# Viral warts (verruca vulgaris & plantar warts)

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: BAD Guidelines for Cutaneous Warts 2014 · Salactol Collodion (salicylic acid 16.7% + lactic acid 16.7%) SmPC sections 4.2-4.3 (eMC product 3766)
- Verified date: 2026-08

## Verified against

- Salactol Collodion (salicylic acid 16.7% + lactic acid 16.7%) SmPC sections 4.2-4.3 (eMC product 3766)

## Treatment metadata

- Salicylic acid — topical

## Complete treatment card

```text
VIRAL WARTS (VERRUCA VULGARIS & PLANTAR WARTS)
Sources: BAD Guidelines for Cutaneous Warts 2014 · Salactol Collodion (salicylic acid 16.7% + lactic
         acid 16.7%) SmPC sections 4.2-4.3 (eMC product 3766)
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (4)
    - Most warts cause no symptoms at all, though they are unsightly
    - A few cause pain in the spot itself
    - Plantar warts hurt from pressure and friction, and can bleed
    - A big plantar wart can interfere with walking and with wearing shoes
  SIGNS - what you find (9)
    - The common wart is a raised growth with an irregular outline and surface
    - Size runs from 1 mm up to several centimetres
    - Most common warts sit on the arms and legs
    - Round the lips and eyelids they may be thin and elongated
    - On the sole they can be mistaken for a callus, but run deep and hurt on pressing
    - Flat warts are fleshy, 1-7 mm across, and can number in the hundreds
    - Butcher warts occur in people handling raw meat, and are large with a cauliflower surface
    - In the mouth they appear as small whitish papules of 1-5 mm, arranged in clusters  [papules]
    - Cystic warts sit on weight-bearing surfaces such as the sole and look smooth
  TESTS (7)
    - Diagnosis is normally clinical, from the examination and the appearance
    - Immunohistochemistry for HPV proteins confirms virus but has poor sensitivity
    - Southern blot for viral DNA is more sensitive, and specific for the HPV type
    - PCR amplifies the viral DNA for testing
    - HPV turns up in younger lesions but is not always present in older ones
    - Biopsy if the diagnosis is in doubt
    - Paring a wart reveals tiny black dots, which are clotted capillaries
  IF NOT THIS - what else fits (3)
    - Molluscum contagiosum is the first alternative to weigh
    - Seborrhoeic keratosis and lichen planus can look much the same
    - Squamous cell cancer and keratoacanthoma are the ones not to miss
  Source  StatPearls "Wart" - disease-level clinical article
  Status  traced to the source above

1. SALICYLIC ACID                                         [1st line]
   Adult    Apply the salicylic acid 16.7% with lactic acid 16.7% collodion to the wart once daily,
            usually at night, after soaking in warm water and paring the surface x up to 12 weeks
   Peds     Children >2 years: apply daily under adult supervision; protect healthy skin
   Source   Salactol Collodion SmPC sections 4.1-4.3 (eMC product 3766): "Salicylic acid 16.7% w/w
            Lactic acid 16.7% w/w", "For the topical treatment of warts, verrucas, corns and
            calluses" and "Salactol should be applied once daily usually at night. It can take up to
            twelve (12) weeks for resistant lesions to disappear". The strength shown is that single
            product; no disease-level article for viral warts is held in this corpus, so no
            percentage range is quoted.
   Why      Keratolytic that softens and dissolves the thickened keratin of a viral wart, allowing
            the infected tissue to be pared away and exposing it to the host immune response; a
            first-line topical treatment for verruca vulgaris and plantar warts.
   Caution  Protect surrounding normal skin with petroleum jelly.
            Do NOT apply to facial warts, anogenital warts, or broken skin.
            Soak wart in warm water and file surface before application.
            Not for a diabetic foot, and not where circulation to the foot is poor. The label rules
            both out flatly. A keratolytic on skin that heals badly is how a wart becomes an ulcer.
            Not on moles, birthmarks or hairy warts.
            Collodion is flammable - no smoking or naked flame until it has dried.
   Egypt    SALICYLIC ACID COLLODION 12% PAINT B.P.2001 UNIPHARMA CO. > UNIPHARMA           3.00 EGP
                -> ? different route - not topical
            SALICYLIC ACID SOAP (WEISER) 45 GM WEISER                                      15.00 EGP
                -> ? different route - not topical

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

---

Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

[Privacy policy](/privacy)