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Reuters are reporting: Duct tape no magical cure for warts, study findsMon Nov 6, 2006 5:12 PM ET
Quote:
WASHINGTON (Reuters) - Duct tape does not work any better than doing nothing to cure warts in schoolchildren, Dutch researchers reported on Monday in a study that contradicts a popular theory about an easy way to get rid of the unattractive lumps.
The study of 103 children aged 4 to 12 showed the duct tape worked only slightly better than using a corn pad, a sticky cushion that does not actually touch the wart and which was considered to be a placebo.
"After 6 weeks, the warts of 8 children (16 percent) in the duct tape group and the warts of 3 children (6 percent) in the placebo group had disappeared," the researchers wrote in the Archives of Pediatrics and Adolescent Medicine.
They said this difference was not statistically significant.
In addition, some of the children who wore duct tape reported itching, rashes and other effects, although none of the children who wore corn pads did.
The researchers, led by Dr. Marloes de Haen of Maastricht University, expressed disappointment with their findings.
Warts are caused by a virus in the skin, and often clear up on their own. They can also be frozen off in a treatment called cryotherapy, or burned off chemically using a strong formulation of salicylic acid.
"Considering the serious discomfort of cryotherapy and the awkwardness of applying salicylic acid for a long time, simply applying tape would be a cheap and helpful alternative, especially in children," de Haen's team wrote.
In 2002, Dr. Dean Focht of Madigan Army Medical Center in Tacoma, Washington and colleagues reported in the same journal that using duct tape on warts worked better than cryotherapy.
The idea of using duct tape to treat warts quickly became common wisdom and is advocated widely on the Internet.
The Dutch researchers said that Focht's team did not actually examine their patients to determine if the warts had disappeared, but called them on the telephone to ask.
Efficacy of Duct Tape vs Placebo in the Treatment of Verruca Vulgaris (Warts) in Primary School Children
Marloes de Haen, MD; Marcus G. Spigt, PhD; Caro J. T. van Uden, PhD; Pierre van Neer, MD; Frans J. M. Feron, MD; André Knottnerus, PhD Arch Pediatr Adolesc Med. 2006;160:1121-1125.
Quote:
Objective To determine the efficacy of duct tape compared with placebo in the treatment of verruca vulgaris.
Design and Setting A randomized placebo-controlled trial in 3 primary schools in Maastricht, the Netherlands.
Participants One hundred three children aged 4 to 12 years with verruca vulgaris.
Interventions Duct tape applied to the wart or placebo, a corn pad (protection ring for clavi), applied around the wart for 1 night a week. Both treatments were applied for a period of 6 weeks. Patients were blinded to the hypothesis of the study.
Main Outcome Measurement Complete resolution of the treated wart.
Results After 6 weeks, the wart had disappeared in 16% of the children in the duct tape group compared with 6% in the placebo group (P = .12). The estimated effect of duct tape compared with placebo on diameter reduction of the treated wart was 1.0 mm (P = .02, 95% confidence interval, –1.7 to –0.1). After 6 weeks, in 7 children (21%) in the duct tape group, a surrounding wart had disappeared compared with 9 children (27%) in the placebo group (P = .79). Fifteen percent of the children in the duct tape group reported adverse effects such as erythema, eczema, and wounds compared with 0 in the placebo group (P = .14).
Conclusion In a 6-week trial, duct tape had a modest but nonsignificant effect on wart resolution and diameter reduction when compared with placebo in a cohort of primary school children.
I would be intersted to hear other pod's opinions on whether they have found duct tape as a reasonable therapy. In most cases I have not used it as a first line of treatment. I have however chosen it if the patient is not keen on using a more aggressive treatment (sal acid/liquid nitrogen etc) or in the younger patient who may not cope with the discomfort from liquid nitrogen. I have also used it when other treatment have failed.
I personally have only applied this treatment with 4 patients. The way we found it worked well was to apply duct tape in small squares over the verruca and then firmly fixing this to the skin with zinc oxide tape or similar for 3 days at a time, replacing this and reporting every 2 weeks for debridement. This seemed to have resolve within 2-3 months.
Would be interested in any comments onthe subject. Has anyone found some success? Tricks they use to help with the treatment?
Anecdotally I think duct tape works as I have used it on some patients and even myself(I had a wart on my finger and covered it up with duct tape.It was soon gone).
I had a lady tell me that her son had a 'huge' wart on his foot. They rubbed freshly cut garlic on it and then applied duct tape. Left it on for a few days, and repeated. Each time, some 'wart' came off with the tape. They showed it to me about 3 weeks later. I didn't see it before, but when I did see it, there was no sign of a wart. Not sure if it's due to something in the garlic, the occlusive nature of the duct tape, or the mechanical ripping off of HPV tissue with the tape. Could be a combination of all 3?
Beth.
I have used duct tape as a combination therapy for example after cryo when site has heald, Thuja pills recomended by homeopath/can be bought over counter or vit A and Zinc. Not sure of validation of any of these but results seem to justify the means. Alterativily I have had results with diabetic or patients or others who cannot or do not want to undergo treatment clear nail varnish has had good results. I think stopping the air getting to the skin is the main therory behind this.
