Hello Lydean,
Verruca Vulgaris, commonly known as warts can be very tenacious!
?Definition and Etiology: Common warts, or verruca vulgaris, are
caused by an infection with a type of human papilloma virus (HPV).
This is a pathogen that targets keratinocytes in the skin, leading to
an excessive pile-up of the hard, crusty proteins that make us
waterproof. (Some varieties of HPV cause genital warts, which may lead
to cervical cancer; it is not the same virus that causes verruca
vulgaris.).
Warts do not typically create a strong or aggressive immune system
response as other infections usually do. This allows them to grow for
months or even years if they are not removed by other means. That
said, they are notoriously tenacious, and many self-administered
remedies (specifically with salicylic acid) may miss some infected
cells deep in the lesion, leading to secondary rings of warts around
the original site of infection.?
http://www.massagetoday.com/archives/2005/01/13.html
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Alternative Therapies
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Cimetidine/Tagamet
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Several doctors on this site concur with Pinkfreud?s use of Tagamet (cimetidine).
?I have used it skeptically and have had some unusual successes.
Perhaps it is a combination of physician enthusiasm and placebo
effect, but what the heck-use it if it works ( or while it works).
One 18 y.o girl saw me for a year for planar warts of the face (facial
warts are my best successes) with failures on cryo, Retin-A, Efudex,
used multiple times and for many months. Gave her cimetidine 800 BID.
They went away in two weeks.
I have had most success with kids and young adults, from a great toe
covered with mosaic warts in a college student, to kids with fingers
covered with periungual warts.?
?I have been using it a lot in patients with extensive warts,
especially on their hands who use their hands extensiveley (a
pianist, chek, and policeman are among the ranks). I use 40mg/kg/day
in kids and 800mg tid inadults, usually in combination with Efudex 5%
solution and/or Retin-A Liquid (if together, the Retin-A precedes the
Efudex by 15-30 minutes) or Sal acid preparations. Some respond
dramatically after a few weeks and some have no response. In the
later group, I will apply Cantharone as a kicker and if they are Rhus
sensitive, I will let them use a crude extract from my road applied
once a day with a toothpick. I always encourage occlusion of the wart
with black electrical tape or grey duct tape and encourage those with
a hot tub to soak frequently. I have also added on half strength
Clorox applied with a toothpick once per day. I have a poster of
"classic" wart regimens in my office which I encourage patients to
read and am waiting to see back one patient who was going to rub his
wart on his modem and then was going to try and Email it to someone.?
?I use 300mg bid of Tagamet. Only 1/3 of my pts have cleared, but,
boy, was it dramatic! I tell them nothing will happen for the first
two months, then the third month will tell the story.?
?I saw an excellent case in last May. A 20-year-old worker
with resistant warts on the hands was treated with Cimetidine of 3
tablets per day for a month. Warts were starting to dissapear in 2
weeks and gone in a month.?
http://dermatology.cdlib.org/rxderm-archives/warts-cimetidine
However, as in many things medical, not all doctors agree:
1. ?In patients with multiple warts who have failed previous topical
treatments, oral cimetidine is not more effective than placebo in
achieving complete cure.1
2. No randomized placebo-controlled trials of cimetidine limited to
children with multiple resistant warts have been done.
?Ten studies of cimetidine treatment for warts have been done; only
three were double-blind, placebo-controlled; the remainder were either
open-label studies, comparison with standard therapy, or case reports.
Cure rates have ranged from 10%-82%. Results have suggested that
younger patients have a greater response rate?
http://www.med.umich.edu/pediatrics/ebm/cats/cimetidine.htm
and
?Comment: Reports of the usefulness of cimetidine were well covered in
the lay press, and many parents brought articles to my attention. The
Turkish study confirms my belief that a placebo can be wonderful when
treating a child with multiple warts. For warts, cimetidine is no
better than placebo, but placebo helped more than half of the children
in this study. The decision is which placebo to use and when.?
http://dermatology.jwatch.org/cgi/content/full/1996/701/1
· ?Systemic agents: Two systemic agents that have been used to treat
warts include cimetidine and retinoids.
o Cimetidine is a type-2 histamine receptor antagonist commonly used
to treat peptic ulcer disease. Because of its immunomodulatory effects
at higher doses, cimetidine was considered a possible treatment for
warts; however, results have varied. Double-blind placebo-controlled
studies have shown no benefit.
