Comparative Efficacy of 50% Trichloroacetic Acid Solution with 10% Potassium Hydroxide Solution in the Treatment of Plane Warts

Background: Warts are very common disorders. Plane warts are caused by Human Papilloma Virus (HPV) occurring mostly in children and young adults. Among the treatment modalities, topical application of trichloroacetic acid (TCA) is age old. Potassium hydroxide (KOH) has a keratolytic effect on virus-infected cells.

Aims: To compare the safety and efficacy of topical 10% KOH solution with 50% TCA solution in the treatment of plane warts.

Materials and Methods: Sixty-four consecutive patients with plane warts were randomly assigned into two groups of thirty-two patients. Group A received 10% KOH solution and group B received 50% TCA solution once weekly until the complete clearance of warts in a maximum period of 12 weeks.

Results: In group under treatment with 10% KOH, 24 patients (75.0%) complete response, 5 patients (15.6%) moderate response, 2 patients (6.3%) mild response, and 1 patient (3.1%) had no response. In group under treatment with 50% TCA, 28 patients (87.5%) showed complete response, 2 patients (6.3%) moderate response, 2 patients (6.3%) mild response. Statistically no significant difference was found between the therapeutic response to 10% KOH and 50% TCA (P=0.41).

Conclusion: 10% KOH was found to be equally effective in the treatment of plane warts compared to 50% TCA with the advantage of fewer side effects.