Good to have lots of treatments up your sleeve.........
Duct tape works,at least anecdotally.It is said to macerate the wart and hence shrink it.then again,on children,anything really works as most warts do respond to any/all treatment.
Much cut....
"Yet, there are too many studies which have found objective improvements in health from placebos to support the notion that the placebo effect is entirely psychological.
Doctors in one study successfully eliminated warts by painting them with a brightly colored, inert dye and promising patients the warts would be gone when the color wore off. In a study of asthmatics, researchers found that they could produce dilation of the airways by simply telling people they were inhaling a bronchiodilator, even when they weren't. Patients suffering pain after wisdom-tooth extraction got just as much relief from a fake application of ultrasound as from a real one, so long as both patient and therapist thought the machine was on. Fifty-two percent of the colitis patients treated with placebo in 11 different trials reported feeling better -- and 50 percent of the inflamed intestines actually looked better when assessed with a sigmoidoscope ("The Placebo Prescription" by Margaret Talbot, New York Times Magazine, January 9, 2000).*"
The studies above also illustrate the necessity for many more Randomly Controlled Trials. I, for one, did not realise that the Focht team did not examine their patients during follow-up, and this study is widely quoted!
Bugger...would love the research to have said otherwise. I find it works just as well as my "Wart Wand", which actually is quite well. Though do find the younger the better with that approach though.
Seriously though, I think warts are the most misunderstood things and we will never know the real 100% proven cure.
Over the years have had sucess with the wart wand, wart fairy, duct tape, Thuja tbs, banana peel, morning spit, nail polish, Duofilm, cryotherapy, posofilin......the list is endless. The mind is a powerful thing and I still think that until a healthy child/adult 100% believes you can fix them, you will have no chance.
i was recommended this tecknique by one of the leading podiatric dermatologists in the UK and have been treating vps for the last 2 years with this theory. What i have found is fochts research time frame is unrealistic and success rates maybe not be quite as high as stated, but i would like to say i have a good success rate (70-75%) which is higher than most other treatments available. Whether its placebo or not my main concern is within 1-2 weeks a painful vp no longer hurts and normally the vp has gone within 2-4 months. At the end of the day normally the patient has tried every other treatment available over the counter and gps etc without success.
The wart fairy is a close cousin to the tooth fairy. She visits each night while you are sleeping and makes your wart smaller and smaller. When the wart is gone, she will leave a present as she is then very grateful that she doesn't have to visit any more as making warts smaller is very hard work.
On last sighting she was very ugly with purple wings and had a very large lump on her nose which may or may not have been a wart......yes I know, I work with waaaay too many young children with great imaginations but trust me, that fairy does good work.
Duct-tape fans stick with remedy despite wart study
FortWayne.com are reporting: Duct-tape fans stick with remedy despite wart study
Quote:
Warts might seem trivial, but the stubborn little virus has long stymied the medical establishment. Nothing reliably kills the ugly growths, though dermatologists have tried liquid nitrogen, anti-ulcer and chemotherapy drugs, electrical currents, acid solutions and surgical knives.
Nothing, of course, except duct tape.
Sticky duct tape, the wondrous all-purpose fixer, is used in everything from auto and spacecraft repair to fashion. Though largely considered one of those wacky "folk remedies," duct tape stuck it to liquid nitrogen in 2002, when researchers found it outperformed the conventional treatment.
And even though the study quality was later criticized - and many common warts disappear within a year or two without treatment - self-respecting dermatologists continued recommending it as a safe, painless treatment, especially for children.
Now, though, duct tape appears to be coming unglued. When it comes to treating warts, duct tape actually is no better than a placebo, according to a study in the Archives of Pediatric and Adolescent Medicine. In addition, 15 percent of the duct-taped children in the study reported adverse effects, such as redness of the skin, eczema and wounds, compared with none in the placebo group.
Duct-tape loyalists took the news hard. In fact, Carolyn Perek of Brookfield, Ill., who used it to banish several unsightly warts on the ball of her foot four years ago, said she still would recommend it. "I'd cover the area with tape and leave it on for several days until it started to peel off," said Perek, a 27-year-old corporate recruiter. "Then I'd wash the area and put on a new piece of tape."
After eight weeks, her warts were gone and haven't been back since. She had no blistering or skin irritation. "It's a safe, pain-free and cheap method of wart removal," she said.
Warts, the most common skin disease, are small growths caused by the human papilloma viruses (HPV). The highly contagious common wart usually is found on the hands, fingers, elbows, forearms, knees, face and the skin around the nails. It can be spread if it's picked, trimmed, bitten or touched.
Plantar warts, which don't tend to spread, pop up on the soles of the feet and the underside of toes. They resemble calluses, except they can be tender when touched and bleed if the surface is trimmed.
Some believe duct tape works because the adhesive is an effective irritant. If you annoy a wart enough, it will go away. Andrea Nugent of Vernon Hills, Ill., who successfully used duct tape to cure her daughter's 20-some warts, said her dermatologist believes the glue in duct tape prompts the immune system to produce something to kill the virus.
