Wart removal and treatment, home remedy by Ray Sahelian, M.D.

Feb 12 2014
Many natural home remedies have been proposed for wart removal. Warts
tend to resolve spontaneously within a couple of years in children, whereas
adults with warts almost always have them for the rest of their lives. Overthe-counter medications containing salicylic acid are often used in
removing warts.
Treatment
A variety of treatment modalities have been described for cutaneous warts.
We sought to determine the safety and efficacy of a topical formulation of
cantharidin, podophyllotoxin, and salicylic acid in the treatment of plantar
warts. This combination treatment is widely used in Europe and elsewhere
but has not been described in the podiatric medical literature. A
retrospective study was conducted of 144 patients with simple or mosaic
plantar warts who were treated with a topical, pharmacy-compounded
solution of cantharidin, 1%; podophyllotoxin, 5%; and salicylic acid, 30%.
All of the patients, aged 8 to 52 years, were treated according to the
authors' standard protocol. Of the 144 patients, 92 were being treated for
the first time. None of the 52 previously treated patients had received more
than one other type of treatment in the past. After 6 months of follow-up,
complete eradication of the plantar warts was noted in 138 of the 144
patients (95.8%). Of these patients, 125 (86.8%) required a single
application of the solution, and 13 (9.0%) needed two or more applications.
No significant adverse effects or complications were observed. A topical
solution of cantharidin, podophyllotoxin, and salicylic acid was found to be
safe and effective in the treatment of simple and mosaic plantar warts. This
formulation is a promising alternative treatment modality for plantar warts. J
Am Podiatr Med Assoc. 2008 Nov-Dec. Application of cantharidin and
podophyllotoxin for the treatment of plantar warts. Escuela Universitaria de
Enfermera, Fisioterapia y Podologa, Universidad Complutense de Madrid,
Madrid, Spain.
Palmoplantar warts are often hard to treat. They tend to relapse and the
course of therapy is frustrating in many cases. The erbium:YAG laser
(Er:YAG) with a wavelength of 2.94 rm is capable of achieving a rapid and
precise ablation of warts, but about 14% of patients are non-responders as
shown in a previous study. Podophyllotoxin is an established antimitotic
agent derived from podophyllum plant resin, approved for human papilloma
virus (HPV)-induced genital warts. The combination of both ablative Er:YAG
laser and topical 0.5% podophyllotoxin solution in hard-to-treat

palmoplantar HPV warts was investigated. Thirty-five patients with hard-totreat warts(palmar or plantar) with various pretreatments that had failed,
were treated once by Er:YAG laser ablation with a spot size of 3 mm, a
frequency between 8 Hz and 10 Hz, and a fluence of 5.7-11.3 J/cm2. After
wound healing, topical podophyllotoxin 0.5% solution was applied for 3
days followed by a break of 4 days. Four to six treatment cycles with
podophyllotoxin were performed. After laser treatment followed by topical
podophyllotoxin cream a complete response was observed in 31 patients
(88.6%). Two patients with plantar warts and a complete response showed
a relapse within 3 months after treatment (5.7%). None of the patients
developed pigmentary changes,wound infections or scarring. The therapy
of hard-to-treat warts with a combination of Er:YAG laser and topical
podophyllotoxin is safe and effective. Compared with laser alone, the CR
percentage seems to be higher and the percentage of relapses reduced. J
Cosmet Laser Ther. 2003 Apr. Er:YAG laser followed by topical
podophyllotoxin for hard-to-treat palmoplantar warts.Wollina U.Department
of Dermatology, Hospital Dresden-Friedrichstadt, Dresden, Germany.
Urologe A. 2013. Proven and new methods in the treatment of genital
warts. Anogenital warts are the most common clinical manifestation of
human papillomavirus (HPV) infections. Although easy to recognize,
asymptomatic anogenital warts (condylomata acuminata) may be
overlooked, leading to unaware transmission to the sexual partner. On the
other hand awareness of this sexually transmitted disease (STD) is largely
associated with a great psychological and social burden, in men as well as
women. Spontaneous regression of genital warts has been observed
mostly within 2-5 years; however, persisting condylomata may prove
refractory to all current treatment options. Because removal of the warts
does not totally eliminate the underlying viral infection, treatment of genital
warts can often be of long duration, of varying effectiveness and with high
recurrence rates. Without a doubt only the patient's own immune system is
capable of clearing HPV infections. Therefore, the solution to one of
mankind's oldest health problems will depend on the future acceptability of
HPV vaccines.
Occlusion therapy for wart removal
Covering up a wart with transparent duct tape or moleskin, commonly
referred to as occlusion therapy, hardly ever cures warts in adults. Even
when a treated wart resolves, it usually recurs within months. Since duct
tape is an inexpensive, nontraumatic way to treat warts, Dr. Rachel
Wenner, from the University of Minnesota in Minneapolis, and her
associates decided to try it on adult patients and compare the results with

