Successful Treatment of Recalcitrant Non-genital Warts (Verruca vulgaris) with a Topical Solution Containing Two Antivirals and a Low Concentration of Salicylic Acid

Abstract

Aims: Commercial formulas for the treatment of warts use salicylic acid in concentrations above 100 mg/ml, which causes skin irritation, and the results are often unsatisfactory. To address this problem, we developed a new formula with a low concentration of salicylic acid (20 mg/ml) and with the addition of virucidal compounds (metallic iodine and benzoic acid) and compared it to a formula currently on the market (Verrux®) containing 165 mg salicylic acid (0.165 g) and 145.2 mg lactic acid (0.145 g) per ml collodion.
 Study Design: A randomized double-blind study was conducted.
 Location and Duration of Study: Department of Biotechnology, UNINCOR, Chácara das Rosas, Três Corações, MG, Brazil; School of Pharmacy, Universidade Federal do Amapá - Campus Universitário Marco Zero do Equador, Rod. Juscelino Kubitschek, KM-02, Jardim Marco Zero, Macapá, AP, Brazil and School of Medicine, Universidad Politécnica y Artística del Paraguay (UPAP), Km 10, Ciudad del Este, Paraguay, between December 2004 and October 2016.
 Methodology: 95 patients were treated with the formula with salicylic acid (20mg), benzoic acid (20mg) and metallic iodine (2.5mg) per ml (group A) and 95 received treatment with Verrux® (salicylic acid 165mg, lactic acid 145.2mg per ml collodion) (group B).
 Results: All patients in Group A (100%) reported complete resolution of signs and symptoms after 13 weeks of treatment. In contrast, 67 subjects (70.5%) in group B reported regression of symptoms during the same period.
 Conclusion: There was a statistically significant difference between the groups studied here (P< 0.05). This new formulation with a low level of salicylic acid and two virucidal agents promotes healing of recalcitrant cutaneous warts without significant side effects. The price of the two formulas is virtually the same (about $8 to $10 each bottle).