Duct tape beat out ten other wart treatments for not only cost but effectiveness, so why isn’t it standard practice?
Can You Really Remove Warts with Duct Tape?
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
One of the “unusual, innovative, and long-forgotten remedies” noted in this dermatology journal was “the use of duct tape” to cure warts—finally put to the test. There’s all sorts of conventional therapies, from acid to cryosurgery to lasers, but most of these are expensive, or painful, or both. Whereas the simple application of duct tape is neither—and may even be “more effective” than trying to freeze the warts off.
Some doctors lauded the study, noting they had been using duct tape for decades as a painless yet effective treatment, as opposed to surgery and other destructive therapies. The only downside being your patients may think you’re off your rocker, but hey, when it works, they appreciate your wise choice to minimize discomfort.
Other doctors were not so amused. Here they are spending money on all this fancy equipment and then along comes duct tape? Studies like that “could damage the reputation of cryosurgery,” complaining that the 10-second application of liquid nitrogen they used in the study was too short, so it was an unfair comparison. And evidently you really have to get in there and freeze until you get a blistering reaction. And yes, it hurts but too bad, even making light of the poor child who vomited out of fear of the pain prior to each freezing by making some joke about it.
Did they have a point, though, about the 10 seconds? Well, in the duct tape versus cryotherapy trial, those 10-second cryotherapy treatments worked 60 percent of the time, which is actually better than the results of most cryotherapy studies that only seemed to cure about 50 percent. In fact, the typical cryotherapy for warts works so poorly that statistically it didn’t even beat out placebo. So, all that pain may be for nothing, though aggressive cryotherapy does seem to work better.
See, what they should have done, wrote another doctor in response to the duct tape trial, is take a scalpel to it, and then really blister it up, and then you go back a week later and try to cut and crater it out, and then maybe go back a third time, bragging that they can get closer to a 90 percent cure rate. Yeah, but at what cost?
In the duct tape trial, one patient “lost his study wart in a trampoline toe-amputation accident.” Hey, there’s a treatment that’s 100 percent effective—amputation! But, at what cost? Eighty-five percent of the duct tape patients were cured with no pain or tissue damage, whereas aggressive cryotherapy may require lidocaine injection nerve blocks to “take the cry out of cryotherapy,” and can cause permanent tissue damage. You can end up with the big necrotic frostbite lesions. I mean, in one sense, tissue damage is the whole point of freezing warts, but you can end up causing these deep burns or end up rupturing tendons, which can cause permanent disability, or cause extensive scarring in rare cases. Just the “psychological stress” of having to keep going back for this painful procedure may ironically impair our ability to fight off the wart viruses in the first place.
And so, “even if the effectiveness of duct tape…is shown to be merely equivalent to that of cryotherapy,” it would be better; and it was shown to be even more effective, in fact maybe most effective. Compared to 10 other wart treatments, duct tape beat out them all in terms of effectiveness, and also in terms of cost—cheaper than all but the DN option (which stands for “do nothing.”) Compared to the most cost-effective prescription treatments available, OTC duct tape, meaning over-the-counter duct tape, is 10 times cheaper. “It is an unusual and welcome event in health care when a common ailment is proven equally amenable to an inexpensive, tolerable, and safe alternative therapy.”
But wait. If you look at the latest Cochrane review, which is like the gold-standard of evidence-based reviews, they acknowledge that cryotherapy is less convenient, more painful, more expensive. But, while in the earlier review they did get excited about the effectiveness of duct tape, in two subsequent studies, duct tape seemed to totally flop. So, should we give up on duct tape for warts, or is there another side of the story? We’ll find out in the thrilling conclusion, next.
Please consider volunteering to help out on the site.
- Abramovits W. Cryotherapy vs Duct Tape. Arch Pediatr Adolesc Med. 2003;157(5):491.
- Yates VM, Scott MM, Carter ED. Rupture of tendon after cryotherapy for hand wart. BMJ. 1988;297(6656):1106.
- Mcgeorge D. Rupture of tendons after cryotherapy for hand warts. BMJ. 1988;297(6661):1475.
- Wagner AM, Suresh S. Peripheral nerve blocks for warts: taking the cry out of cryotherapy and laser. Pediatr Dermatol. 1998;15(3):238-41.