those achieved with moleskin occlusion. So patients wouldn't know which

treatment they received, the researchers used moleskin alone (Dr. Scholl's
Moleskin Plus) on 46 patients, and duct tape (Scotch Transparent Duct
Tape) applied to the adhesive side of moleskin for 44 patients. Small pads
were cut out that would cover each patient's largest "target" wart. The wart
was first pared with a scalpel blade and the pad was applied. Patients were
allowed to use reinforcing tape to hold the pad in place. Their instructions
were to wear a pad for 7 days, remove it for 1 night, then soak the wart and
lightly scrape it with an emery board the next morning before reapplying
another pad. The subjects' average age was 54 years, the average number
of warts was 1.4 per person, and the average wart diameter was 5.3 mm.
About two thirds of the subjects had tried other treatments, including liquid
nitrogen and salicylic acid. Most had had warts for years or even decades.
After 2 months, there were no significant difference between the two
groups; the wart cleared up in 21 percent in the duct tape group and 22
percent in the moleskin group. However, of the 17 warts that disappeared,
9 returned within 6 months. Dr. Rachel Wenner says previous studies that
reported occlusion therapy was successful in most patients, the trial
included children, not adults. Archives of Dermatology, March 2007.

Plantar Warts
Written By: Kirk A. Koepsel, D.P.M. Editor, PodiatryNetwork.com

Description
The common wart is known as verruca vulgaris. They are caused by a viral infection of the
skin. This occurs as a result of direct contact with the virus. They do not spread through the
blood stream. They occur more commonly in children than adults. When they occur on the
bottom of the foot, they are called plantar warts. This name is derived from the location of the
foot on which they are found; the bottom of the foot is called the plantar aspect of the foot. A
common misconception is that plantar warts have seeds or roots that grow through the skin
and can attach to the bone. The wart may appear to have a root or seeds, but these are in
fact small clusters of the wart just beneath the top layer of the skin. The wart cannot live in
any tissue except the skin. Moist, sweaty feet can predispose to infection by the wart virus.
They can be picked up in showers and around swimming pools. They are not highly
contagious, but being exposed in just the right situation will lead to the development of the
wart. Avoiding contact in the general environment is nearly impossible. If a member of the
family has the infection, care should be taken to keep shower and tile floor clean. Children
who have plantar warts should not share their shoes with other people. Young girls often
share shoes with their friends and this should be discouraged.

Diagnosis
The warts have the appearance of thick, scaly skin. They can occur as small, single warts or
can cluster into large areas. These clustered warts are called mosaic warts. They often
resemble plantar calluses. A simple way to tell the difference between a wart and a callous is
to squeeze the lesion between your fingers in a pinching fashion. If this is painful, it is likely
that the lesion is a wart. A callous is generally not painful with this maneuver but is tender
with direct pressure by pressing directly on the lesion. Other lesions on the bottom of the foot
that are often confused with plantars warts are porokeratoses and inclusion cysts.
Treatment
There are a variety of ways to treat warts. The over-the-counter medications have a difficult
time penetrating the thick skin on the bottom of the foot, so they do not work well in this
area. Professional treatment consists of burning the wart with topical acids, freezing with
liquid nitrogen, laser surgery or cutting them out. All methods have the possibility of the wart
coming back. Surgical excision of the wart has the highest success rate with a relatively low
rate of recurrence. There is some mild discomfort with this procedure and it takes several
weeks for the area to completely heal. Normal activity can generally be resumed in a few days
depending on the size and number of warts that have been removed. The risks associated
with surgical removal of warts are the possibility of infection, or the formation of a scar, which
can be painful when weight is applied while walking.
Laser removal of the wart works by burning the wart with a laser beam. The area must be
numbed with an anesthetic prior to the procedure. There is little advantage to removing warts
with a laser unless the warts are very large (mosaic warts) or there are a large number to be
removed. The risks associated with the use of the laser are the same as for cutting the warts
out. These risks include infection and the development of a scar after healing. A new type of
laser has been developed to treat several different types of skin lesions called the Pulsed Dye
Laser. This new laser has promise in the effective treatment of warts.
Freezing the wart with liquid nitrogen is another form of treatment. This form of treatment
when the warts are on the bottom of the foot can be very painful and take several days or
weeks to heal.
Topical acids can also be a useful means of treating warts. The advantage to this form of
treatment is the fact that they are nearly painless and there is no restriction of activity. The
down side to this form of treatment is that it frequently requires several treatments and the
failure rate is higher than surgical excision of the wart.

