Actikerall® to treat warts

Warts are a common kind of skin growth. Most warts usually clear up without treatment but sometimes we treat warts if they are painful, in an awkward position or causing distress.

Actikerall® full name is Actikerall® 5mg/g + 100mg/g cutaneous solution.

In adults, it is used to treat a skin condition called actinic keratosis. At GOSH, we use Actikerall® to treat very stubborn warts which have failed to respond to other treatments.

Actikerall® is ‘unlicensed’ for use in children. However, you can be assured that your child’s medical team have only prescribed Actikerall® because they think that it will benefit your child and no licensed alternative is available.

Actikerall® is usually applied directly to the affected areas of skin, once a day for up to 12 weeks. Your child’s medical team will advise exactly how to use it in your child’s case.

Before applying to your child’s skin, Always check that the liquid hasn’t dried up or formed crystals. If the liquid looks different or you can see crystals, do not use it. Instead, return it to your pharmacist for disposal.

How to apply:

1. Shake the bottle well.
2. Remove the top off the bottle.
3. Wipe the brush against the neck of the bottle to remove excess liquid.
4. Dab the liquid onto the wart and a very small area of surrounding skin.
5. Leave the liquid to dry. Do not cover it. A white film will form.
6. Put the top back on the bottle and tighten.

Removing the previous dose:

Before applying the next dose, you will need to remove the previous day’s dose.

The manufacturers advise to simply peel the white film off. You may find it helpful to use tweezers or a cocktail stick to help gently lift off the edge so you can grasp it with your fingers. Warm water can also be used, but this is less effective, and some film may remain.

After applying:

Wherever possible, the skin area treated with Actikerall® should be protected against direct sunlight and other forms of ultraviolet radiation (for e.g. sunbeds, nail lamps) using hats and clothing. The treated skin should not be covered with dressings or bandages.

People with the following should discuss using Actikerall® with their medical team:

· Allergy to Actikerall® or any of its ingredients.

· Pregnant, could be pregnant, trying to become pregnant or breastfeeding.

· Existing kidney problems.

Side effects usually occur where the liquid is applied and can include:

• Redness
• Inflammation
• Itching
• Bleeding
• Flaky skin
• Scab formation

If you are concerned about any of these side effects, please discuss this with your child’s medical team.

Every person reacts differently to medicines, so your child will not necessarily suffer every side effect mentioned.

Some medicines can react with Actikerall® and alter how well it works. Always check with your child’s medical team or pharmacist before giving your child any other medicine. This includes medicines on prescription, medicines bought from a pharmacy or any herbal or complementary medicines.

The following medicines are known to react with Actikerall®:

• Anti-virals including brivudine, sorivudine or similar medicines.
• Phenytoin- an anti-epileptic medication.

• Keep all medicines in a safe place where children cannot see or reach them.
• Keep Actikerall® in a cool, dry place away from direct sunlight or heat.
• Actikerall® is flammable (it can catch fire). Never apply it by candlelight, near an open fire or while smoking. Once the liquid has been applied, your child must avoid naked flames, such as candles or open fires.
• Actikerall® can stain fabrics or acrylic surfaces, such as acrylic baths.
• Actikerall® should only be used for three months after opening- write the date you opened the bottle on the label to remind you.
• If your child’s medical team decides to stop treatment with Actikerall® or the medicine passes its expiry date, return any remaining medicine to the pharmacist. Do not flush it down the toilet or throw it away.

• GOSH Switchboard – 020 7405 9200
• Pharmacy medicines information – 020 7829 8608 Monday to Friday from 9am to 5pm