Compounding for Warts

Custom dermatological compounds that are efficacious and economical.

Safe + Effective Compounding for Warts

Safe + Effective Compounding for Warts

The term 'verruca' was first used by Sennertus, the renowned German physician. Originally meaning a steep place or height, Sennertus applied the term to warts because 'They appear on the surface of the skin like the eminences of little hills'. Compounding offers multiple methods to resolve warts. 1

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Warts are benign skin growths caused by the human papillomavirus (HPV) infecting the top layer of the skin. Wart viruses are contagious and can spread through direct contact with the wart or a contaminated surface. 2

Common in children, warts are typically raised bumps, skin-colored, and rough to the touch. They can also be darker in color (brown or even gray-black), flat, and smooth. It is common for warts to grow on hands. Ultimately, the type of wart is determined by where it grows on the body and what it looks like.

Common warts (also called Verruca vulgaris) commonly:

  • Grow on the fingers, around the nails, and on the back of the hands
  • Infect broken skin (e.g., from biting fingernails or picking at hangnails)
  • Create a rough bump
  • Infect children

Foot warts (also called plantar warts)

  • Grow on the soles (plantar surface) of the feet
  • Cause pain when walking
  • Contain black dots or “seeds”

Flat warts

  • Occur on the face of children, in the beard area of men, and the legs of women
  • Smaller and smoother than other warts
  • Grow in large numbers – up to 100 at a time

Filiform warts

  • Look like long threads or thin fingers that stick out
  • Grow on the face, particularly around the mouth, eyes, and nose
  • Grow quickly

Warts may resolve without treatment, especially in children. Patients who do not successfully resolve their warts, who suffer pain, or have multiple warts should be treated. Warts may persist even following treatment. Managing patient expectations is, therefore, an important component of support. Successful shedding of virus cells onto the skin before treatment may allow the wart to return, either in a new location or the original. Thus, early intervention is advised.

Treatment strategies should be customized according to the patient’s age and health as well as the wart type. Options include:

  • Blistering: This treatment cuts off the blood supply to the wart. Blistering may be painful, which is why it is not commonly practiced on young children.

  • Chemical blister: Compounded Cantharidin solution may be painted onto a wart to induce a blister to form underneath. This practice allows the dead wart to be removed within a week or so.

  • Cryotherapy: Freezing with liquid nitrogen is a popular treatment option in adults and older children. Repeated treatments may be required. Patients with melanin-rich skins (dark skins) are at greater risk of developing dark spots.

  • Chemical peels: Flat warts often respond well to peels. Common peels include salicylic acid, tretinoin, and glycolic acid, which patients can self-administer daily. This treatment is cost-effective but may require several weeks of daily use to see results.

    • Salicylic acid: Combined with freezing, peels with salicylic acid have excellent efficacy.

    • Trichloroacetic acid and curettage: Consider trichloroacetic acid if there is no response to salicylic acid. Curette the surface of the wart and paint weekly. Side effects such as burning and stinging are more apparent.

  • Electrosurgery and curettage: Burning is a highly effective treatment for common warts, foot warts, and filiform warts. Curettage may then be successful following the electrosurgery. Healing may take two to four weeks.

  • Excision: Excision is a minor surgery. The wart may be cut out, but this option may cause scarring.

  • Laser treatment: If a wart does not respond to other therapies, consider laser treatment and a local anesthetic for pain management. Pulsed-dye laser treatment cauterizes tiny blood vessels, killing affected tissue. It can cause pain and scarring and is not commonly practiced on young children.

  • Bleomycin: This anti-cancer medication shows good efficacy. However, the treatment is often painful and commonly causes side effects, such as nail loss if given in the fingers.

  • Immuno-stimulation: Persistent warts that do not respond well to treatment may be resolved with immunotherapy.

    • Allergic stimulation with diphencyprone (DCP) causes a mild allergic reaction, which may prove cross-effective against persistent warts.

    • Interferon, given as subcutaneous interferon-alpha, may stimulate the body’s immune system enough to assist the patient’s response to the HPV.

Type of Wart Compounded Formula & Treatment Options
Common Warts

Chemical Peels

  • Compounded salicylic acid daily treatment pads or topical solution

  • Compounded trichloroacetic acid solution and curettage (repeat treatments)

Blistering (not recommended in young children)

  • Cantharidin

  • Freezing with liquid nitrogen

Electrosurgery and curettage

Excision

Laser treatmen

Bleomycin (consider side effects)

Immuno-stimulation

Foot Warts

Electrosurgery and curettage

Excision

Laser treatment

Bleomycin (consider side effects)

Immuno-stimulation

Flat Warts

Chemical Peels

  • Salicylic acid daily treatment pads or topical solution

  • Trichloroacetic acid and curettage (repeat treatments)

Electrosurgery and curettage

Excision

Laser treatment

Bleomycin (consider side effects)

Immuno-stimulation

Filiform Warts

Electrosurgery and curettage

Excision

Laser treatment

Bleomycin (consider side effects)

Immuno-stimulation

Genital Warts

Electrosurgery and curettage

VLS Pharmacy & New Drug Loft can assist with compounding a customized wart removal medicine to meet your patient’s needs. Patient tolerance for pain and their skin’s response to the chemicals used to treat warts is highly variable. Effective wart removal may require customized concentrations of the therapy to ensure efficacy.

To learn more about our custom compounding options, please contact us here.

Please note: information on this site is not intended as medical advice and the medications listed are not specific to any individual. The content is intended to inform as to what may be possible. Listed medications and/or compounded formulas are not necessarily those compounded at VLS Pharmacy & New Drug Loft . Please speak with your prescribing clinician about your specific needs.

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As a 503A pharmacy, VLS Pharmacy* is committed to providing high-quality formulations of sterile and non-sterile compounded medications to you and your patients. Thanks to rigorous testing measures, we guarantee the safety, stability, purity, sterility, and quality of each formulation from preparation to administration. We use high-quality, active pharmaceutical ingredients sourced directly from PCCA, the leader of superior-quality APIs. Additionally, our pharmacy network meets USP <795> non-sterile standards and USP <797> sterile compounding guidelines. We’re also proud to host one of the first pharmaceutical labs built to USP <800> standards for handling hazardous drugs.

All of our medications undergo third-party potency and stability testing, and we complete high-sensitivity rapid endotoxin detection on-site. These measures allow for shorter delivery times to the patient without compromising our product quality. Because we source all of our active ingredients from PCCA, we also promise an additional level of pre-formulation testing, as PCCA ingredients undergo 14 high-level checks and reviews in order to pass inspection.

*New Drug Loft is also a 503A compounding pharmacy but specializes in strictly non-sterile compounding and therefore abides by USP <795> only.

For almost three decades, our team has been committed to serving our network of physicians and patients. We appreciate the opportunity to share our expertise as we develop advanced compounded formulations for those who need and want more than what is commercially available. We work hard to achieve excellence in all areas of our business -- from investment and advancement to personalized customer service and rigorous in-house and third-party safety testing and quality assurance. We are proud to prove the best, individualized medical solutions, compounded as needed.

Our 503A pharmacy network specializes in providing custom-made sterile and non-sterile compounded medications to physicians and patients across the country. Each prescription is crafted and delivered with a commitment to the highest level of quality, safety and service.

For more information about VLS Pharmacy, click here.