct tape, with a follow-up visit in two weeks. 5FU should not be used by pregnant women.

Dinitrochlorobenzene (DNCB)
DNCB works as a contact sensitizer, inducing the body’s immune system to attack the wart. Efficacy rates in small trials have been 80%, compared to placebo at 38%. Some patients require multiple applications to become sensitive to DNCB. Common dose is 1% DNCB ointment applied by toothpick or cotton swab once with a follow-up visit in two weeks. If there is an insufficient reaction, a second application can be applied two weeks after first, with subsequent applications once weekly thereafter. A higher concentration may be necessary for plantar warts. DNCB should not be used by pregnant women.

Podophyllum Resin
Podophyllum resin is a cytotoxic agent that prevents mitosis in dividing cells. It is used mostly to remove genital warts. Efficacy is between 45-77% of people treated. Common dose is 10-50% podophyllum in benzoin tincture, usually applied sparingly by the prescriber in office on a weekly basis. The first application should only be left on for 30-40 minutes to gauge patient sensitivity, with following applications left on for up to four hours and then removed with soap and water or alcohol to limit systemic absorption. If there is any broken skin or the patient has diabetes, is pregnant, has poor circulation or is immunocompromised, podophyllum resin should not be used as it is a caustic irritant.
Interesting fact: Podophyllum resin comes from the mayapple, a herbaceous perennial plant native to the eastern part of North America.

Trichloroacetic (TCA) or Bichloroacetic (BCA) Acid
TCA or BCA cause protein destruction in cells leading to apoptosis. They can be used to treat warts or genital warts with 60-70% efficacy, and are not absorbed systemically. Common dose is % solution, applied by prescriber in office weekly. Due to irritation at the site, TCA and BCA may not be suitable for large areas. TCA or BCA may be used by pregnant women.

All of these wart solutions are available at Pacific Compounds Pharmacy with a doctor's prescription.