o Retinoids are synthetic vitamin A analogs that may help with
extensive disabling hyperkeratotic warts in immunocompromised
patients. They may help alleviate pain and facilitate the use of other
treatments. Retinoids also have helped reduce the number of lesions in
immunosuppressed renal transplant patients. The limiting side effects
include liver function abnormalities, increased serum lipid levels,
and teratogenicity.?
http://www.emedicine.com/derm/topic457.htm
· ?Alternative treatments: Several alternative treatments have been
reported as successful in treating warts, including adhesiotherapy,
hypnosis, hyperthermia, garlic, and vaccines.
o Perform adhesiotherapy by applying duct tape to the wart daily. This
method is painless and inexpensive and has reports of good success.
o Hypnosis has been used to treat refractory warts. Several published
studies have documented the success of hypnotherapy. Cure rates have
been reported from 27-55%, with prepubertal children more likely to
respond than adults.
o Hyperthermia involves immersing the involved surface in hot water
(113ºF) for 30-45 minutes, 2-3 times per week.
o Raw garlic cloves have been demonstrated to have antiviral activity.
This can be rubbed onto the wart nightly, followed by occlusion.
o Vaccines currently are in development.
http://www.emedicine.com/derm/topic457.htm
Duct Tape
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Duct Tape has developed a reputation as a wart-killer! ?(AP) Duct
tape, the all-purpose household fix-it with hundreds of uses, can also
remove warts.
Researchers say over-the-hardware-counter duct tape is a more
effective, less painful alternative to liquid nitrogen, which is used
to freeze warts.
The study was reported in the October issue of the Archives of
Pediatrics and Adolescent Medicine.
In the study, patients wore duct tape over their warts for six days.
Then they removed the tape, soaked the area in water and used an emery
board or pumice stone to scrape the spot. The tape was reapplied the
next morning. The treatment continued for a maximum of two months or
until the wart went away.?
http://www.cbsnews.com/stories/2002/10/14/health/main525523.shtml
?Treatments such as cryotherapy, acid preparations, laser therapy,
heat, and tape occlusion have been used in the management of warts,
with cure rates ranging from 32 to 93 percent. However, most of these
therapies are expensive, painful, or labor intensive. A few small,
nonrandomized trials have studied the use of tape occlusion in wart
treatment, with one study reporting cure rates of approximately 80
percent. Focht and associates compared the effectiveness of
cryotherapy with duct tape applied to common warts.?
?In patients treated with duct tape, 85 percent of the warts
completely resolved, compared with 60 percent in the cryotherapy
group. These results were statistically significant. Resolution of
warts treated with duct tape usually occurred within the first 28 days
of therapy. If there was no response within the first two weeks, the
warts were unlikely to respond to a longer course of therapy. The main
adverse outcomes with duct-tape therapy were difficulty keeping the
tape on the wart and minor skin irritation. The main adverse effect in
the cryotherapy group was mild to severe pain at the freeze site
during and after the treatment.
The authors conclude that duct tape occlusive therapy is more
effective than cryotherapy in the treatment of common warts. They also
state that duct tape therapy is less expensive and has fewer adverse
effects than cryotherapy.?
http://www.aafp.org/afp/20030201/tips/8.html
?Treatments for warts abound, varying from as gentle and simple as
taping a patch of banana peel on before bed, to as high-tech and
powerful as superpulsed carbon-dioxide-laser vaporization. A study
published in the October 2002 issue of the Archives of Pediatric and
Adolescent Medicine compared having warts frozen by a doctor to having
them treated by a nurse with duct tape, followed by an emery board at
home. It turned out that the homespun therapy was significantly more
effective. A small piece of duct tape covered the wart for 6 days in a
row (if the duct tape fell off, a replacement piece was applied).
After 6 days, the children soaked the wart in water and then rubbed it
with an emery board or pumice stone. The next morning, fresh duct tape
was applied for another 6 days. This was continued for 2 months,
unless the wart disappeared earlier. I?m not surprised that this
treatment worked so well. Even though both of these techniques destroy
some of the wart viruses, direct destruction is only a part of the
story. In the final analysis, it's our own immune systems that are
activated and engaged to eliminate the warts.?
http://www.drgreene.com/21_1017.html
Candela/Flashlight Pulsed Dye/FPD
-----------------------------------
?Warts are contagious. You can spread it to yourself and others.
