Which medications in the drug class Keratolytic 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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Answer

Keratolytic agents

Keratolytic agents cause cornified epithelium to swell, soften, macerate, and then desquamate.

Salicylic acid topical (Compound W, Compound W for Kids, Dr. Scholl's Advanced Pain Relief Corn Removers)

Salicylic acid is available over the counter in 5-40% concentration and in a variety of vehicles, including creams, paints, gels, karaya gum, impregnated plasters, collodion, or sodium carboxycellulose tape. Lactic acid may be a second ingredient in some wart varnishes. By dissolving the intercellular cement substance, salicylic acid desquamates the horny layer of skin. Therapeutic effect may be enhanced by removal of surface keratin prior to application. Apply topically once or twice daily for several weeks.

Podofilox (Condylox)

Podofilox is a purified ingredient of podophyllin and, therefore, is less irritating. It is available by prescription and can be applied by the patient at home. A 0.5% purified solution may be applied topically twice daily for 3 consecutive days, repeated weekly, not exceed 4 weeks.

Podophyllum resin (Podocon-25)

Podophyllum resin is an extract derived from the May Apple plant that contains several cytotoxic compounds. It has a powerful irritant effect and must be used with caution. It works better on mucosal surfaces than keratinized surfaces and is therefore more commonly used for genital warts. Trained personnel must apply it topically because of adverse effects; it may be left on the skin for 1-6 hours before washing.

Cantharidin

Cantharidin is the dried extract of the blister beetle (also termed Spanish fly). It causes epidermal necrosis and blistering. Apply the 0.7% solution sparingly with the wooden end of cotton-tipped applicator in the physician's office, and allow it to completely dry; do not cover the area with a bandage after application; repeat the application at 3- to 4-week intervals may be required.

Trichloroacetic acid (Tri-Chlor)

Trichloroacetic acid is a caustic compound that causes immediate superficial tissue necrosis. It is available as 80% solution that is painted onto lesions in the physician's office; apply after excess keratotic debris is pared; repeat therapy weekly as necessary until the wart is cured.


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