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The Apothecary

Extemporaneous Prescribing Guide

Menthol and Eucalyptus Inhalation BP

Chlorinated Lime and Boric Acid Solution BP (Eusol)

Toothpaste ACH

Trichloroacetic Acid Paste APF (Upton's Paste)

Zinc and Castor Oil Ointment APF

Additional information: Trichloroacetic acid is a caustic agent whilst salicylic acid is a keratolytic. Thus, this preparation removes the hyperkeratotic areas and destroy the underlying epidermis.

Directions for use: Apply sparingly to warts twice daily, taking care to avoid surrounding skin, using an appropriate applicator eg. toothpick, cotton bud. Skin may be protected using a paraffin based product eg. Vaseline, or by applying a plaster with a hole cut out in the size of the wart. The use of a pumice stone to remove dead skin may be useful prior to the application of the paste. The wart should then be covered using a plaster.

Precautions for use: Trichloroacetic acid is highly caustic and this preparation may be irritating. Cease use if pain or inflammation occurs. Care should be taken when used on patients with peripheral vascular disease or neuropathy eg. people with diabetes. For these patients, particularly if being used for plantar warts, it is recommended that regular checks (eg. by the patient or carer) be undertaken to ensure that the “normal” skin is not affected. The advice of a podiatrist may be useful under such circumstances.