Salicylic acid with lactic acid

How it works

Both components are keratolytic: salicylic acid softens and desquamates hyperkeratotic skin by dissolving intercellular cement, while lactic acid (an alpha-hydroxy acid) further promotes shedding of the affected keratinocytes, gradually destroying the wart.

Prescribing in practice

• Apply only to the wart or verruca and protect surrounding healthy skin, as the keratolytic action can cause irritation, burning and ulceration of normal skin.
• Avoid use on the face, anogenital region and on broken or inflamed skin, and do not use on warts in patients with diabetes or peripheral vascular disease without specialist advice.
• The flammable collodion or paint base should be kept away from naked flames and allowed to dry before dressing.

Monitoring

No laboratory monitoring is required; review the treated lesion periodically for excessive irritation and response, abrading the softened keratin between applications.

Counselling the patient

• Soak the area in warm water and gently file down the softened skin before each application, applying the liquid only to the wart.
• Treatment often takes several weeks of regular use; persist but stop and seek advice if the skin becomes very sore or broken.
• Keep the product away from the eyes, mouth and flames as it is flammable.

Evidence & guidelines

Topical salicylic acid preparations are an established first-line self-care treatment for cutaneous warts, supported by Cochrane evidence showing modest benefit over placebo.