Viral warts are benign proliferations of the skin and mucosa caused by infection with Human Papilloma Virus (HPV); more than 150 subtypes of the DNA virus are known.
Intraoral warts are usually misplaced genital types but those on the lips may also be common or filiform variants.
Immunosuppression can result in malignant transformation of warts on non-genital sites, most commonly ten or more years after organ transplantation. Rarely, longstanding non-genital warts can cause verrucous carcinoma (large solitary well differentiated squamous cell carcinoma usually found on plantar surface). In children, even without treatment, 50% of warts disappear within 6 months; 90% are gone in 2 years. Daily application of paints or gels containing keratolytics such as 15 to 60% salicylic acid.
Cryotherapy with liquid nitrogen (cotton bud or cryospray) to wart and 1-2 mm rim of normal tissue. If simple treatments do not prove effective, there is little point in pursuing more elaborate and sometimes very expensive options as the success rates are little better.
Podophyllotoxin (refined podophyllin), applied to genital warts for 4-day courses each week for several weeks. Trichloacetic acid 80% applied weekly by the physician, resulting in immediate superficial (and sometimes deep) tissue necrosis. Contact allergens such as dinitrochlorobenzene (a mutagen) or dibutyl squaric acid, which cause local inflammation.
Laser vaporisation using carbon dioxide laser, used for diffuse warts or deep plantar warts. Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. Although the exact mode of action for salicylic acid in the treatment of warts is not known, its activity appears to be associated with its keratolytic action which results in mechanical removal of epidermal cells infected with wart viruses. Salicylic Acid, 27.5% Wart Remover is indicated for the topical treatment and removal of common warts and plantar warts.
Salicylic Acid, 27.5% Wart Remover should not be used by diabetics or patients with impaired blood circulation.

A localized irritant reaction may occur if Salicylic Acid, 27.5% Wart Remover is applied to the normal skin surrounding the wart.
Prior to application of Salicylic Acid, 27.5% Wart Remover, soak wart in warm water for five minutes.
Salicylic Acid, 27.5% Wart Remover is supplied in 10 mL amber bottles with a brush applicator, (NDC 42192-135-10).
Your health care provider has prescribed Salicylic Acid, 27.5% Wart Remover, a topical prescription preparation for the treatment of common and plantar warts. Using the brush applicator supplied, apply twice to entire wart surface, allowing the first application to dry before applying the second.
Best Medications To Treat Warts Salicylic Acid Salicylic acid preparations are usually available over-the-counter for treating warts.
Cantharidin When treatment with salicylic acid fails to remove the warts, your doctor may prescribe cantharidin. Wart Remover is used on the skin to remove warts and to treat psoriasis and other skin conditions. Be careful when applying Wart Remover as it can irritate normal skin around the application site.
Tell your doctor if you have any of the following conditions: diabetes, poor circulation, any allergies (especially to salicylic acid). Viral warts are particularly common in childhood (affecting about 15% of school children) but may arise at any age. Persevere for twelve weeks or longer; up to 70% of warts will resolve with wart paints, and removing the keratinised surface relieves discomfort.
The hard skin should be rubbed away from the wart surface with a piece of pumice stone or emery board. These require prescription by a dermatologist and have mucocutaneous and systemic side effects.
The pharmacologic activity of Salicylic Acid, 27.5% Wart Remover is generally attributed to the keratolytic activity of salicylic acid which is incorporated into a film-forming vehicle designed to cover the wart without the need for a bandage.
Salicylic Acid, 27.5% Wart Remover should not be used on moles, birthmarks, unusual warts with hair growing from them or warts on the face.

Any irritation may normally be controlled by temporarily discontinuing use and by applying the medication only to the wart site when treatment is resumed.
In order for Salicylic Acid, 27.5% Wart Remover to work correctly and to ensure maximum benefit, the following instructions should be followed carefully. It works by softening the skin that forms the wart, which is then easily rubbed off with a pumice stone. The wound heals in about two weeks; even then 20% of warts can be expected to recur within a few months.
Moreover, by irritating the wart, salicylic acid stimulates the immune response against the HPV virus that helps to kill the virus, arresting progression of the infection. Side effects include pain, injury to underlying tendons and superficial nerves (avoid the sides of digits), postinflammatory depigmentation, scarring and recurrent warts (often as a ring around the treated site). It works better if covered with adhesive tape (particularly recommended when the wart is on the foot). Salicylic Acid, 27.5% Wart Remover should not be allowed to contact normal skin surrounding wart.
Salicylic Acid, 27.5% Wart Remover is flammable and should be kept away from fire or flame. Damage to the healthy skin around the wart is a common side effect that can be avoided by taking preventive measures to protect the surrounding skin from the salicylic acid preparation. Burning, tenderness and swelling of the application site are common side effects of treatment with BCA. It works by triggering the immune system.It is primarily reserved for treating warts that do not respond to conventional treatments. Itching, burning, hypopigmentation and blistering are possible side effects of the treatment.

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