Health Library Trichloroacetic Acid or Bichloroacetic Acid for Genital Warts (Human Papillomavirus)From Healthwise

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

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

One study found that TCA and BCA treatment removes warts in 60% to 70% of people.¹ TCA and BCA are most effective on small, moist areas of warts.

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.)

If large areas of warts are being removed and multiple treatments are needed, health professionals 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 health professional.

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

Citations

1. Wiley DJ, et al. (2002). External genital warts: Diagnosis, treatment, and prevention. Clinical Infectious Diseases, 35(Suppl 2): S210–S224.

Author:	Robin Parks, MS	Last Updated: August 17, 2006
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Jeanne Marrazzo, MD, MPH - Infectious Disease
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