Duct tape for viral warts

The British Skin Foundation note "Although there is conflicting evidence regarding the effectiveness of duct tape in the treatment of cutaneous warts, it might still be well worth trying, especially in children" (1).

Evidence for use of duct tape:

• a study done in 2002 concluded that the occlusion of warts with duct tape was significantly more effective than treatment with cryotherapy (85% of those treated with duct tape cleared compared to 60% clearance with cryotherapy) (2).
• adverse events associated with duct tape use are minimal and include skin irritation from the glue. Tolerability is also better with duct tape than with cryotherapy. In one randomized controlled trial, 15% of those in the duct tape group stopped treatment early either because of a skin reaction to the treatment or because the tape did not stick well (3)
  • in this study duct tape had a modest but nonsignificant effect on wart resolution and diameter reduction when compared with placebo in a cohort of primary school children.

Evidence against use of duct tape:

• a systematic review (4) stated two trials of clear duct tape demonstrated no advantage over placebo - however the trial in children did show a non-significant improvement when compared with placebo (3); in adults there was no evidence of benefit (5).

Pragmatic approach:

• a review concluded that (6) :
  • with the clear pathway for spontaneous resolution of warts within 1 to 2 years, it is acceptable to recommend no intervention. However, if parents or children ask to apply “something,” one can recommend either over-the-counter salicylic acid patches or duct tape. When using duct tape for warts, apply a small piece of duct tape directly to the wart once every 4 to 7 days; then remove the tape, clean the area with soap and water, and remove the dead skin using an emery board. Apply another piece of tape 12 hours later. Repeat this cycle for 4 to 6 weeks

Advice to patients if using duct tape in the treatment of verrucas:

Duct Tape is a strong waterproof sticky tape used in the building trade. It is not available on prescription but can be bought easily from most DIY shops and supermarkets.

• Cut a piece of Duct Tape as close to the size of the wart as possible and place this over the wart. Leave in place for 6 days. If it falls off, replace it with a new piece as soon as possible
  
  
• at the end of 6 days, remove the tape and soak the area in warm water and gently rub the wart with a pumice stone or emery board to remove any dead white skin
  
  
• leave overnight without any tape then start the 6 day regime with duct tape again the next day
  
  
• repeat this 7 day cycle for 2 months or until the wart goes, whichever comes first

Reference:

• British Skin Foundation.Plantar Warts (Verrucas)

(Accessed 7/3/2020)

• Focht DR, Spicer C, Farchok M P. The efficacy of duct tape versus cryotherapy in the treatment of verruca vulgaris (the common wart). Arch Pediatr Med 2002; Vol 156, Pg 971-974.
• De Haen M et al. Efficacy of duct tape vs placebo in the treatment of verruca vulgaris (warts) in primary school children. Arch Pediatr Adolesc Med. 2006;160(11):1121–5.
• Kwok CS et al. Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD001781
• Wenner R et al. Duct tape for the treatment of common warts in adults: a double-blind randomized controlled trial.

Arch Dermatol 2007 Mar;143(3):309-13.

• Goldman RN. Duct tape for warts in children Should nature take its course?

Can Fam Physician 2019 May; 65(5): 337–338.