Verrucas are common. Prevalence varies with age, with the lowest estimates at 4% and the highest at 24%. Those at highest risk are young people sharing communal “bare-foot” areas. Current first line therapies for verrucas are “wart paints” usually containing salicylic acid or cryotherapy. Duct tap has been proposed as alternative first line treatment.
Treatment of verrucas with duct tape is known as occlusive therapy. This typically involves application of tape for seven continuous days followed by a 12 h overnight rest; this cycle is repeated for a total of 6-8 weeks. This at first seems a bizarre idea and occlusive duct tape therapy has been controversial and has provoked much debate and prompted the conduct of three TCTs during the last 10 years.
The biological plausibility for this treatment is debatable. It is thought that the duct tape acts through stimulations of the patient’s immune system by causing local irritation, in a similar manner to the proposed mechanism for cryotherapy. Duct tape certainly seems to cause local irritation in some patients, with around 15% reporting side effects such as erythema. It is uncertain from the literature what specifically about duct tape makes it preferable compared with other plaster tapes, but there are no RCTS examining this.
The side effect profile of treatment with duct tape was generally minor, with most people reporting mild skin irritation or erythema. However, in one study three participants left the study due to side effects including discomfort and numbness. We also noted one participant undertaking duct tape treatment lost their verruca due to a trampoline accident in which their toe was amputated. It is also worth considering the potential embarrassment associated with the overt nature of this treatment.