Bleomycin Treatment for Wart Removal

Bleomycin, also known as bleomycin sulfate or Blenoxane, is an anti-cancer drug that can be used to remove warts.  It tends to be offered when all other wart removal treatments have failed or if the warts are difficult to remove surgically because they are in a hard to reach location.  Bleomycin is an antibiotic produced by the bacterium Streptomyces verticillus and acts by inhibiting DNA synthesis in cells and viruses; it breaks up strands of the DNA molecule.  The human papilloma virus (HPV) that infects the skin and causes the wart to form dies as its DNA is chopped up by the bleomycin.  Bleomycin may also target the blood vessels that feed the wart.

Bleomycin Treatment

Bleomycin is usually diluted in a saline solution and then injected directly into the wart, the area having at first been anesthetized with a local anesthetic.   A blood blister soon forms with the wart in the roof of the blister.  The wart turns black and after a few weeks falls off or can be removed by a doctor with a scalpel.

Additional injections may need to be given every three or four weeks until clearance has been achieved.   Bleomycin is not absorbed into the body and so it does not produce any of the side effects usually associated with chemotherapy such as hair loss or lung complications.

Bleomycin Disadvantages

The major disadvantage of Bleomycin treatment for warts is that it can be painful and several side effects have been reported by patients including scarring, nail damage, change in skin pigmentation, and skin irritation.  However, it can be a very effective treatment.  Bleomycin wart treatments can also be very expensive.

Bleomycin Success Rates

One study showed that a 92% clear up rate was achieved when the antibiotic was injected directly into the wart (Munn SE, Higgins E, Marshall M, Clement M.  A new method of intralesional bleomycin therapy in the treatment of recalcitrant warts.  Br J Dermatol 1996; 135: 969-71).  The researchers were treating intractable palmar, plantar, and periungual warts.  First a topical local anesthetic was applied to the affected area and then 1 mg/ml bleomycin solution was dropped on to the wart and injected into it via a needle.  The success rates compared favorably with other studies that had demonstrated positive outcomes in 33%-92% of cases.

When compared with cryotherapy treatment for wart removal, bleomycin comes out as more effective.  In a 2003 study (H Adalatkhah et al. Compared therapeutic efficacy between intralesional bleomycin and cryotherapy for common warts: A randomized clinical trial.  Dermatology Online Journal 13 (3): 4) scientists observed that when the two procedures were compared on 44 patients over 12 years of age, the mean clear up rate for bleomycin on hands and feet was 91.8%  and for cryotherapy it was 76.1% - a statistically significant difference.

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