Warts (wart) are skin surface growths caused by viruses, first documented in the Neijing. They are more common in children and young adults, with an incubation period of 1 to 3 months, and can spread by self-infection. The virus resides in the stratum spinosum cells, promoting cell proliferation and forming wart-like lesions. Common types include common warts, flat warts, molluscum contagiosum, and condylomata acuminata. In traditional Chinese medicine, they are referred to as "youmu," "shuru," "kujinjian," "qianrichuang," "jiechuang," or "huiqichuang," commonly known as "huzi" or "jiantourou." So, what are the treatment methods for warts?
Treatment Measures
1. Internal Treatments:
1. Traditional Chinese Medicine (TCM): The treatment focuses on clearing heat, detoxifying, nourishing blood, promoting blood circulation, and softening hard nodules. The prescription could include treatments like Zhiyou Tang. Adjustments may be made based on symptoms, such as adding Smilax glabra, Coix seed, Portulaca oleracea, or Oldenlandia diffusa for severe wind-heat dampness; pearl powder, white peony root, raw oyster shell, and red beans for liver deficiency and blood dryness; or modified Gui Shao Dihuang Tang with Ligusticum wallichii and Achyranthes bidentata for kidney yin deficiency and liver blood insufficiency.
2. Western Medicine: One of the following methods may be chosen:
- Virolex 0.1g, taken orally three times daily.
- Urotropin 0.3g–0.6g, taken orally three times daily.
- 10% Bismuth subsalicylate oil 2ml, intramuscular injection.
- 1% Potassium antimony tartrate 3–5ml, intravenous injection, twice weekly.
- Interferon 2–5ml, intramuscular injection, once weekly.
2. External Treatments:
The following methods may be used with caution to protect healthy skin:
1. Wanlingdan Caustic Agent: Composed of minium (1.5g), salicylic acid (25g), procaine (1g), sugar (1.5g), and 95% alcohol, mixed into a paste and applied to the wart.
2. Crushed Brucea Javanica Seeds: Applied to the affected area daily, typically curing within 2–3 uses. Alternatively, Brucea oil (prepared by soaking Brucea seeds in peanut oil for half a month) can be applied.
3. Equal Parts Sodium Carbonate and Quicklime: Mixed with 2% procaine solution into a paste and applied to the wart. Stop application when a burning sensation occurs.
4. Compound Salicylic Acid Collodion: A mixture of salicylic acid (30g), lactic acid (30g), and elastic cotton (100g). Soak the affected area in warm water for 5 minutes, dry, and apply directly to the wart once daily. This is an effective keratolytic agent but is flammable; handle with care.
5. Historical Method from Waike Qixuan: "Rub the wart with chicken gizzard skin, or burn the first emerging wart with moxa to make the rest fall off."
3. Injection Therapy:
1. 2.5% Iodine Tincture (0.1–0.2ml) or 18% Saline Solution (with 2% procaine, 0.5–1ml): Injected into the base of the wart, causing it to dry and fall off within a week.
2. Interferon (0.5–1ml): Injected into the wart weekly or sprayed locally.
4. Surgical Therapy:
Options include cryotherapy, electrocautery, laser treatment, or surgical excision. Care must be taken to preserve healthy skin or islands of skin to prevent scarring or anal stenosis.
Efficacy Criteria:
- Cured: Warts and symptoms completely disappear, skin color normalizes, no new warts appear.
- Significant Improvement: Most warts (>50%) disappear, no new warts appear.
- Improved: Some warts fall off, no new warts appear.
- Ineffective: Warts remain unchanged or worsen, new warts appear within 3 months.
Specific Treatment Types:
1. Wind-Heat Type: Treatment focuses on clearing heat, detoxifying, and dispelling wind and dampness. Prescription includes Isatis root, Smilax glabra, Coix seed, Rehmannia root, and Equisetum hyemale. Adjustments are made for lung heat, liver qi stagnation, or spleen-stomach deficiency.
- Efficacy: 93.9% effectiveness in 114 cases.
- Common Formulas: Modified Universal Benefit Detoxification Decoction.
2. Blood Stasis Type: Treatment involves dispersing liver qi, resolving stasis, and detoxifying. Prescription includes peach kernel, safflower, Chinese angelica, red peony root, Rehmannia root, and Ligusticum wallichii.
- Efficacy: 94.68% effectiveness in 188 cases.
- Common Formulas: Modified Peach Kernel and Safflower Four Ingredients Decoction or Rhubarb and Ground Beetle Pills.
3. Liver Hyperactivity Type: Treatment focuses on clearing heat, cooling blood, and calming the liver to resolve nodules. Prescription includes magnetite, hematite, pearl powder, Rehmannia root, and lithospermum root.
- Efficacy: 87.27% effectiveness in 55 cases.
- Common Formulas: Modified Liver-Calming and Blood-Activating Decoction or Liver-Sedating and Wind-Stopping Decoction.
Specialized Formulas:
1. Xiaoyou Yin: Contains Coix seed, Atractylodes, Hyacinth bean, Isatis root, and Lithospermum root.
- Efficacy: 97.8% effectiveness in 135 cases.
2. Modified Universal Benefit Detoxification Decoction: Contains Isatis root, Coix seed, Bupleurum root, Scutellaria root, Forsythia, and peach kernel.
- Efficacy: 100% effectiveness in 185 cases.
3. Ma Xing Yi Gan Tang: Contains ephedra, apricot kernel, Coix seed, and Isatis root.
- Efficacy: 98.75% effectiveness in 80 cases.
4. Quyou Tang: Contains cinnamon twig, Schizonepeta, peony root, and moutan bark.
- Efficacy: 100% effectiveness in 29 cases.
5. Zhiyouling Liniment: Contains Cyperus rotundus, Dioscorea bulbifera, and Solanum nigrum.
- Efficacy: 86.7%–93.7% effectiveness in 188 cases.
Other Therapies:
1. Acupuncture:
- Body Acupuncture: Targeting the affected area. Efficacy: 95.4% in 153 cases.
- Point Injection: Using Lugol's solution or interferon. Efficacy: 92.5% in 40 cases.
- Moxibustion: Applied to the wart. Efficacy: 100% in over 100 cases.
- Ear Acupuncture: Targeting specific ear points. Efficacy: 87.3% in 173 cases.
2. Simple Remedies:
- Crystal Paste: Made with glutinous rice and potassium hydroxide. Efficacy: 100% in 800 cases.
- Vinegar Saussurea Liquid: Made with Equisetum hyemale and Cyperus rotundus. Efficacy: 84.4% in 32 cases.
- Brucea Javanica Seeds: Applied to the wart. Efficacy: 100% in 110 cases.
- Calystegia Sepium Juice: Applied topically. Efficacy: 92.5% in 40 cases.
Additional Measures:
Cryotherapy, electrocautery, and laser treatment are suitable for a small number of common warts and plantar warts. Surgical excision can be used for common warts and condylomata acuminata, although recurrence is common post-surgery.
