Treatment of Recalcitrant Common Warts:
Approximately 50% of warts will clear spontaneously without treatment. Multiple topical chemicals can be used along with cryotherapy with either liquid nitrogen or nitrous oxide. However, for those common (including plantar) warts that do not respond several other more unusual methods can be tried. The first is to paint the wart with castor oil and cover the wart for 24 hours with adhesive tape. Reapply as needed. Another adjunct technique is the use of cimetidine which has been shown to modulate the immune system. The dose studied is between 25-40 mg per kg per day. Treatment can still take up to 3 months and failures have still occurred in several studies. Even so, this gives the nurse practitioner another tool in the treatment of warts. This author has used this treatment
in conjunction with topical chemicals and freezing in several children who had very recalcitrant warts, with excellent results.
Last updated: April 20, 2000
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