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The Mystery of Warts: Duct Tape, Moleskin or What?
Abstract & Commentary
By Joseph E. Scherger, MD, MPH, Professor, University of California, San Diego. Dr. Scherger reports no financial relationship to this field of study.
Synopsis: Duct tape is no more effective than moleskin for the treatment of common warts. Occlusion therapy with both for 7 days will give resolution in just over 20% of patients.
Source: Wenner R, et al. Duct tape for the treatment of common warts in adults: A double-blind randomized controlled trial. Arch Dermatol. 2007;143:309-313.
The history of the treatment of common warts is a curious blend of folklore and science. The mysterious thing about warts is that they spontaneously go away in most patients. When they spontaneously resolve is highly variable, from a few months to years. People, including clinicians, have tried lots of remedies, and when they seem to work, new folklore is created.
In 2002 and 2003, the use of duct tape for common warts became popular after a clinical trial comparing it favorably to cryotherapy.1,2 Duct tape became part of the medical tool kit of physicians and patients wishing to avoid the traditional use of salicylic acid or liquid nitrogen. Seven days of duct tape occlusion sure was easier than weeks of messy acid treatment or liquid nitrogen which is not available in many primary care offices.
Wenner and his colleagues at the University of Minnesota performed a double-blind randomized controlled trial of duct tape and moleskin on 90 immunocompetent volunteers at the VA hospital in Minneapolis. Both groups wore pads for 7 days, either duct tape or moleskin. The 7-day process was repeated for 2 months or until the wart resolved. Patients were seen at 1 month and 2 months, with a follow-up visit at 6 months.
Eight of 39 patients in the duct tape group (21%) and 9 of 41 patients in the moleskin group (22%) had complete resolution of the wart by two months. The authors concluded that there was no difference between occlusion therapy with duct tape and moleskin for the treatment of common warts.
Controlled clinical trials have a nice way of bringing truth to folklore in medicine. Duct tape received such praise for wart treatment that I suspected we would have medical suppliers carrying it. Now we know it helps in the resolution of common warts, but no more than moleskin, which is designed to be on the skin for extended periods.
So what should we do with warts? I still personally favor liquid nitrogen. Good deep freezing gives rapid results. After 30 years, I have never met a wart I couldn't kill, but sometimes 3-5 applications 2-3 weeks apart are necessary. Salicylic acid remains an option, but I find it messy and uncomfortable over many weeks. Occlusion therapy is simple and sometimes effective, whether with duct tape or moleskin. Just clean the skin and apply it for a week. Repeat as necessary for two months.
Reassure all patients that common warts resolve spontaneously. Our immune systems ultimately take care of the problem.
1. Focht DR, et al. Arch Pediatr Adolesc Med. 2002;156:971-974.
2. Lynch TJ. J Fam Pract. 2003;52:111-112.