 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 and 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. Doctors 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 can cause permanent tissue damage. You can end up with these big necrotic frostbite lesions. I mean, one sense, I mean, tissue damage, is 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 it, 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 and more painful and 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.