New Wart Treatment Shows Promise for Children
Intralesional Cidofovir Offers Hope for Stubborn Infections
A novel approach to treating persistent warts in children is showing encouraging results, offering a new option for cases resistant to traditional methods. The treatment involves injecting an antiviral medication directly into the lesions.
Promising Results in Case Series
A recent presentation at the Society for Pediatric Dermatology (SPD) 2025 Annual Meeting detailed findings from a case series involving seven children aged 7 to 17. These participants had tried multiple standard therapies, including salicylic acid, cryotherapy, and Candida antigen injections, without success for their recalcitrant warts located on the extremities.
“Treatment was well tolerated, and we were able to control pain,”
—Vivian Iloabuchi, BS, Study Author, Mayo Clinic Alix School of Medicine
The study involved injecting cidofovir, an antiviral drug typically used for cytomegalovirus retinitis, directly into each wart. Doses varied per session, with several children requiring pain management during the procedure. Three participants experienced complete resolution of their warts after just two treatment sessions.
Addressing Difficult-to-Treat Warts
Cutaneous warts, a common ailment in children caused by the human papillomavirus, can sometimes prove stubbornly resistant to conventional treatments. While many warts resolve spontaneously, a significant portion can persist and evade standard therapies, posing a challenge for both patients and clinicians.
Previous research has indicated the potential effectiveness of intralesional cidofovir for these difficult cases. A retrospective analysis of 58 individuals, including children as young as 10, found that nearly all warts improved, with a substantial majority resolving completely after an average of 3.4 treatments.
Another case series involving nine adults with recalcitrant periungual warts also demonstrated similar efficacy, with the majority achieving near-complete resolution after an average of 2.7 treatments, and improvements noted in all patients. These findings, along with the latest pediatric data, suggest cidofovir’s potential as a valuable treatment option.
Expert Commentary and Future Directions
Luke S. Johnson, MD, an associate professor at the University of Utah, acknowledged the supportive evidence presented by the case series. Anecdotally, some of my colleagues are using this in adults with decent success,
he commented, noting that accessibility and cost can be hurdles.
While the results are encouraging, further investigation is warranted. We do need larger studies with more patients and longer follow-up,
stated **Vivian Iloabuchi**. Research indicates that severe wart infections can impact a child’s quality of life, with some studies finding that over 60% of children with warts report emotional distress or self-consciousness (PubMed Central, 2022).
Expert Weighs In
Dr. Johnson emphasized the need for more comparative studies. I would use it if I could get it and be reimbursed for it,
he added, highlighting the practical considerations for widespread adoption of the therapy.
The authors concluded that this case series contributes to the growing body of evidence supporting intralesional cidofovir as a viable treatment for challenging warts in pediatric populations.