What Is It?
Your doctor is trying a novel therapy for warts called squaric acid, or squaric acid dibutyl ester. This is a very dilute solution that causes an allergic reaction in the skin, and which has been shown to help many warts resolve.
The therapy will begin with an application of the solution to the forearm of your child. This usually causes no reaction, although the occasional patient will get some mild redness. Even though you see no reaction at the site where the solution was applied, this does not mean it is not working correctly.
Your doctor will then instruct you on applying the solution to your child's warts, which you will start 1-2 weeks after the application in the office. Using the Q-tip, put enough of the medicine on the individual wart to saturate the top. It will evaporate quickly, and leave no residue. Do not reapply, even if you feel too little was applied. You should wear gloves when applying the medicine, and apply it with Q-tips, only to the affected areas (the actual warts). Be sure to keep the medicine out of reach of children.
The medicine should initially be applied 3 times per week, preferably at night. The goal of treatment is to have some mild redness of the warts, without causing a reaction that will cause your child to be uncomfortable (ie pain or marked itching). Gradually increase the frequency of applying the medication, on a weekly basis (ie 4 nights per week, then 5 nights per week, etc). If your child experiences severe itching or discomfort, do not increase the frequency of application.
Side-effects can include redness, tiny blisters, pustules and broken skin at the site of application. If this occurs, stop the therapy immediately and call us. We will prescribe a strong cortisone cream to stop the irritation. Irritation or dermatitis may occur at the site of sensitization on the forearm as long as a month after the start of therapy. Do not be concerned, but do stop the medicine and call us immediately.
Remember that some redness is necessary in order for the medication to help. We do not want broken skin or infection. Also keep in mind that this treatment takes time, sometimes as long as several months, before you begin to see results. As with all treatments for warts, squaric acid does not work in all patients. If it seems to be ineffective, we will discuss other alternatives. Recurrence, or rate of return, varies with the patient. Please have reasonable expectations.
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|Sensitization (done in office)
||2% Squaric Acid Dibutyl Ester
||0.2% Squaric Acid Dibutyl Ester