"Wive's tales" and podiatry

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Vic's vapor rub to cure onychomycosis?

Duct tape and apple cider vinegar to cure verruca?

Other strange things you have heard (I'm sure attending physicians have some good ones)?

Do they work or have any basis? Or are they just wive's tales?

The boards have been kinda slow, so maybe a lighter thread to stimulate a new conversation?

Too many questions?

Sorry I'm not a clinician, but here's a paper on duct tape

Focht, DR, et al. The efficacy of duct tape vs. cryotherapy in the treatment of verruca vulgaris (the common wart). Arch Pedi Adolesc Med 2002; 156:971-974

showed an 85% efficacy for duct tape, which was a better outcome than that experienced by patients who received the cryotherapy. Another paper compared mole skin and duct tape with both having similar results, only the recurrence rate was higher in those treated with the duct tape. We have a clinician that uses it as an adjunct for occlusion when applying a topical tx. Makes sense in theory...

It's not that duct tape is actually a cure of verrucae. One theory is that the adhesive on the tape acts as an irritant, and duct tape is not really meant to be placed on the skin. As a result of the irritation, one theory is that it stimulates the body's immune response and in turn "attacks" the area where the wart is located, since that's the site of irritation.

My personal belief is that the duct tape or any similar product is simply acting as a great method of mechanical debridement. Since duct tape is relatively sticky, every time it's removed you are mechanically debriding the lesion.

One of the biggest "wive's" tales is when patients "assume" a bone can't be broken because "I can move it". Hear that ALL the time.

Interesting, and thanks for the replies.

According to this study, Vicks vaporub has some efficacy

I had a patient with a five inch wide venous ulcer who self treated himself for over a year at the advise of his RN wife. When asked about her treatment plan, he replied, "Just let it dry". No wonder it was not healing.

A friend of mine used apple cider vinegar on his plantar warts and I've seen first hand that it works. Considering the active ingredient in vinegar is acetic acid, and salicylic acid is what is used in many OTC wart treatments, it sort of follows that it would have a similar effect.

You will learn that personal anecdotes are the lowest form of research proof.

Treatment of large lower genital tract condylomata acuminata with local excision plus topical acetic acid. A preliminary study.

Monochloroacetic acid and 60% salicylic acid as a treatment for simple plantar warts: effectiveness and mode of action.

Both of these studies mechanically destroyed the wart before application though.

Originally Posted by HaimFeldman

A friend of mine used apple cider vinegar on his plantar warts and I've seen first hand that it works. Considering the active ingredient in vinegar is acetic acid, and salicylic acid is what is used in many OTC wart treatments, it sort of follows that it would have a similar effect.

Sig is exactly right. The warts on your friend may have resolved in the same time span whether he used apple cider vinegar, whale blubber or moose turds. One case study is really of no validity.

And step back and think about one point. IF Vick's vapor rub was REALLY helpful for onychomycosis, don't you believe that a major company would repackage the product and market it for onychomycosis. It's a gazillion dollar industry. If it worked consistently, we wouldn't have to ask.

Same thing with apple cider vinegar. If it REALLY worked for all it's claimed to, it would also be repackaged and remarketed.

And as far as the analogy of comparing acetic acid to salicylic acid, I just don't see any validity in that comment. Not all acids are created equal, otherwise you would be able to soak your foot is some orange juice to clear your warts. After all orange juice contains citric acid.

Originally Posted by PADPM

Sig is exactly right. The warts on your friend may have resolved in the same time span whether he used apple cider vinegar, whale blubber or moose turds. One case study is really of no validity.

And step back and think about one point. IF Vick's vapor rub was REALLY helpful for onychomycosis, don't you believe that a major company would repackage the product and market it for onychomycosis. It's a gazillion dollar industry. If it worked consistently, we wouldn't have to ask.

Same thing with apple cider vinegar. If it REALLY worked for all it's claimed to, it would also be repackaged and remarketed.

And as far as the analogy of comparing acetic acid to salicylic acid, I just don't see any validity in that comment. Not all acids are created equal, otherwise you would be able to soak your foot is some orange juice to clear your warts. After all orange juice contains citric acid.

I'm aware that personal anecdotes are the lowest form of medical research, but often times larger clinical trials stem from these small case studies. Furthermore, there is an exorbitant amount of pharmaceuticals that originated from some plant, herb, or natural remedy. Just look at willow tree bark. It was used by Hippocrates himself as a treatment for minor aches and pains and to reduce fever. Centuries later people even used it in the treatment of warts. The active chemical in willow tree bark? Salicylic acid. Today salicylic acid is a mainstay for the treatment for warts. Aspirin was created from the salicylic acid found in the willow tree, which was modified by replacing the hydroxyl group on the benzene ring with an acetyl group, which reduced the GI distress while maintaining its antipyretic/analgesic qualities.

Considering there is a lack of research in using acetic acid to treat warts, and the large amount of people that swear by it, it's also quite possible that it actually does work and more research needs to be done to confirm it. Did you look at the articles Sig provided? Seems like there's enough evidence supporting its use to do more research.

Also, since you mentioned citric acid, I did a little googling and came across these studies:

Citric acid: http://www.e-ijd.org/article.asp?iss...98;aulast=Vali

Vitamin A (retinoic acid): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3274422/

Maybe there's even more to that acid theory than I originally thought, and perhaps I'll start doing the research and get it repackaged as such... Perhaps I'll make a fortune