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Warts: beware of acid-based wart removers

In recent years, in France and elsewhere, deep burns and necrosis, sometimes with permanent after-effects, have been reported with concentrated acid-based topical wart removers.

Acids cause chemical burns on contact with the skin. Acidic wart removers are packaged in small quantities. However, even with an applicator, it is difficult to apply these products only on the wart, without touching the surrounding skin. Serious adverse effects are also due to confusion with other products, accidental ingestion and misuse.

On contact with healthy skin surrounding the wart, acidic, highly corrosive wart removers can cause burns, sometimes deep burns or even necrosis depending on the amount of product used, the number or the duration of applications, and the absence, or inadequacy, of a way of protecting healthy skin.

Over the years, in France and elsewhere, burns and deep necrosis have been reported with concentrated acidic wart removers.

The burns caused by these acids sometimes have lasting after-effects. Depending on the depth of the burn and the affected tissue (skin, tendons and other musculoskeletal structures, or nerves) the after-effects include scars, finger deformities, pain and loss of sensation.

Many concentrated acidic wart removers are sold over the counter. While not very effective, they are highly corrosive. Neither the recommended precautions for use, nor devices such as pens or brushes designed to reduce errors in use, provide complete protection against serious burns. Use of acidic wart removers is unjustified given that warts are benign, and acids have a low efficacy.

©Prescrire 1 May 2018

"Acid-based wart treatments: burns and sequelae" Prescrire Int 2018; 27 (193): 131-132. (Pdf, subscribers only).

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