Warts are tenacious, although most go away within two years by
themselves (I see all the ones that don't).
There are many treatments for warts (as in all conditions that have no
great treatment), but some warts continue to recurr no matter what the
treatment. Find a good dermatologist and begin a treatment protocal.
Call around in your area and see if anyone is using the Candela
(flashlamp pulsed dye) laser for warts. I've found this to be pretty
humane and successful in periungual (around the nail) warts. Good
luck.?
http://www.ofcn.org/cyber.serv/hwp/hwc/general/news/gen008.html
Candela (flashlamp pulsed dye)
?The laser is a flashlamp pulsed-dye unit used as an alternative to
dermatological procedures. The Candela laser is safe for all ages and
is designed to preserve normal skin texture, color and feel. It
virtually eliminates the risk of scarring associated with previous
treatment methods. The laser is focused exclusively on the targeted
vessels, limiting the effects of on the surrounding tissue.
The Candela laser can treat any vascular lesion or blood vessel on the
surface of the skin, but can not be used for tattoo removal. The most
common treatable conditions:
· telangiectasias (spider veins)
· port wine stain birthmarks
· strawberry hemangiomas
· warts
· scars
http://www.wehealny.org/advances/birthmarks.html
This site discusses warts of the larynx. ?Methods: Patients with
laryngeal papillomas were treated with the PDL at fluences of 6 J/cm2
(double pulses per irradiated site), 8 J/cm2 (single pulses), and 10
J/cm2 (single pulses), at noncritical areas within the larynx, using a
specially designed micromanipulator. Lesions on the true cords were
treated with the CO2 laser, using standard methodology.
Results: Clinical examination of three patients treated to date showed
that PDL treatment appeared to produce complete regression of
papillomas. Unlike the sites of lesions treated by the CO2 laser, the
epithelial surface at the PDL treatment sites was preserved intact.
Conclusions: These preliminary results suggest the PDL may eradicate
respiratory papillomas with minimal damage to normal laryngeal tissue.
Further analysis of the ongoing study is required to demonstrate
potential benefits of the technique.?
http://www.laryngoscope.com/pt/re/laryngoscope/abstract.00005537-199807000-00003.htm;jsessionid=DWSgtfBGBy17WlHQl8OxM6jD1qshB5IVaWO4dMEqXEgI7VJGjno7!1213474754!-949856144!9001!-1
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Finally: ?Like many small towns in Mountain Country, we had our little
old lady with a pointed hat and a warty nose who removed warts from a
host of fingers when I was a growin' up boy. A quick rub for a penny a
wart did the trick. Sometimes there were a dozen or more per head (on
the hands). The pennies disappeared even quicker than the warts into a
deep apron pocket. Warts were soon forgotten by the children and the
pennies were well-remembered by the little old lady on her way to the
bank every day. It was a pretty good moonlight job back then.?
http://www.thecountrydoctor.com/prescriptions/altmed.htm
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Standard Medical Therapies:
===========================
Acids
Over-the-counter salicylic acids (e.g., Compound W, DuoFilm liquid or patches)
Bi- or trichloroacetic acid
Freezing
Liquid nitrogen freeze via spray gun or cotton-tipped applicator at
196?C (320.8°F)16
Cryogun with nitrous oxide tank freeze at 89°C (128.2?F)16
Aerosol spray with adapter freeze (e.g., Verruca-Freeze) at 70°C (94°F)16
Burning
Electrocautery, LEEP, laser
Chemotherapy
Bleomycin (Blenoxane)
Injected agents
Candida antigen
Mumps antigen
Interferon alfa-2b (Intron A) and interferon alfa-N3 (Alferon N)*
Topical agents
Imiquimod (Aldara)
Systemic agents
Cimetidine (Tagamet)
http://www.aafp.org/afp/20030315/1233.html
I hope this has helped you out! If any part of my answer is unclear,
please, before rating, request an Answer Clarification. I will be
happy to respond!
Sincerely, Crabcakes
Search Terms
============
verruca vulgaris
Wart therapy
Alternative + remedies + warts
Candela + flashlamp pulsed dye + warts
Tenacious warts |
