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09-06-2011 | Article

Salicyclic acid and cryotherapy found effective for warts


Free abstract

MedWire News: A comprehensive review of treatments for warts has found that the most effective approach is a combination of salicyclic acid and cryotherapy (freezing).

Based on a detailed analysis of the available evidence, UK researchers say that this two-pronged approach to the treatment of skin warts will offer a cure in more than half of cases.

Warts are a common, harmless type of skin lesion that affect both children and adults. Warts are frequently self-limiting and clear without treatment; however, other cases need treatment, such as warts on the face or hands and those causing pain.

In this study, Chun Shing Kwok (University of East Anglia, Norwich, UK) and colleagues sought to evaluate the effectiveness of various treatments for warts.

They searched the medical literature and identified 77 relevant clinical trials. Although all of the trials used a "randomized controlled" design to reduce the influence of confounding factors, the authors nevertheless say that most studies were of "low methodological quality."

When the findings from all 77 studies were pooled and analyzed, the researchers found that two individual treatments - salicylic acid and cryotherapy - were significantly more effective than an inactive control (placebo).

Salicylic acid, which is applied as a solution directly to the wart, has a "cure rate" of 52%, say the researchers. Cryotherapy, which involves freezing the wart using liquid nitrogen, has a cure rate of 54%.

Meanwhile, the combination of both salicyclic acid and cryotherapy had the highest cure rate, at 58%.

The researchers say that several other treatments were either ineffective or have not yet been proven to be effective. Such therapies included bleomycin, 5-fluorouracil, and dinitrochlorobenzene.

Writing in the British Journal of Dermatology, Kwok and co-authors conclude: "The findings of this meta-analysis and pooled analysis provide further evidence to support the use of salicylic acid as the first-line therapy for cutaneous warts. Cryotherapy, especially aggressive cryotherapy, should be considered as second-line therapy or as an alternative treatment."

They add: "More high-quality evidence is needed to evaluate these specialized treatments and other therapies in order to make further recommendations."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Joanna Lyford