Common, or non-genital viral warts (verruca vulgaris), caused by the human papillomavirus (HPV), including plantar warts, are one of the most common skin diseases. Though non-genital warts can appear at almost any location on the body, they are most typically located on the hands and feet. Non-genital warts are extremely common, occurring in 7-10% of the general population. Each year, approximately 4.2 million patients seek treatment from physicians for non-genital warts, with about 71% of these patients opting to visit a dermatologist, podiatrist, or pediatrician. In addition to their adverse cosmetic effects, warts can also cause pain, especially in small children. Moderate to extreme discomfort has been reported in 51.7% of patients and social or leisure activities are adversely impacted to a moderate or extreme degree in 38.8%.1
Abundant treatment options for non-genital warts exist, but they are far from optimal. Reported efficacies vary widely and can depend on the patients’ ages, compliance and immunocompetence, wart location, duration of presence, and skill of the treating healthcare provider.11 Application of liquid nitrogen is the most common treatment in a physician’s office (used in about 20% of patients), but tends to cause intense pain at the application site. Other treatments, including intralesional bleomycin, have been shown to improve the physical appearance of warts, but dyschromia (discoloration of the skin) and scarring are known associated risks.
A number of over the counter treatments exist as well, but may show minimal efficacy. Nitric Bio is in Phase 2 development using iontophoresis in the treatment of non-genital warts.