Common warts and plantar warts are viral infections caused by the human papilloma virus. Viral warts can be stubborn and difficult to get rid of. When warts have failed the usual remedies, such as over-the-counter salicylic acid liquid or freezing with liquid nitrogen, then treatment with immunotherapy might be an appropriate next treatment. Immunotherapy harnesses the body's natural healing energy by trying to fight the invading viral infection.
Candida immunotherapy for warts was first described in Japan in 1978 by Seichi Harada, MD, who was professor of dermatology at the Nippon University School of Medicine in Tokyo. In the 1980's, Ruth Bolton, MD pioneered the treatment for warts while at the University of Minnesota. In the first few years of the new century, 3 groups in the U.S. published studies supporting the efficacy of Candida immunotherapy for warts: Dr. John Pfenniger's group in Bay City, Michigan; the University of Arkansas (Dr. Sandra Marchese-Johnson, Dr. Thomas Horn and colleagues); and our office in Tinley Park, Illinois (Dr. Robert Signore, and staff).
A special thank you goes out to Dr. Kimberly Huntington, DO who first informed me of this useful treatment for warts. Since then, Candida allergenic extract intralesional injection immunotherapy for warts has become more widely used by dermatologists around the world.
During this form of immunotherapy, warts on the hands, fingers, feet, or toes are injected with a sterile solution called Candida albicans allergenic extract. The warts often get itchy, or sore for 1 to 2 days after the injections. Patients get these immunotherapy injections every 4 to 8 weeks until the warts are gone. It is not uncommon for uninjected warts also to resolve during immunotherapy. If the warts are not completely clear after 3 sessions, patients may select another form of treatment. While this wart treatment is not always effective, we have seen patients' warts resolve dramatically with this form of immunotherapy even if they have failed other treatments, such as laser treatment, surgery, or freezing.
While Candida allergenic extract has been FDA- approved since 1958 for injection into the skin for allergy immunotherapy and detection of allergic hypersensitivity, it is not FDA-approved for immunotherapy of warts yet. Candida immunotherapy is an off-label use of Candida albicans allergenic extract.
Side-effects include itching, localized soreness, swelling, pain, and rarely, shedding of fingernail. If you are having warts injected on your fingers, it is a good idea to remove your rings before treatment, in case your fingers swell after injection. Chills and fever are uncommon, but usually respond to acetaminophen. Hives or severe allergic reactions could be a rare possibility. For safety reasons, in our office we pre-test suitable patients with a simple prick test of the forearm to detect severely hypersensitive patients prior to the first immunotherapy session.
You should NOT get Candida immunotherapy injections for your warts if: you are pregnant or breast feeding, sick with a fever or the flu, are currently experiencing hives or a recent asthma attack, or have an active vaginal yeast infection, are taking immunosuppressant medicines, have a solid organ transplant, are taking beta-blocker medicines, or have had a previous allergic reaction to Candida albicans allergenic extract.
You can discuss with our staff whether this treatment would be suitable for you at your office appointment. We have found that Candida immunotherapy can be quite helpful in the treatment of common warts and plantar warts. However, we have not found it helpful for flat warts.
PUBLISHED REFERENCES - Candida albicans Intralesional Injection Immunotherapy of Warts: