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COMMON WARTS (Verruca vulgaris), plantar warts (Verruca plantaris) and flat/plane warts (Verruca plana), collectively known as cutaneous warts, are benign growths of the skin caused by the human papillomavirus (HPV). In Australia, up to 24% of children and 5% of adults are affected. 1 A break in the epidermal barrier of the skin allows entry of HPV and subsequent infection of basal epithelial cells. HPV replicates alongside the natural lifecycle of epithelial cells, and is eventually released from desquamated keratinocytes on the surface of warts, potentially infecting other sites via direct contact or through fomites. 2 Cutaneous warts generally self-resolve. Up to two-thirds of immunocompetent children experience spontaneous clearance of their cutaneous warts by two years of age. 3 Adults tend to take longer. Patients might request treatment for their warts when they cause discomfort, functional impairment, social ostracism, are numerous, grow large or raise concerns regarding transmission. 4 Treatment for cutaneous warts can be painful, scar, cause pigmentary disturbances and might not be effective. 5 Therefore, clinicians should be wary of the evidence behind the efficacy of cutaneous wart treatment. This review summarises high-quality studies investigating the efficacy of chemical and physical destructive wart therapies. MethodsWe performed a literature review (up to June 2021) of published articles for wart management from the MEDLINE and Embase databases. No language restrictions were applied. We considered systematic reviews, randomised controlled trials (RCTs), cohort studies and case series. Case reports were excluded. For MEDLINE, we used the Boolean operation to combine MeSH terms 'warts' AND 'therapeutics'. For Embase, we used the Boolean operation to combine MeSH terms 'Verruca vulgaris' AND 'therapy'. We included studies that investigated chemical or physical destructive therapies.

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