Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Zinc Oxide for plantar warts

Discussion in 'General Issues and Discussion Forum' started by MicW, Oct 27, 2015.

  1. MicW

    MicW Active Member

    Members do not see these Ads. Sign Up.
    Can anyone inform me of the effectiveness of Zinc Oxide for treating chronic verrucae as a non invasive option
  2. W J Liggins

    W J Liggins Well-Known Member

    I know of no clinical studies. However, years ago zinc oxide plasters were used to adhere padding. To the best of my knowledge, apart from the odd case of sensitivity, there were no adverse dermal reactions. Therefore, I imagine that, leaving aside some maceration, that ZO would have no effect on VPs whatever.

    Bill Liggins
  3. MicW

    MicW Active Member

    Thanks for your response Bill. I was aware of what you have stated.

    My interest is in regards to ORAL zinc sulphate.

    This treatment option I spotted in a power point presentation by Kerwin Talbot (APodA(SA)) entitled "Monochloroacetic Acid - Limitations on use and Alternatives"

    As quoted below :

    "Dietary zinc has profound effects on the human immune
    system, and deficiency leads to reduced immune
    capacity.211,212 Based on this, a placebo-controlled clinical
    trial was attempted using oral zinc sulphate (10 mg/kg daily)
    to treat recalcitrant warts. Complete clearance was reported in
    87% of the treatment group versus no clearance in the
    placebo group."

    Thanks Mike
  4. blinda

    blinda MVP

    Hi Mike,

    Do you have a reference for the above quoted placebo-controlled trial?

  5. NewsBot

    NewsBot The Admin that posts the news.


    Oral zinc sulphate in the treatment of recalcitrant viral warts: randomized placebo-controlled clinical trial.
    Al-Gurairi FT, Al-Waiz M, Sharquie KE.
    Br J Dermatol. 2002 Mar;146(3):423-31.
  6. blinda

    blinda MVP

  7. Craig Payne

    Craig Payne Moderator

    I have not read full paper, but Red flags:
    - it was "randomised", but ended up with 40 in each group --> that's really hard to do if randomisation done properly
    - ~50% drop out in each group; did not do an intention to treat analysis

    All participants were zinc deficient (maybe dietary issue in that part of Iraq); so zinc supplements fixed that --> better immune response

    HOWEVER, that has nothing to do if zinc is any good or not for VP's in those with normal zinc levels and there is no data what-so-ever that shows that taking supplementary zinc above the normal dietary requirements "strengthens" the immune system.
  8. MicW

    MicW Active Member

    Thanks Craig. Dubious at best. That puts it to bed for now then
  9. blinda

    blinda MVP

    Indeed. Particularly when you consider that HPV is often recalcitrant in an immunocompetent population, because this virus has adapted ways to positively avoid detection by preventing a localised innate immune response in order to survive.

    Whilst it is true that patients with compromised immunity are prone to all manner of infections, inc HPV, we should not assume that the vice is versa. One of my biggest bugbears is the assumption that HPV infection is indicative of a "weakened immune system".

    And another thing; Do we really want to "boost" the antibodies in patients with over-active immune systems, due to an auto-immune disorder? Hmm.
  10. wdd

    wdd Well-Known Member

    Would it acceptable to suggest that concomitant (or starting before and finishing after ) with other forms of verruca treatment there might be some positive value and no negative value in taking a course of oral zinc sulphate?

  11. wdd

    wdd Well-Known Member

  12. blinda

    blinda MVP

    Hi Bill,

    I like this definition; having an obstinately uncooperative attitude towards authority or discipline - "a class of recalcitrant fifteen-year-olds"

    Stubborn (or thrawn) comes to mind. I would class both long-standing lesions that have had a plethora of treatments thrown at them as well as long-standing ones that have not, as recalcitrant. The idea of all treatment is to create an appropriate innate response, which COULD produce an adaptive response to eradicate all lesions, even those not directly treated. Frequently, this immune response is spontaneous, particularly in the younger population. The recalcitrant lesions just fail to produce enough cytokines to cause the adaptive response, which is what renders them equally `stubborn` to treatment and to the host`s Langerhan cells surveillance.

    The very nature of the Human Papilloma Virus positively evades immune regulator detection, i.e. it is not the immune regulators which are `weakened` or `not doing their job` in an immunocompetent patient, so the overall immune status is largely irrelevant.

    Moreover, there is no such thing as no-negative value in any oral supplement;

  13. wdd

    wdd Well-Known Member

    Hi Bel,

    Thanks for your comprehensive reply.

    The above statement I would think applies to everything in life. There is an upside and a down side, advantages and disadvantages, one risk balanced against another. It's just as well that most of the time we are oblivious to the risks.''

    It knocks that part of the Hippocratic oath, popularly stated as 'first do no harm' right on the head?

    The princess kissing the frog and turning it into a prince demonstrates the upside of the risk and is apparent in youth.

    The princess continuing to kiss the prince and eventually turning him into a frog is the downside of the risk that only becomes apparent with experience, if only vaguely.

    There is no doubt that maximising the upside of the risk while minimising the downside is difficult ground to hold in almost all contexts.

    Best wishes,

  14. blinda

    blinda MVP

    Indeed it is, Bill.

    That risk-benefit assessment governs most of which we do. :drinks
  15. wdd

    wdd Well-Known Member

    Dear MicW,

    I wondered if you had ever heard of zinc oxide being used in the treatment of verrucae or possibly even used it yourself in their treatment? Along with that do you have a rationale as to why it might be useful in the treatment of verrucae?

  16. blinda

    blinda MVP

    It is mentioned in the British Association of Dermatologists guidelines for the management of cutaneous warts 2014, but they came to the same conclusion as we did;


Share This Page