Callusol
DESKRIPSI
Asam salisilat 0.2 gr, Asam laktat 0,05 gr,Polidocanol 0,02 gr

INDIKASI
Mata ikan, kalus ( kapalan),kulit yang mengeras dan kutil.

KEMASAN
Botol @ 10 ml

DOSIS
Satu tetes larutan dipakai padadaerah kulit yang sakit ( pagi dan malam hari ).Ratakan dan biarkan mengring
beberaoa menit.
CARA PEMBERIAN :

Ambil kapas secukupnya disesuaikan dengan luas permukaan mata ikan/kutil/kapalan.

Tuang Callusol secukuonya pada kapas.

Tempelkan kapas yang telah dibasahi Callusol pada mata ikan/kutil/kapalan.

kemudian tutuplah dengan plester.

Ulangi pemberian Callusol/ganti kapas setiap kali habis mandi.

SAGESTAM KRIM / SALEP KULIT (GENTAMICIN /

GENTAMISIN)
Obat Generik : Gentamicin / Gentamisin Sulfat
Obat Bermerek : Balticin, Bioderm, Dermabiotik, Dermagen / Dermagen Forte,
Garabiotic, Garamycin, Garapon, Gentamerck, Genticid, Ikagen, Konigen, Licogenta,
Nichogencin, Ottogenta, Sagestam, Salticin.
KOMPOSISI / KANDUNGAN
Tiap 1 gram Sagestam Krim mengandung Gentamisin Sulfat yang setara dengan 1 mg
Gentamisin.
FARMAKOLOGI (CARA KERJA OBAT)
Krim Sagestam mengandung gentamisin sulfat, suatu antibiotik spektrum luas yang efektif
untuk pengobatan topikal pada infeksi kulit primer dan sekunder yang disebabkan oleh
bakteri.
Bakteri yang sensitif terhadap krim Sagestam termasuk :

Streptococci (beta-hemolitik grup A, alfa-hemolitik),

Staphylococcus aureus,
Bakteri gram negatif,
Pseudomonas aeroginosa,
Aerobacter aerogenes,
Escherichia coli,
Proteus vulgaris, dan Klebsiella pneumoniae.
Krim Sagestam bersifat bakterisid dan tidak efektif terhadap bakteri anaerob, jamur, atau
virus. Sagestam krim mudah diabsorpsi pada kulit terinfeksi.
INDIKASI / KEGUNAAN
Indikasi Sagestam Krim adalah :

Infeksi kulit primer : folikulitis superfisial, furunkulosis, impetigo

kontagiosa, pioderma gangrenosa.

Infeksi kulit sekunder : dermatitis eksimatus infeksiosa, akne pustularis,

psoriasis pustular, dermatitis seborheik terinfeksi, dermatitis kontak.
KONTRAINDIKASI
Sagestam krim jangan diberikan kepada penderita yang hipersensitif terhadap gentamisin
atau antibiotika aminoglikosida lainnya.
DOSIS DAN ATURAN PAKAI
Tanyakan kepada dokter anda mengenai dosis dan aturan pakai krim Sagestam.
Oleskan krim dengan hati-hati pada kulit yang terinfeksi, 3 4 kali sehari.
Apabila diinginkan, pada bagian terinfeksi dapat ditutup dengan pembalut

tipis.

Pada impetigo kontagiosa, krusta harus dihilangkan terlebih dahulu

sebelum menggunakan krim Sagestam.
EFEK SAMPING
Efek samping Sagestam : kadang-kadang terjadi iritasi (eritema atau pruritus).
PERINGATAN DAN PERHATIAN

Jika terjadi iritasi atau superinfeksi, pengobatan harus dihentikan dan

diberikan pengobatan yang tepat.
Tidak dianjurkan untuk pemakaian terus-menerus baik oleh perorangan
maupun di rumah sakit, karena dapat menimbulkan resistensi.
KEMASAN
Sagestam Krim, Tube, @ 10 gram.
KETERANGAN
HARUS DENGAN RESEP DOKTER.
Simpan di tempat kering dan sejuk. Jauhkan dari jangkauan anak-anak.