- Kwok CS, Gibbs S, Bennett C, Holland R, Abbott R. Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2012;(9):CD001781.
- Kwok CS, Holland R, Gibbs S. Efficacy of topical treatments for cutaneous warts: a meta-analysis and pooled analysis of randomized controlled trials. Br J Dermatol. 2011;165(2):233-46.
- Focht DR, Spicer C, Fairchok MP. The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart). Arch Pediatr Adolesc Med. 2002;156(10):971-4.
- Allen JJ, Dveirin K. Mechanism of wart disappearance: an alternative hypothesis. Arch Pediatr Adolesc Med. 2003;157(5):490.
- Engel JJ. Effective wart removal. Arch Pediatr Adolesc Med. 2003;157(5):490-1.
- Rudolph RI. Warts and duct tape--a good combo!. Arch Pediatr Adolesc Med. 2003;157(5):489-90.
- Thomas KS, Keogh-brown MR, Chalmers JR, et al. Effectiveness and cost-effectiveness of salicylic acid and cryotherapy for cutaneous warts. An economic decision model. Health Technol Assess. 2006;10(25):iii, ix-87.
- Stone SP. Unusual, innovative, and long-forgotten remedies. Dermatol Clin. 2000;18(2):323-38, xi.
- Keogh-brown MR, Fordham RJ, Thomas KS, et al. To freeze or not to freeze: a cost-effectiveness analysis of wart treatment. Br J Dermatol. 2007;156(4):687-92.
- Sarwar U, Tickunas T. Frostbite developing secondary to cryotherapy for viral warts. Br J Gen Pract. 2013;63(610):239-40.
- Buccolo LS, Moore TK. Duct tape occlusion for common warts: is effectiveness overestimated?. Arch Pediatr Adolesc Med. 2003;157(5):491.
- Lynch TJ. Duct tape removes warts. J Fam Pract. 2003;52(2):111-2.
Image credit: kerttu via pixabay. Image has been modified.
Motion graphics by Avocado Video
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
One of the “unusual, innovative, and long-forgotten remedies” noted in this dermatology journal was “the use of duct tape” to cure warts—finally put to the test. There’s all sorts of conventional therapies, from acid to cryosurgery to lasers, but most of these are expensive, or painful, or both. Whereas the simple application of duct tape is neither—and may even be “more effective” than trying to freeze the warts off.
Some doctors lauded the study, noting they had been using duct tape for decades as a painless yet effective treatment, as opposed to surgery and other destructive therapies. The only downside being your patients may think you’re off your rocker, but hey, when it works, they appreciate your wise choice to minimize discomfort.
Other doctors were not so amused. Here they are spending money on all this fancy equipment and then along comes duct tape? Studies like that “could damage the reputation of cryosurgery,” complaining that the 10-second application of liquid nitrogen they used in the study was too short, so it was an unfair comparison. And evidently you really have to get in there and freeze until you get a blistering reaction. And yes, it hurts but too bad, even making light of the poor child who vomited out of fear of the pain prior to each freezing by making some joke about it.
Did they have a point, though, about the 10 seconds? Well, in the duct tape versus cryotherapy trial, those 10-second cryotherapy treatments worked 60 percent of the time, which is actually better than the results of most cryotherapy studies that only seemed to cure about 50 percent. In fact, the typical cryotherapy for warts works so poorly that statistically it didn’t even beat out placebo. So, all that pain may be for nothing, though aggressive cryotherapy does seem to work better.
See, what they should have done, wrote another doctor in response to the duct tape trial, is take a scalpel to it, and then really blister it up, and then you go back a week later and try to cut and crater it out, and then maybe go back a third time, bragging that they can get closer to a 90 percent cure rate. Yeah, but at what cost?
In the duct tape trial, one patient “lost his study wart in a trampoline toe-amputation accident.” Hey, there’s a treatment that’s 100 percent effective—amputation! But, at what cost? Eighty-five percent of the duct tape patients were cured with no pain or tissue damage, whereas aggressive cryotherapy may require lidocaine injection nerve blocks to “take the cry out of cryotherapy,” and can cause permanent tissue damage. You can end up with the big necrotic frostbite lesions. I mean, in one sense, tissue damage is the whole point of freezing warts, but you can end up causing these deep burns or end up rupturing tendons, which can cause permanent disability, or cause extensive scarring in rare cases. Just the “psychological stress” of having to keep going back for this painful procedure may ironically impair our ability to fight off the wart viruses in the first place.
