 You can find home remedies for all sorts of ailments, but the science doesn't always back them up. What does it have to say about using a common household product on warts? When I was reviewing the science behind common over-the-counter remedies used in dermatology, such as tea tree oil for acne or nail fungus, I was surprised to see on the same page a section on duct tape. The only time I remember saying duct tape used in a medical study was on the identification of the gases responsible for the odor of human farts, which involved a collection system comprised of gas-tight pantalones sealed to the skin with duct tape. That's the study where they assessed the wind-breaking ability of a cushion called the Toot Traber. But what the dermatology journal was talking about is warts. Duct tape brings out our inventive slightly kooky side, given this versatility it wasn't so surprising a few years ago when a group of doctors reported that duct tape could get rid of warts. As I noted in my last wart video, all sorts of strange things are purported to cure warts, because most go away on their own. A thousand kids will fall for two years, and two-thirds of the warts disappeared without doing a thing. So maybe we should just leave them alone, although there are cases that may warrant treatment. Otherwise, we can just let our own body take care of them. Warts are caused by wart viruses, and so spontaneous wart disappearance is assumed to be an immune response where our body finally wakes up and takes notice. This assumption is based on studies like this, where foreign proteins were injected into the wart itself, like a measly lumps rubella vaccine, straight into the wart, which compared to placebo, appeared to accelerate the immune clearance process. The problem, of course, is that injections hurt, and 30% of the kids that got their warts injected with the vaccine suffered a flu-like syndrome. Yikes. Okay, scratch that. What else do we got? Within a few months, any placebo treatment will work in about a quarter of the cases, so if you put duct tape on 100 warts and you have 23, go away, that wouldn't mean much. The traditional medical therapies, acid treatments, and freezing treatments, bumps to cure it up to around 50%. So if you were really serious about testing the efficacy of duct tape, you would pit it head-to-head against one of those, and that's exactly what happened. The efficacy of duct tape versus cryotherapy in the treatment of the common wart. Cryotherapy is one of the treatment of choices for many pediatricians. Objective. To determine if application of duct tape is as effective as cryotherapy in the treatment of common warts. Patients were randomized to receive either liquid nitrogen applied to each wart, or duct tape occlusion. When I heard about treating warts with duct tape, I had this image where they were like trying to rip them off or something. No, no, no, no. They're just applying a little circle of duct tape every week or so. Here are the details. Although there have been a few anecdotal reports of using tape, no prospective randomized controlled trial had yet been performed until this study, which found that the duct tape was not only equal to, but exceeded the efficacy of cryotherapy, which worked in 60% of the cases, but 85% of the duct tape patients were cured, significantly more effective than cryotherapy for treatment of the common wart, more effective and fewer side effects. I mean, the only adverse effect observed in the duct tape group during our study was a small, minimal amount of local irritation. Redness, whereas cryotherapy hurts. You want to hear the saddest thing? One young child actually vomited in fear of pain before each cryotherapy session. They were like torching the poor kid. Cryotherapy can cause pain and bloody blisters that can get infected and mess up your nail bed. So duct tape, more effective, fewer side effects, and more convenient compared to applying a little duct tape at home to making multiple clinic visits, dragging the poor kid back every two weeks. I mean, it's like a win-win-win. Duct tape can now be offered as a non-threatening, painless and inexpensive technique for the treatment of warts and children. I mean, how much does a little piece of duct tape cost? It's like a win-win-win-win. Ah, but the money you save is the money the doctor loses. There's no way the medical profession is going to just let this go unchallenged. Other studies were performed and failed to show an effect. And so we end up in the medical literature with conclusions like this. Is duct tape effective for treating warts? Bottom line, no. Huh, is duct tape really not effective after all? Or was there some kind of critical design flaw in the follow-up studies? We'll find out next. One of the unusual, innovative, and long-forgotten remedies noted in this dermatology journal was the use of duct tape to cure warts. Finally, put to the test, there's all sorts of conventional therapies from acid to crowd therapy to lasers, but most of these are expensive or painful or both. Whereas the simple application of duct tape is neither. It may even be more effective than trying to freeze the warts off. Some doctors lauded the study, noting that they've been using duct tape for decades as a painless, yet effective treatment. As opposed to surgery and other destructive therapies, the only downside being your patients may think you're off your rocker. But hey, when it works they appreciate your wise choice to minimize discomfort. Other doctors were not so amused. Here they are spending money on all this fancy equipment and then along comes duct tape. Things like that could damage the reputation of cryo-surgery, complaining that the 10-second application of liquid nitrogen they used in the study was too short. So it was an unfair comparison. And evidently you really got to get in there or freeze until they get a blistering reaction. And yes, it hurts, but too bad, even making light of the poor child who vomited out of fear of the pain prior to each freezing by making some joke about it. Did they have a point, though, about the 10 seconds? Well, in the duct tape versus cryotherapy trial, those 10-second cryotherapy treatments worked 60% of the time, which is actually better than results of most cryotherapy studies that only seem to cure about 50%. In fact, the typical cryotherapy for warts works so poorly that statistically it didn't even beat out placebo. So all that pain may be for nothing, though aggressive cryotherapy does seem to work better. What they should have done, wrote another doctor in response to the duct tape trial, is take a scalpel to it and then really blister it up. And then you go back a week later and try to cut and crater it out and then maybe go back a third time, bragging that they can get closer to a 90% cure rate. Yeah, but at what cost? In the duct tape trial, one patient lost a study wart in a trampoline toe amputation accident. Hey, there's a treatment that works 100% effective, right? Amputation, right? But at what cost? 85% of the duct tape patients were cured with no pain or tissue damage, whereas aggressive cryotherapy may require lidocaine injection nerve blocks to take the cry out of cryotherapy and cause permanent tissue damage. You can end up with these big necrotic frostbite lesions. I mean, one sense, I mean tissue damage, that's the whole point of freezing warts, but you can end up causing these deep burns or end up rupturing tendons, which can cause permanent disability or cause extensive scarring in rare cases. Just the psychological stress of having to keep going back for this painful procedure may ironically impair our ability to fight off the wart viruses in the verse place. And so even if the effectiveness of duct tape is shown to be merely equivalent to that of cryotherapy, it would be better and it was shown to be even more effective. In fact, maybe most effective compared to 10 other wart treatments, duct tape beat out them all in terms of effectiveness and also in terms of cost, cheaper than all, but the DN option, which stands for do nothing. Compared to the most effective prescription treatments available, OTC duct tape, meaning over-the-counter duct tape, is 10 times cheaper. It's an unusual and welcome event in healthcare when a common ailment is proven equally amenable to an inexpensive, tolerable, and safe alternative therapy. But wait, if you look at the latest Cochrane review, which is like the gold standard of evidence-based reviews, they acknowledge that cryotherapy is less convenient, more painful, more expensive. But while in the earlier review, they did get excited about the effectiveness of duct tape into subsequent studies, duct tape seemed to totally flop. So, should we give up on duct tape for warts, or is there another side of the story? We'll find out in the thrilling conclusion next.