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Local treatments for cutaneous warts.
S Gibbs1, I Harvey, J C Sterling
1Ipswich Hospital NHS Trust, Ipswich, UK, IP4 5PD. gibbses@ukgateway.net
The Cochrane Database of Systematic Reviews
|June 19, 2001
Summary
Salicylic acid topical treatments are effective for common warts, outperforming placebo. Other treatments like cryotherapy show less evidence, and some therapies carry significant risks.
Area of Science:
- Dermatology
- Infectious Diseases
- Evidence-Based Medicine
Background:
- Viral warts, caused by human papillomavirus, are common skin infections affecting various body areas, particularly hands and feet.
- Numerous local treatment options exist for viral warts.
Purpose of the Study:
- To evaluate the effectiveness of diverse local treatments for non-genital cutaneous warts in immunocompetent individuals.
- To synthesize evidence from randomized controlled trials on wart treatment efficacy.
Main Methods:
- Comprehensive literature search of multiple databases (Cochrane, MEDLINE, EMBASE) and contact with experts.
- Inclusion of randomized controlled trials (RCTs) comparing local treatments for non-genital warts in healthy individuals.
- Independent review of study selection and quality assessment by two reviewers.
Main Results:
- Forty-nine trials were included, though many had weak methodology. Placebo cure rates averaged 30% over 10 weeks.
- Salicylic acid treatments demonstrated clear efficacy over placebo (75% vs. 48% cure rate).
- Cryotherapy showed no significant difference compared to placebo or salicylic acid. Other treatments like bleomycin and 5-fluorouracil had limited or inconsistent evidence and potential toxicity.
Conclusions:
- A significant lack of high-quality evidence exists for many common wart treatments.
- Topical salicylic acid is a proven effective treatment for common warts.
- The efficacy and safety of treatments like cryotherapy, bleomycin, and 5-fluorouracil require further investigation.