Which prescription topical agents are used in the treatment of nongenital warts?

Updated: Sep 25, 2020
  • Author: Philip D Shenefelt, MD, MS; Chief Editor: William D James, MD  more...
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Several topical agents are available that can be applied by trained personnel in a physician's office. Cantharidin is an extract of the blister beetle that causes epidermal necrosis and blistering. Dibutyl squaric acid, also known as squaric acid dibutyl ester (SADBE), and diphencyclopropenone (DCP) are contact sensitizers. Trichloroacetic acid is a caustic compound that causes tissue necrosis. Podophyllin is a cytotoxic compound used more commonly in the treatment of genital warts. Aminolevulinic acid (ALA) is a photosensitizer that has been successfully used topically in combination with blue light to treat flat warts. [14]

Several prescription medications have proven beneficial in treating warts. These can be applied at home by the patient. Imiquimod is an immune response modifier approved for the treatment of genital warts. Reports indicate successful treatment of common warts. [15]

Cidofovir is an antiviral agent used for the treatment of cytomegalovirus infection in HIV patients. Several reports describe successful treatment of recalcitrant warts using various concentrations of topical cidofovir. [16, 17, 18, 19, 20]

Podophyllotoxin is a purified ingredient of podophyllin. Since it tends to work better on mucosal surfaces, it is used primarily to treat genital warts. Little information is available regarding treatment of nongenital warts with this medication.

5-Fluorouracil is a topical chemotherapeutic agent primarily used to treat actinic keratoses. It has been reported to be effective in treating warts when used under occlusion daily for up to 1 month. It has been used in children. [21]

Tretinoin is a topical retinoic acid that primarily is used to treat acne. It has been successful in treating flat warts.

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