Duct tape occlusion therapy
Encyclopedia
Duct tape occlusion therapy (DTOT): is a method for treating warts by keeping them covered with duct tape
for an extended period. The putative mechanism is not well understood and is likely a result of stimulation of the host immune system. Similar treatments involving silicone
gel sheets are often used with hypertrophic scar
s, also with an unknown method of action.
and subungual warts.
Another study led by Rachel Wenner, however, found no statistically significant effect in a double-blind, randomized and controlled clinical trial in 90 adults when transparent duct tape was compared to moleskin
. There was no statistically significant difference for resolution of the target wart between patients treated with moleskin versus patients treated with duct tape. Eight of 39 patients (21%) in the treatment group vs 9 of 41 patients in the control group [22%] had complete resolution of the target wart. Fewer of the patients achieving resolution of their wart in the moleskin group had recurrence of their wart.
Of the patients who had complete resolution, 6 (75%) in the treatment group and 3 (33%) in the control group had recurrence of the target wart by the sixth month. "Whether or not the standard type of duct tape is effective is up in the air," said co-author Dr. Rachel Wenner of the University of Minnesota, who started the new study as a medical student. "Theoretically, the rubber adhesive could somehow stimulate the immune system or irritate the skin in a different manner." Since Wenner's study protocol covered the adhesive with waxed paper, the treatment did not achieve the combination of airtight occlusion and a reaction to the adhesive suggested by Litt in his paper as the mechanism of action.
A second trial found duct tape had a modest but nonsignificant effect on wart resolution. The statistical power
of the latter trial has been questioned.
One randomized controlled trial
found that more people having occlusive treatment with duct tape than cryotherapy had complete clearance of warts at two months. The randomized controlled trial did not assess recurrence.
Duct tape
Duct tape, or duck tape, is cloth- or scrim-backed pressure sensitive tape often sealed with polyethylene. It is very similar to gaffer tape but differs in that gaffer tape was designed to be cleanly removed, while duct tape was not. It has a standard width of and is generally silver or black...
for an extended period. The putative mechanism is not well understood and is likely a result of stimulation of the host immune system. Similar treatments involving silicone
Silicone
Silicones are inert, synthetic compounds with a variety of forms and uses. Typically heat-resistant and rubber-like, they are used in sealants, adhesives, lubricants, medical applications , cookware, and insulation....
gel sheets are often used with hypertrophic scar
Hypertrophic scar
Hypertrophic scars are a cutaneous condition characterized by deposits of excessive amounts of collagen which gives rise to a raised scar, but not to the degree observed with keloids. Like keloids, they form most often at the sites of pimples, body piercings, cuts and burns. They often contain...
s, also with an unknown method of action.
Procedure
Litt reported that adhesive tape left in place for 6½ days and then removed for 12 hours before the cycle was repeated was successful in treating periungualPeriungual wart
Periungual warts are warts that cluster around the fingernail or toenail. They appear as thickened, fissured cauliflower-like skin around the nail plate. Periungual warts often cause loss of the cuticle and paronychia...
and subungual warts.
- Place a piece of duct tape on the lesion.
- Leave the tape in place for 6½ days (156 hrs), replacing any duct tape that falls off with a new piece as soon as possible.
- After 6½ days, remove tape. Gently debride the lesions with a pumicePumicePumice is a textural term for a volcanic rock that is a solidified frothy lava typically created when super-heated, highly pressurized rock is violently ejected from a volcano. It can be formed when lava and water are mixed. This unusual formation is due to the simultaneous actions of rapid...
stone or emery board. - Leave off for 12 hrs, then apply a new piece of duct tape to begin another 6½ day cycle for up to two months or until the wart is gone.
Effectiveness
Duct tape occlusion therapy is not yet proven to be effective, with some studies showing some effectiveness, and others finding no significant efficacy. One study by Focht et al. found that the duct tape method was 85% effective, compared to a 60% success rate in the study's cryotherapy group.Another study led by Rachel Wenner, however, found no statistically significant effect in a double-blind, randomized and controlled clinical trial in 90 adults when transparent duct tape was compared to moleskin
Moleskin
Moleskin, originally referring to the short, silky fur of a mole, is heavy cotton fabric, woven and then sheared to create a short soft pile on one side. The word is also used for clothing made from this fabric, as well as adhesive pads stuck to the skin to prevent blisters.Clothing made from...
. There was no statistically significant difference for resolution of the target wart between patients treated with moleskin versus patients treated with duct tape. Eight of 39 patients (21%) in the treatment group vs 9 of 41 patients in the control group [22%] had complete resolution of the target wart. Fewer of the patients achieving resolution of their wart in the moleskin group had recurrence of their wart.
Of the patients who had complete resolution, 6 (75%) in the treatment group and 3 (33%) in the control group had recurrence of the target wart by the sixth month. "Whether or not the standard type of duct tape is effective is up in the air," said co-author Dr. Rachel Wenner of the University of Minnesota, who started the new study as a medical student. "Theoretically, the rubber adhesive could somehow stimulate the immune system or irritate the skin in a different manner." Since Wenner's study protocol covered the adhesive with waxed paper, the treatment did not achieve the combination of airtight occlusion and a reaction to the adhesive suggested by Litt in his paper as the mechanism of action.
A second trial found duct tape had a modest but nonsignificant effect on wart resolution. The statistical power
Statistical power
The power of a statistical test is the probability that the test will reject the null hypothesis when the null hypothesis is actually false . The power is in general a function of the possible distributions, often determined by a parameter, under the alternative hypothesis...
of the latter trial has been questioned.
One randomized controlled trial
Randomized controlled trial
A randomized controlled trial is a type of scientific experiment - a form of clinical trial - most commonly used in testing the safety and efficacy or effectiveness of healthcare services or health technologies A randomized controlled trial (RCT) is a type of scientific experiment - a form of...
found that more people having occlusive treatment with duct tape than cryotherapy had complete clearance of warts at two months. The randomized controlled trial did not assess recurrence.