And so, “even if the effectiveness of duct tape…is shown to be merely equivalent to that of cryotherapy,” it would be better; and it was shown to be even more effective, in fact maybe most effective. Compared to 10 other wart treatments, duct tape beat out them all in terms of effectiveness, and also in terms of cost—cheaper than all but the DN option (which stands for “do nothing.”) Compared to the most cost-effective prescription treatments available, OTC duct tape, meaning over-the-counter duct tape, is 10 times cheaper. “It is an unusual and welcome event in health care when a common ailment is proven equally amenable to an inexpensive, tolerable, and safe alternative therapy.”
But wait. If you look at the latest Cochrane review, which is like the gold-standard of evidence-based reviews, they acknowledge that cryotherapy is less convenient, more painful, more expensive. But, while in the earlier review they did get excited about the effectiveness of duct tape, in two subsequent studies, duct tape seemed to totally flop. So, should we give up on duct tape for warts, or is there another side of the story? We’ll find out in the thrilling conclusion, next.
Please consider volunteering to help out on the site.
- Abramovits W. Cryotherapy vs Duct Tape. Arch Pediatr Adolesc Med. 2003;157(5):491.
- Yates VM, Scott MM, Carter ED. Rupture of tendon after cryotherapy for hand wart. BMJ. 1988;297(6656):1106.
- Mcgeorge D. Rupture of tendons after cryotherapy for hand warts. BMJ. 1988;297(6661):1475.
- Wagner AM, Suresh S. Peripheral nerve blocks for warts: taking the cry out of cryotherapy and laser. Pediatr Dermatol. 1998;15(3):238-41.
- Kwok CS, Gibbs S, Bennett C, Holland R, Abbott R. Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2012;(9):CD001781.
- Kwok CS, Holland R, Gibbs S. Efficacy of topical treatments for cutaneous warts: a meta-analysis and pooled analysis of randomized controlled trials. Br J Dermatol. 2011;165(2):233-46.
- Focht DR, Spicer C, Fairchok MP. The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart). Arch Pediatr Adolesc Med. 2002;156(10):971-4.
- Allen JJ, Dveirin K. Mechanism of wart disappearance: an alternative hypothesis. Arch Pediatr Adolesc Med. 2003;157(5):490.
- Engel JJ. Effective wart removal. Arch Pediatr Adolesc Med. 2003;157(5):490-1.
- Rudolph RI. Warts and duct tape--a good combo!. Arch Pediatr Adolesc Med. 2003;157(5):489-90.
- Thomas KS, Keogh-brown MR, Chalmers JR, et al. Effectiveness and cost-effectiveness of salicylic acid and cryotherapy for cutaneous warts. An economic decision model. Health Technol Assess. 2006;10(25):iii, ix-87.
- Stone SP. Unusual, innovative, and long-forgotten remedies. Dermatol Clin. 2000;18(2):323-38, xi.
- Keogh-brown MR, Fordham RJ, Thomas KS, et al. To freeze or not to freeze: a cost-effectiveness analysis of wart treatment. Br J Dermatol. 2007;156(4):687-92.
- Sarwar U, Tickunas T. Frostbite developing secondary to cryotherapy for viral warts. Br J Gen Pract. 2013;63(610):239-40.
- Buccolo LS, Moore TK. Duct tape occlusion for common warts: is effectiveness overestimated?. Arch Pediatr Adolesc Med. 2003;157(5):491.
- Lynch TJ. Duct tape removes warts. J Fam Pract. 2003;52(2):111-2.
Image credit: kerttu via pixabay. Image has been modified.
Motion graphics by Avocado Video
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Can You Really Remove Warts with Duct Tape?
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Content URLDoctor's Note
Sorry to tease everyone with the cliff-hanger! I just wanted to emphasize how important the stakes are. If you missed the first video, check out Duct Tape & Wart Removal. Stay tuned for the conclusion in Which Type of Duct Tape Is Best for Wart Removal?
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