Terrasil (Thuja Occidentalis) Ointment: What It’s For

Recently, a patient asked me about using Terrasil for wart removal. Thuja Occidentalis Ointment, also known as Terrasil Wart Removal, is a homeopathic remedy for warts.  Natural ingredients include: organic beeswax, cedarwood oil, and jojoba.

Because Terrasil is a homeopathic remedy and not a drug, the FDA does not regulate non-drug substances for accuracy of the company’s claim of effectiveness. Thus, there is no scientific evidence yet to support the claim that homeopathy is an effective method of treatment. It may work, but the company doesn’t need to prove it.

But this patient’s question jogged my memory about an article in the New England Journal of Medicine in 2004. The article describes a clinical trial of human alpha-lactalbumin coupled to oleic acid that was highly effective for treating human warts. The substance, known as HAMLET, is purified from human breast milk and applied topically.

In an accompanying editorial, commenters expand the possibilities for HAMLET treating malignant tissue such as HPV induced cervical cancer and cutaneous squamous cell carcinoma (which may have HPV as a cofactor with ultraviolet light). HAMLET is used to treat cells causing apotosis (cellular death) and appears to be a leave normal cells alone. Thus, the side effects on normal tissue would be minimal.

Medications like HAMLET are no doubt in the pipeline. Additionally, I think it’s curious that breast milk may provide answers to some of our most pressing medical problems. There may be room for more research there.


Bavinck JNB, Feltkamp MC. Milk of Human Kindness? — HAMLET, Human Papillomavirus, and Warts. New England Journal of Medicine N Engl J Med. 2004;350(26):2639-2642. doi:10.1056/nejmp048086.

Label: TERRASIL WART REMOVAL- thuja occidentalis ointment. DailyMed. https://dailymed.nlm.nih.gov/dailymed/druginfo.cfm?id=119689. Published February 28, 2014. Accessed August 1, 2016.

Topical Cortiscoteroid Therapy’s Lesser Known Side Effects

A long time patient of mine made an appointment with me just to ask some questions about his topical corticosteroid therapy. He had read the package insert, and had become concerned. The side effects stated that the medication could potentially make his diabetes worse. His “sugars” were higher after applying the medication for a couple of weeks.

I have to admit, I was dismissive at first. But when I researched my patient’s question, I found that that he was correct. I also discovered that potent topical corticosteroids can cause significant pituitary gland suppression. 20% of patients using these drugs for more than 3 weeks suppress the release of cortisol from their adrenal gland. The dose can be as low as 2 grams per day.

So sometimes, I find I need to rediscover things that I used to know. Thanks to this patient’s perceptive question, I can help others avoid side effects from these frequently prescribed medications.

Healthcare Progress Wasn’t Made in a Day

Rome wasn’t built in a day. Neither was the current state of healthcare progress in the US. While watching the film Ben Hur last week, the subplot of Leprosy in the ancient world impressed me. The fear of contagion and social isolation is reminiscent of some recent epidemics: syphilis, TB, and HIV. Now, Ebola and Zika trigger the most panic.

What struck me is how much healthcare progress the global medical community made in the last century. We’ve been able to eliminate and control so many infectious diseases. The USA is the primary leader in this effort, with investments in basic medical research. Shoutout to taxpayers!

Although many see large pharmaceutical companies as “robber barons”, they have also played a major role in drug development. They conducted well-crafted clinical trials that were necessary to healthcare progress. So while there is much to gripe about in the current state of healthcare in the US, what we can cure would amaze a citizen of Ancient Jerusalem.

In conclusion, we have much to be thankful for in the way of healthcare progress. But while we are arguing about healthcare delivery, let’s make sure we invest heavily in the basic research of disease. Collectively, I think it is one of the costs we must bear.

Surgical Technique From The Western Frontier to Present

I recently watched The Revenant and am now reading the book. Wound care in the 1800s Western frontiers shocked me. I’m sure surgical technique was different in big city hospitals. But out in the wilderness, all people had were crude remedies. There was no local anesthesia. People treated wounds with poultices of pine tar and Native American astringents.

In 200 years, we have come so far with surgical technique: we’ve developed anesthesia (circa 1850), sterile technique (circa 1860), and antibiotics (circa 1930). Now, major trauma centers (circa 1980) are a large part of the medical world.

Doctors learned many of the innovations in military field hospitals. As a result, these techniques made their way to general practices. Looking back, this is an area where necessity is the mother of invention. The medical community has advanced significantly in helping the body to do its job. This is truly an impressive feat in a short amount of time.