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Verruca Treatment - KOH?

Discussion in 'General Issues and Discussion Forum' started by GarethNZ, Jan 13, 2007.

  1. GarethNZ

    GarethNZ Active Member

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    I have would like to ask about a older style treatment method used as treatment. It starts with debridement of the overlying hyperkeratosis. You then use a chemical treatment in the form of a crystal, dipping it into a liquid possibly water) and then working the crystal into the verruca until you manage to break it down. Then use a white vinegar to neutralise the chemical used. This seemed to be a useful alternative option for salicylic acid and liquid nitrogen. I have discussed this with a local pharmacist, but feel maybe need to speaking to a local school chemistry supplier.

    Any ideas out there?? Does anyone use this as a treatment??
  2. Craig Payne

    Craig Payne Moderator

    Do you mean trichloroacetic acid crystals?
  3. Admin2

    Admin2 Administrator Staff Member

  4. R.E.G

    R.E.G Active Member

    KOH, for some reason I thought it was NaOH, but Google says no.

    I used it on a fellow student, to the dismay of the lecturers. It was quite 'uncomfortable, and was neutralised with 'glacial acetic acid' (could be white vinegar?)

    So it is just another 'caustic'. so tissue destruction.

    Does anyone know anything about Imiquimod?

  5. Cameron

    Cameron Well-Known Member


    KOH (potassium hydroxide or caustic potash) is alkaline but very caustic. Has been used in veterinary medicine and human medicine to disolve proteins (such as keratin), and was used as corn and wart solvents. The KOH test was used to diagnose fungal infection.

    More information at: http://en.wikipedia.org/wiki/Potassium_hydroxide

    Like other caustic treatments it kind of fell out of favour for a variety of reasons but mainly because of the complications which could arise after use i.e it can be painful. Availability and storage aside the skill to use crystal approach direct to the skin, fell out of favour with easier and more convenient alternatives. The introduction of cryotherapy heralded the beginning of a new order with most of the risky caustics, sidelined to history.

    Bit like myself really

  6. mahtay2000

    mahtay2000 Banya Bagus Makan Man

    Using KOH and a curette as a blunt dissection is very effective on intractable large area warts. Only a small area of a verruca infection needs to be treated to facilitate clearance of the rest of the foot.
    Some things that need to be done;
    1. Local anaestic via a tibial block and maybe local infiltration as well.
    2. Stanch the blood flow with a torniquet at the ankle. (Elevate first.)
    3. Use a curette to remove the jellied tissue.

    The method is good as you can go all the way to dermis and not damage it with the curette.
    The KOH is self limiting-saline is enough to dilute it sufficiently if at all worried.

    A dressing as would be used on an ulcer with deflection is adequate and if the pt is young and fit it is not unusual for everything to be healed and forgotten about in two weeks.

    A word of caution-people dread this kind of procedure-so I usually do it on painful weightbearing areas after they say 'I'll do anything to get rid of it.'

  7. yvonnespod

    yvonnespod Member

    I use KOH as a softening agent before treatment of subungul H'Ds or ingrown toenails or neuro vascular H'D just be sure to rinse area after use
  8. GarethNZ

    GarethNZ Active Member

    For podiatrists using KOH in Melbourne, do you know of anywhere I could possibly obtain this, my local pharmacy suggested it is not available to him. Maybe get in touch with a chemist of some sort?
  9. yvonnespod

    yvonnespod Member

    KOH is available from BRIGGATE MEDICAL of Melbourne
  10. GarethNZ

    GarethNZ Active Member

    thanks fro the reply, although i have used it on numerous times previously i am not sure that i'm too keen to be using it again due to the discomfort that it caused. maybe one for the brave patient...
  11. yvonnespod

    yvonnespod Member

    KOH is a softening agent I use it to soften callus and neurovascular h'd subugual callus /h'd even og and oc nails .Just remember to rinse off with saline .I have been using it for over 20 years with no ill effect and veery good results yvonnespod
  12. Trent Baker

    Trent Baker Active Member

    I have used KOH (potassium hydroxide) in my practice for the last 7 years. Despite the painfull results of this treatment option, it is very effective. I explain in detail to a potential KOH 'victim' :) the discomfort associated with the treatment. They either decline in favour of less painfull but less effective options, or tough it out. For those that resist the ellure of the KOH method, several weaks of treatment (as we all know) usually follows. The patients brave enough to tackle the KOH often only need one or two applications and the lesion resloves.

    A word of caution though. To use this tretament on even the most mild aterial insufficiency is absolutely out of the question. Ulceration as a result is a certainty, the VP will resolve but the resultant wound may not be optimal.

  13. Angeles

    Angeles Welcome New Poster

    I have used KOH potassium hydroxide to get rid of my plantar warts with success.
    It is surprising that is not better know. I just applied the "crystals" directly to the warts every 3rd day (and every week later) and kept them covered at all times.
    As I only started treating them about 5 yrs after getting them, it took me 2 years to finally remove them. Hope this is useful,
  14. BRo

    BRo Welcome New Poster

    I have been using KOH for the past 8years. It is a fantastic treatment for VPs usually requiring a one off treatment, and in some persistant cases a 2nd.

    Unfortunately, I went through QUT where KOH is not kept at the school due to an incident between a few students self treating.

    I have had great success with it. I do not use local anaesthetic, so it is a painful treatment, but very effective.
  15. hamish dow

    hamish dow Active Member

    Saw it used once, decided I did not want to be on the recieving end nor the other either. I was not comfortable with the scale of destruction and the discomfort generated so rapidly and figured I would leave it to the braver souls to use it.
  16. NewsBot

    NewsBot The Admin that posts the news.

    Efficacy of 10% KOH in Palmoplantar Warts
    J M H S Vol. 11, NO. 2, APR – JUN 2017

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