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Trichloroacetic acid or bichloroacetic acid for genital warts (human papillomavirus)

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By Sandy Jocoy, RN

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Brand Name Chemical Name

How It Works

Trichloroacetic acid (TCA) and bichloroacetic acid (BCA) kill genital warts by destroying the proteins in the cells. TCA and BCA also can destroy normal cells, which is why careful application is needed.

A doctor applies TCA or BCA once a week. It is important that only the wart be treated to avoid irritation to surrounding normal tissue.

Why It Is Used

TCA and BCA may be used to treat genital warts. They are considered safe during pregnancy because they cause only local reactions.

How Well It Works

Studies show that TCA and BCA treatment can remove warts up to 88% of the time after 6 to 10 weeks of treatment.1 TCA and BCA are most effective on small, moist areas of warts.

Side Effects

The application of TCA or BCA usually causes several minutes of mild to moderate discomfort at the site. The medicines are not absorbed easily by the body, so both may cause local skin irritation but not whole-body (systemic) side effects.

It is difficult to control how deeply the acid penetrates the skin. If the acid burns too deeply, you may have pain, skin irritation, and ulcers.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

If large areas of warts are being removed and multiple treatments are needed, doctors may not recommend TCA and BCA treatment because of the pain and burning.

Genital warts may go away on their own. Treating warts may not cure infection with human papillomavirus (HPV), the virus that causes genital warts. The virus may remain in the body in an inactive state after warts are removed. A person treated for genital warts may still be able to spread the infection. Condoms may help reduce the risk of HPV infection.

The benefits and effectiveness of each type of treatment need to be compared with the side effects and cost. Discuss this with your doctor.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Buck HW Jr (2007). Warts (genital), search date February 2007. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

Credits

Author Sandy Jocoy, RN
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Jeanne Marrazzo, MD, MPH - Infectious Disease
Last Updated July 2, 2008
Last Updated: 07/02/2008

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