Salicylic acid with rhubarb extract

How it works

Salicylic acid provides the principal keratolytic action by softening and dissolving hyperkeratotic skin, while the rhubarb extract contributes an astringent, staining effect; the combined action gradually erodes the wart tissue.

Prescribing in practice

• Apply only to the lesion and protect surrounding healthy skin, as the salicylic acid can cause chemical irritation and damage to normal skin.
• Avoid application to the face, anogenital area and broken skin, and avoid use on warts in patients with diabetes or impaired peripheral circulation.
• The preparation stains skin and may stain clothing, so apply carefully and allow to dry.

Monitoring

No laboratory monitoring is needed; inspect the treated area periodically for irritation and treatment response.

Counselling the patient

• Apply the paint accurately to the wart only and avoid the surrounding skin.
• Expect temporary staining of the treated skin; persist with regular application over several weeks.
• Stop and seek advice if the skin becomes sore, broken or inflamed.

Evidence & guidelines

Topical salicylic acid is the evidence-based active in such wart paints, with the additional botanical component being a traditional formulation adjunct.