Evaluation of topical potassium hydroxide in the treatment of nongenital warts

Background Despite the availability of various treatment modalities of warts, recurrences, relapses, and the recalcitrant nature of warts are common because of the lack of specific antiviral medications against warts. The ideal treatment for warts should be effective, safe, lead to less morbidity, and provide long-lasting immunity against the human papillomavirus. Potassium hydroxide (KOH) solution is a well-known keratolytic agent with many dermatological uses. Objective To evaluate the efficacy and safety of different concentrations of topical KOH solution in the treatment of nongenital warts. Patients and methods This study included 60 patients of different ages with nongenital warts of different durations and types. They were divided into three groups, 1, 2, 3, and each group included 20 patients. Group 1 was treated with topical 10% KOH, group 2 was treated with a topical 15% KOH solution, and group 3 was treated with a saline solution as a placebo control group. All patients applied the medications daily at night for a maximum of 8 weeks. The patients were examined every 2 weeks for a total duration of 8 weeks and followed up for 3 months to detect any recurrence and side effects of the treatment. Results Complete clearance of the warts without recurrence over a 3-month follow-up period was found in 75% of patients in group 1, 80% of patients in group 2, and 10% of patients in group 3. The study found a few tolerable and transient side effects such as erythema, itching, burning, and temporary pigmentation. Conclusion Topical KOH solution is a promising treatment modality for warts. It seems to be an easy, effective, painless, inexpensive, and safe treatment option.