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Dermatology Facts—Squaric Acid Dibutylester


Home Immunotherapy of Common Warts—Protocol

Benefits: 58% to 84% of patients clear their warts in three months. Partial clearing occurred in 10% to 18% of patients.

Safety: Is non-toxic, non-mutagenic and easy to use.

Risks: Possible mild to severe allergic reaction to SADBE (resembling poison oak). This is managed with a topical cortisone cream. Blistering and hypopigmentation (lightening of the skin) may occur.

Cost: To the patient, approximately $45 to $110 depending on size. Cost may vary depending on the compounding pharmacy.

Sensitization: 3% SABDE will be applied to a dime-sized area of the upper arm by the doctor or nurse. At this site, in the following one to two weeks, redness may develop in 10% of patients. A small amount of topical steroid will be given to treat this.

Starting therapy:

  1. Patient to start applying 0.2% squaric acid (SADBE) approximately 2 weeks after sensitization in office.
  2. Apply a small amount with a Q tip to warts each day.
  3. Avoid application to facial warts unless instructed to do so by the doctor.
  4. The medicine is drippy and evaporates easily, so application should be quick and be performed with care not to spill it or drip it.
  5. If after 3 months, there is no response, the concentration of the medicine will be increased to 1% and the process repeated for 3 more months.
  6. Please call the office if you have questions about this protocol.

Note: If you develop rash during therapy with SADBE, discontinue therapy and call our office.

What to expect: Responders can expect improvements as early as one month, and clearance as early as three months. No change will generally be seen for the first 4 weeks of therapy. If nothing happens, do not stop the medication because you do not think it is working. Just be patient.

Modifying therapy: If no response is seen at six weeks, the concentration of SABDE may be increased

Made by: Squaric acid dibutylester: Made by Spectrum Chemicals Co., Gardena, CA.

Compounding pharmacies:

  1. Dollar drug
    1055 W College Ave (in G and G shopping center) Santa Rosa, 95401
    Phone: 707-575-1313  ::  Toll Free:800-728-3173 (takes 24 hours to prepare)
  2. Jayes Compounding Pharmacy
    13222 Riverside Dr., Sherman Oaks, CA 91423
    Toll Free: (888) 999-5293
  3. Parnassus Heights Pharmacy
    350 Parnassus St., 1st floor, San Francisco, CA 94143
    Phone: (415) 564-9191
  4. Myers Apothecary
    238 Hospital Drive, Ukiah, CA 95482
    Phone: (707) 468-8991


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Our Locations

Santa Rosa

Redwood Family Dermatology
2725 Mendocino Avenue
Santa Rosa, CA 95403
Phone: 707-545-4537
Fax: 707-545-6726

Monday through Friday 8:30 to 5:00pm by appointment.

Ukiah

Redwood Family Dermatology
555 South Dora Street
Ukiah, CA 95482
Phone: 707-462-3996
Fax: 462-3363

Monday through Thursday:
8:30 to 4:30pm.
Friday: 9:00 to 2:00pm.
Occasional Saturdays.