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Crude coal tar is the most effective, but few outpatients tolerate the mess and smell. In hospitals, coal tar is often combined with ultraviolet B (UVB) radiation. There are many proprietary preparations, which are more refined and therefore more acceptable to patients, but they are less effective. They are used as a creams, lotions, ointments and bath oils in concentrations from Coal tar preparations are less irritating to normal skin than dithranol, but can cause folliculitis. Keratolytics break down keratin and soften skin, which improves penetration of other treatments.

This means that the effect of the original oncogene is blocked. Cancer cells produce enzymes that can breakdown the extracellular matrix between normal cells and allow cancer cells to invade and spread in normal tissue. New drugs are being developed that inhibit these enzymes. In order for tumours to grow they need to develop a blood supply. Drugs are being developed that inhibit angiogenesis, which is the growth of new blood vessels.

Repeated treatment is often necessary and can be painful. One preparation contains podophyllum, which is a cytotoxic drug and must not be used in patients who are pregnant or considering pregnancy or breast-feeding. Podophyllum inhibits cell division in virally infected cells. Treatment with wart paints is usually once or twice a day with abrasion between applications. Perseverance with treatment is essential and surrounding skin should be protected with plasters or Vaseline.

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