Duct tape occlusion therapy

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Duct tape occlusion therapy (DTOT): is a controversial method for treating warts by keeping them covered with duct tape for an extended period. The putative mechanism is not well understood and is likely a result of stimulation of the host immune system[1]. Similar treatments involving silicone gel sheets are often used with hypertrophic scars, also with an unknown method of action.

Suggested procedure:

  1. Place a piece of duct tape on the lesion
  2. Leave the tape in place for six days, replacing any duct tape that falls off with a new piece as soon as possible
  3. After six days, remove tape and soak the wart in warm water
  4. Gently debride the lesions with a pumice stone or emery board
  5. Next morning, apply a new piece of duct tape to begin another six-day cycle for up to two months or until the wart is gone

[edit] Studies of effectiveness

Duct tape occlusion therapy is not yet proven to be effective, with some studies showing some effectiveness, and others finding no significant efficacy. One study by Focht et al. found that the duct tape method was 85% effective, compared to a 60% success rate in the study's cryotherapy group.[2]

Another study by Wenner and coworkers, however, found no statistically significant effect in a double-blind, randomized and controlled clinical trial in 90 adults when transparent duct tape was compared to mole skin.[3] There was no statistically significant difference for resolution of the target wart between patients treated with moleskin versus patients treated with duct tape. Eight of 39 patients [21%] in the treatment group vs 9 of 41 patients in the control group [22%] had complete resolution of the target wart. Fewer of the patients achieving resolution of their wart in the moleskin group had recurrence of their wart.

Of the patients who had complete resolution, 6 (75%) in the treatment group and 3 (33%) in the control group had recurrence of the target wart by the sixth month. "Whether or not the standard type of duct tape is effective is up in the air," said co-author Dr. Rachel Wenner of the University of Minnesota, who started the new study as a medical student. "Theoretically, the rubber adhesive could somehow stimulate the immune system or irritate the skin in a different manner."[4]

Another randomized clinical trial found that DTOT was more effective than cryotherapy at removing warts[5].

A second trial found duct tape had a modest but nonsignificant effect on wart resolution[6]. The statistical power of the latter trial has been questioned.[7]

One RCT found that more people having occlusive treatment with duct tape than cryotherapy had complete clearance of warts at 2 months. The RCT did not assess recurrence.[8].

[edit] See also

[edit] References

  1. ^ Common wart self care by Mayo Clinic staff February 17, 2006
  2. ^ Focht DR III, Spicer C, Fairchok MP (2002) The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart). Archives of Pediatrics & Adolescent Medicine 156(10): 971-4 (reviewed in Miller KE (2003) Duct tape more effective than cryotherapy for warts. American Family Physician 67(3) & DeMichele J (2003) A new medical breakthrough: wart to do when verruca vulgaris attacks. Journal of Young Investigators 7(5))
  3. ^ Wenner 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.
  4. ^ Study Casts Doubt on Duct Tape Wart Cure. March 21, 2007.
  5. ^ The Efficacy of Duct Tape vs Cryotherapy in the Treatment of Verruca Vulgaris (the Common Wart)
  6. ^ Efficacy of Duct Tape vs Placebo in the Treatment of Verruca Vulgaris (Warts) in Primary School Children
  7. ^ Interpreting negative results from an underpowered clinical trial: warts and all. PMID 17088515
  8. ^ Duct tape occlusion in treatment of Warts - BMJ Clinical Evidence