What over-the-counter (OTC) treatments are available for common warts?

OTC Wart Remover for Common Warts

For common cutaneous warts, use salicylic acid 15-26% as your first-line over-the-counter treatment, applied daily after paring down the wart, continuing for 3-4 months. 1

First-Line OTC Treatment: Salicylic Acid

• Salicylic acid is the only OTC treatment with strong evidence-based efficacy and receives an "A" strength recommendation from the British Association of Dermatologists for hand warts. 1

• The mechanism works through promoting exfoliation and stimulating host immunity against the virus. 1

• Application technique is critical: Debride or pare down the wart before each application to remove the thick keratin layer that blocks penetration, then apply 15-26% salicylic acid preparations daily. 1

• Continue treatment for 3-4 months before considering it a failure. 1

• Pooled data from five placebo-controlled trials showed a cure rate of 73% with salicylic acid compared to 48% with placebo (risk ratio 1.60,95% CI 1.16-2.23). 2

When to Escalate Beyond OTC Options

• If salicylic acid fails after 3 months of proper use, switch to provider-administered cryotherapy with liquid nitrogen (not available OTC). 1

• Change treatment modality if no substantial improvement occurs after 3 months of daily salicylic acid use. 1

Location-Specific Considerations

• For hand and periungual warts: Salicylic acid 15-26% remains first-line OTC treatment. 1, 3

• For facial warts: Avoid salicylic acid due to risk of irritation and scarring on facial skin; these require provider-administered treatments like cryotherapy or curettage. 4

• For plantar warts: Higher concentrations (up to 70% salicylic acid) may be used, though these typically require provider application. 5

Critical Pitfalls to Avoid

• Do not damage surrounding healthy skin during paring or treatment, as this can spread the viral infection through autoinoculation. 1

• Avoid overtreatment, as scarring in the form of persistent hypopigmentation or hyperpigmentation is common with ablative modalities. 1

• Do not expect immediate results—placebo cure rates average 27% after 15 weeks, so patience is essential. 2

Alternative OTC Considerations (Weaker Evidence)

• Topical vitamin A (25,000 IU from fish liver oil) showed success in case reports for recalcitrant warts, though this lacks controlled trial evidence. 6

• Duct tape occlusion has been studied but showed no significant difference compared to cryotherapy in one trial. 2