Does Bichloroacetic Acid Remove Warts?
Yes, bichloroacetic acid (BCA) treats warts by chemically burning the infected skin, causing the wart tissue to peel away. Doctors apply it in-office as a 50-90% solution directly to the wart, often repeating weekly until the wart clears, typically in 4-6 sessions. It's effective for common warts (verruca vulgaris), genital warts, and plantar warts, with success rates around 70-90% in studies.[1][2]
How Does BCA Work on Warts?
BCA is a caustic agent that coagulates skin proteins, destroying the wart's top layers without deeply penetrating healthy tissue. The acid is neutralized with water or soap after 3-5 minutes per application. Patients feel stinging or burning, but it's quick and doesn't require anesthesia.[1][3]
Compared to Trichloroacetic Acid (TCA)
BCA and TCA are similar strong acids used interchangeably for warts, but BCA may penetrate faster and cause less surrounding damage due to higher reactivity. Both outperform salicylic acid for stubborn warts, though TCA is more common in clinics.[2][4]
What Are Common Side Effects?
Skin irritation, redness, blistering, or temporary pigmentation changes occur in most cases. Scarring or infection is rare if applied correctly. Avoid home use—BCA is prescription-only to prevent burns.[1][3]
Who Should Avoid BCA Treatment?
Not suitable for pregnant patients, young children, or those with open wounds, eczema, or diabetes near the site. Genital warts need specialist care to avoid mucosal damage.2
Alternatives if BCA Fails
- Salicylic acid plasters: Over-the-counter, milder for home use (40-60% success).
- Cryotherapy: Freezing with liquid nitrogen, often first-line.
- Laser or surgery: For large/recurrent warts.
- Immunotherapy (e.g., imiquimod cream): Boosts immune response.
BCA works best combined with debridement for thick warts.[1][4]
[1]: https://www.ncbi.nlm.nih.gov/books/NBK482318/
[2]: https://www.aad.org/public/diseases/a-z/warts-treatment
[3]: https://www.cdc.gov/std/treatment-guidelines/anogenital-warts.htm
[4]: https://pubmed.ncbi.nlm.nih.gov/25905511/