And Oak Lawn, Ill., podiatrist John Grady, who often fields questions about duct tape, said it's the placebo effect. "A small percentage spontaneously resolve, and people think it's what they put on the wart," said Grady, a fellow of the American College of Foot and Ankle Surgeons. "But it would go away anyway. The truth is, placebos work well in wart treatment."
This might explain the other unorthodox remedies, such as taping a small piece of banana peel over a wart. Others say crushing a garlic clove directly onto the growth, then covering it with an adhesive bandage for 24 hours will do the trick. Blisters are supposed to form, and the warts should fall off in a week.
Some people have had luck with immunotherapy and injections of the candida allergen.
"The list of things to treat warts is about a mile long, which means nothing on the list works that well," said Charles Crutchfield, an associate professor of dermatology at the University of Minnesota Medical School. "Duct tape works sometimes, but so does hypnosis and so does doing nothing (sometimes). Duct tape works best to treat warts when it is used to hold other treatments in place!"
Many years ago I lived in a city divided by sectarianism. As as podiatry student I working in a clinic for school kids where verrucae were common. My tutor ran a pilot study where he compared clinical outcomes. Bare in mind there was no need for ethical approval at the time.
He took three matched groups. The control were given Formaldehyde solution (6% ?) to paint daily on their plantar wart, the second group made up of Catholic children were presented with a bottle of tap water and told it was blessed Holy water and to apply daily as a paint. The third group were of the Protestant faith and they too were told to apply the Holy water to their warts.
The controlk were made up of the kids who refused to be treated with holy water and represented a conglomerate of faith.
The clear up rates were compared and from memory the Catholic children had a more favourable outcome than the copntrol; and the Protestants a much less successful outcome compared to the control.
I took from this experience there was a psycho-social component to treating warts. In more recent years I have made a fairly extensive study of superstition and old remedies for treating warts. Use of the onion family as a dressing is pretty common and I also believe in the wart fairy.
For decades now I have preferred a herbal approach and used the leaf of kalanchoe blosfidiana as a wart treatment. Like duct tape one of the action of the kalanchoe dressing is hydration of the epidermis. I believe kalanchoe is a natural salicylate and causes water to be trapped in the side salt linkages of the keratin molecule, whereas an occlusive dressing such as duct tape would increase local hydration though reduction of evaporation from the covcered skin surface. Increased hydrate encourages desquimation which may influence the virus site or the increased bulk may form an epidermal blister displacing the infected component. Either way the approach may give a credible alternative to wart treatment.
In any event I will be very interested to see if the availability of antiviral innoculation as a prevention for cervical cancer will influence the incidence of plantar warts. As a further precaution I would think greater awareness of treating verruce in adolescent males may be worth while too.
It's interesting to hear about all the treatment modalities used to eradicate verrucae. I have used all of the above mentioned and many, many more besides, but still struggle with the blighters, despite treating an average of 10 a day over the past 35 years.
I still question why we, as a profession, don't do more to try and prevent them from occurring in the first place?
This is my first posting - I have chosen to examine the literature on Duct tape occlusion therapy for my 3rd year literature review. I am struggling to find any research other that that by Focht et al, DeHaen et al and Wenner. If anyone can direct me to any more research of this nature, including general tape or occlusion for the treatment of plantar warts, I would be most grateful! It is interesting that despite the lack of credible evidence to support the use of this tape so far, there are still many anecdotal success stories!
you might want to contact ivan bristow at southampton university as he is the leading podiatric dermatologist in the uk and he was the person who recommended this to me.
chris
The Following User Says Thank You to slaveboy For This Useful Post:
Have used monochloroethanoic acid crystals in 70% sal acid ointment in the past with much success. Now find it difficult to see patients within 2-3 days for review so no longer used - don't really want any unecessary appearances in court!
Russ.
Have used monochloroethanoic acid crystals in 70% sal acid ointment in the past with much success.
Russ.
I too have used this tx with great success if they can handle the pain that it can cause with some people. My experience is that 40 year old bikies covered in tatoos can not handle the pain aswell as the little 6 year old girls who come in.
Nail polish, anything that occludes the area have all worked with varying success for me in the past.
But I strongly believe that immune function plays a more pivotal role than our tx (don't tell my pt though).
Multi vitamins, balanced diet with lots of broccoli, regular exercise, a good sleeping pattern, and a relaxing glass of red wine after work for all those adults seem to vastly improve my tx outcomes.
you might want to contact ivan bristow at southampton university as he is the leading podiatric dermatologist in the uk and he was the person who recommended this to me.
chris
Ivan recommended this to us also....varying degrees of success and i have tried monochloracetic acid xystals in sal acid too but this is painful as it causes the tissues to breakdown and ulcerate so you then treating an ulcer. Doesnt take long to heal but it is an effective way to get rid of the VP.
Duct tape does not work for VP's
for all those adults seem to vastly improve my tx outcomes.
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