Resistant Plane Warts Treated by 40% Salicylic Acid and 16% Lactic Acid Combination on the Face

Abstract

Human papillomaviruses (HPV) cause warts, which are the benign epithelial proliferation of the mucous membrane and skin. HPV-3 and HPV-10 commonly cause plane warts. Multiple treatment options must be used as no specific treatment option is available. We have a lot of limitations for the face as treatment can cause permanent scarring on the face. We report a case of 41 years immunocompetent male presenting with many plane warts on the face who was successfully treated with topical application of 40% Salicylic acid cream and 16% lactic acid cream made up of 44% of bees wax on lesions after a failure of many other treatment options, a) Topical zinc oxide twice per day for 3 months, b) Topical 5% salicylic acid dispensing cream made in 95% bees wax, c) Topical 5% fluorouracil cream, d) Topical imiquimod cream, e) Topical retinoids cream only at night for one month, f) Oral Isotretinoin 20mg twice per day for 2 months, and 3 sessions of cryotherapy. The patient's last treatment was oral isotretinoin 20 mg twice per day for the last 2 months. In general, doctors avoid using more than 5% salicylic acid, but after a detailed discussion with the patient, we decided to try this combination and succeeded.