Warts and molluscum

Himalayan mayapple

Sinopodophyllum hexandrum

Genital warts (caused by human papillomavirus): podophyllotoxin is the active ingredient of marketed creams and solutions such as Wartec and Condylox, sometimes combined with imiquimod to reduce recurrence.

Mayapple

Podophyllum peltatum

For external genital warts (condyloma acuminata, caused by human papillomavirus), purified podophyllotoxin 0.5% solution cleared lesions more often than imiquimod 5% cream in a 2020 network meta-analysis of 41 trials (6371 patients), at the cost of more side effects.

Spanish fly

Lytta vesicatoria

For molluscum contagiosum (a poxvirus skin infection), cantharidin 0.7% topical solution applied by a clinician every 21 days for up to four treatments cleared all lesions in 46% and 54% of patients versus 18% and 13% on vehicle in two phase 3 trials (CAMP-1, CAMP-2); a Japanese phase 3 trial found 50% versus 23%. Approved by the FDA in 2023 (YCANTH) for patients aged 2 and over. The drug is made synthetically, not from beetles.

Tea plant

Camellia sinensis

Sinecatechins (Veregen, Polyphenon E), a defined green tea extract ointment approved by the FDA in 2006, cleared all anogenital warts in about 53–57% of patients on the 15% ointment versus 34–37% on vehicle in two randomised trials.

Common fig

Ficus carica

Fig sap is a rural Iranian and Mediterranean remedy for common warts. In an open trial in 25 patients, warts treated with fig latex cleared completely in 44%, compared with 56% for cryotherapy on the other side of the body; the study was small and unblinded.

Indian sandalwood

Santalum album

For warts and molluscum (skin viruses): in an open-label pilot of 10 people with common warts, 8 cleared all treated warts after 12 weeks of twice-daily oil, and a 10-person open pilot in molluscum contagiosum reported clearance in 9. An unpublished placebo-controlled dose-finding wart trial by the oil's developer reported more clearance than placebo. Very small, uncontrolled or unpublished.

Job's tears

Coix lacryma-jobi

In Japan, yokuinin (adlay seed extract) is used to treat common warts (verruca vulgaris) caused by HPV. A retrospective study of 73 women with mildly abnormal cervical smears found those given 1 g/day yokuinin returned to normal cytology sooner (median 3 v 5 months), with no side effects; this was not randomised.

Lemon myrtle

Backhousia citriodora

In a randomised trial in 31 children with molluscum contagiosum (a viral skin infection with wart-like bumps), a 10% lemon myrtle oil solution applied once daily for 21 days cut lesions by more than 90% in 9 of 16 children, versus none of 16 given olive oil. A later report described its use in children with atopic dermatitis.

Indian spurge tree

Euphorbia neriifolia

The juice is applied externally to remove warts, relying on its caustic action. It blisters surrounding skin.

Northern white cedar

Thuja occidentalis

The tincture has been used for warts, papillomas and condylomas caused by human papillomavirus; a case report describes its use as an add-on for laryngeal papillomas in a child. No controlled trials of the herbal tincture; a homeopathic warts trial in which Thuja was the most prescribed remedy was inconclusive.