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Local treatments for cutaneous warts
S Gibbs1, I Harvey, J C Sterling
1Ipswich Hospital NHS Trust, Ipswich, UK, IP4 5PD.
The Cochrane Database of Systematic Reviews
|August 15, 2003
Summary
Salicylic acid treatments are effective for common warts, outperforming placebo. Other treatments like cryotherapy show less evidence of efficacy and may not be superior to simpler, safer options.
Area of Science:
- Dermatology
- Evidence-based medicine
Background:
- Viral warts, caused by human papillomavirus, are common skin conditions affecting hands and feet.
- A wide array of local treatment options are available for viral warts.
Purpose of the Study:
- To evaluate the effectiveness of various local treatments for non-genital cutaneous warts in healthy individuals.
Main Methods:
- Systematic review of randomized controlled trials from multiple databases (Cochrane, MEDLINE, EMBASE) up to January 2003.
- Inclusion criteria: randomized controlled trials of local treatments for non-genital viral warts in immunocompetent hosts.
- Study selection and quality assessment performed by two independent reviewers.
Main Results:
- Fifty-two trials were identified, but evidence quality was often weak due to poor methodology.
- Salicylic acid treatments demonstrated clear superiority over placebo (75% cure rate vs. 48%).
- Cryotherapy showed no significant difference compared to placebo or salicylic acid in limited trials; other treatments like bleomycin and 5-fluorouracil had limited or concerning evidence.
Conclusions:
- A significant lack of high-quality evidence exists for the rational use of many common wart treatments.
- Topical salicylic acid is supported by evidence as an effective treatment for common warts.
- The efficacy and safety of more potent treatments like bleomycin and 5-fluorouracil require further investigation.