Wart Remove SL Ointment


Dosage Strength of Wart Remove SL Ointment

Salicylic Acid / Lactic Acid 26/10% 5 mL Pump

General Information

Salicylic Acid

Salicylic acid is a topical keratolytic agent. It is used to remove excess keratin in hyperkeratotic skin disorders such as common and plantar warts, psoriasis, seborrheic dermatitis, calluses, and corns. Salicylic acid also is used to treat acne. Salicylic acid works by causing desquamation of the horny layer of skin. Prolonged or repeated daily use over large areas of skin may result in salicylism, especially in children and patients with renal or hepatic impairment. This drug was approved by the FDA in 1939.

Lactic Acid

Lactic Acid is a keratolytic used in removal to remove warts, calluses and other lesions in which the epidermis produces excess skin. Keratolytic therapy thins the skin on and around the lesion. It causes the outer layer of the skin to loosen and shed.

Keratolytics can also be used to soften keratin, a major component of the skin. This serves to improve the skin’s moisture binding capacity, which is beneficial in the treatment of dry skin.

Mechanisms of Action

Salicylic Acid

Salicylic acid exhibits keratolytic action by dissolution of intercellular cement substance causing desquamation of the horny layer of skin.

Lactic Acid

Lactic acid has actions similar to those of acetic acid (Acetic Acid) and has been used similarly in the treatment of skin and vaginal disorders. It has been used in the preparation of lactate injections and infusions to provide a source of bicarbonate for the treatment of metabolic acidosis (for the problems of using lactate in metabolic acidosis, see Electrolytes). It is applied topically in the treatment of warts (Dermatological Drugs and Sunscreens), often with salicylic acid, and in emollient creams. Other uses include the treatment of severe aphthous stomatitis in terminally ill, immunocompromised patients.

Contraindications / Precautions

Salicylic Acid

Salicylic acid preparations are contraindicated in patients who have previously exhibited salicylate hypersensitivity.

Topical salicylic acid preparations in concentrations greater than 6% are contraindicated in patients with diabetes mellitus and other conditions of poor blood circulation such as peripheral vascular disease. Do not use these preparations on moles, birthmarks, warts with hair growing from them, genital warts, or warts on the face or mucous membranes.

Prolonged use of salicylic acid over large areas, especially in children and patients with renal impairment or hepatic disease may increase the risk for development of salicylism. In such patients, limit the treated area and closely monitor the patient for signs of salicylate toxicity such as nausea, vomiting, dizziness, loss of hearing, tinnitus, lethargy, hyperpnoea, diarrhea, and psychic disturbances. When the potential for toxicity is present, advise patients not to apply occlusive dressings, clothing or other occlusive topical products such as petrolatum-based ointments to prevent excessive systemic exposure to salicylic acid. Concomitant use of other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin and other salicylate containing medications, such as sports injury creams) should be avoided. Discontinue use of salicylic acid if salicylic acid toxicity occurs and treat appropriately.

The potential for Reye’s syndrome should be considered with administration of salicylic acid products in children and adolescents with varicella or influenza.

Avoid accidental exposure of salicylic acid products to the eyes, lips, mucus membranes and inflamed or broken skin as increased absorption may occur. If unintended mucus membrane or ocular exposure occurs, thoroughly rinse affected areas with water.

Lactic Acid

Lactic acid preparations are contraindicated in patients who have previously exhibited lactate ester or other hypersensitivity.

Avoid accidental exposure of lactic acid products to the eyes, lips, mucus membranes and inflamed or broken skin as increased absorption may occur. If unintended mucus membrane or ocular exposure occurs, thoroughly rinse affected areas with water.


Salicylic Acid

There are no adequate and well-controlled studies in pregnant women. Salicylic acid products should only be used during pregnancy if the potential benefit to the mother outweighs the potential risk to the fetus.

Lactic Acid

Lactate crosses the human placenta by diffusion and by active transport  and is normally present in the fetus and amniotic fluid. Fetal lactate concentrations have been used in fetal monitoring. A 2014 Swedish study found amniotic fluid lactic acid to correlate with the administration of oxytocin #1899 during delivery. Amniotic fluid lactic acid concentration at the time of fetal surgery for spine defects was associated with risk of preterm prelabor rupture of membranes. Not all studies found a clear relationship between perinatal lactate concentrations and neonatal outcomes. Maternal lactic acid concentrations were elevated during labor. Lactic acidosis is caused by the excess production or underutilization of lactic acid. It has been associated with low fetal pH and low Apgar score.


Salicylic Acid

It is not known whether topically applied salicylic acid is excreted into breastmilk. According to the manufacturer, salicylic acid should not be used during breast-feeding. However, if the drug is used by nursing mothers, care should be taken to avoid application to the skin of the breast during lactation; oral ingestion by the infant could be harmful. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breast-feeding infant experiences an adverse effect related to a maternally administered drug, healthcare providers are encouraged to report the adverse effect to the FDA.

Lactic Acid

Lactic acid is a normal component of human milk. The concentration of lactic acid was increased after exercise. Infants of women engaging in moderate to maximal exercise accepted milk 1 hour after exercise as readily as milk expressed 1 hour prior to exercise. The pre-exercise milk lactic acid concentration was 0.08 mM, and the post-maximal exercise concentration was 0.21 mM.

Adverse Reactions / Side Effects

Salicylic Acid

Prolonged and repeated daily use over large areas, especially in children and patients with significant renal or hepatic impairment increases the potential for development of salicylism.

Topical application of salicylic acid is generally well tolerated, but may result in skin irritation including transient stinging, burning, or pruritus. Excessive erythema, peeling of the skin, and scaling may also occur, particularly if used on open skin lesions. Advise patients to discontinue use and consult a physician if excessive burning, stinging, or peeling occurs.

Topical over-the-counter (OTC) acne products, including salicylic acid, have been associated with rare but serious and potentially life-threatening hypersensitivity reactions. These reactions may occur within minutes to a day or longer after use of the product. Instruct patients to stop using topical acne products if they experience signs of anaphylactoid reactions such as throat tightness; difficulty breathing; feeling faint; or swelling of the eyes, face, lips, or tongue. The product should also be discontinued in patients who develop urticaria or pruritus. Based on the information reported to the FDA, it is uncertain whether the reactions are caused by the active ingredients benzoyl peroxide or salicylic acid, the inactive ingredients or a combination of both. When initiating therapy with an OTC topical acne product, advise patients to apply a small amount to one or two small affected areas for 3 days and monitor for signs of a hypersensitivity reaction. If no discomfort occurs, the instructions on the Drug Facts label may be followed.

Lactic Acid

Burning, itching, stinging, redness, or irritation may occur. Unlikely but serious side effects that may occur: unusual changes in the skin (e.g., blistering, peeling, turning white/soft/soggy from too much wetness), signs of skin infection.

A very serious allergic reactions to lactic acid rare. However, immediate medical attention should be sought any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.


Store this medication at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.


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