Dibutyl Squaric Acid Topical Solution


 dibutyl squaric acid topical solution application


Dermatologists, Pediatricians, and other qualified practitioners can benefit from choosing an FDA-Registered Outsourcing Facility like Edge for compounded Dibutyl Squaric Acid Topical Solution (Squaric acid dibutyl ester) because we are able to dispense for office use. 


Dibutyl Squaric Acid Topical Solution (PF) 

  • 1% and 2% Dibutyl Squaric Acid Topical Solution available
  • 10mL bottle
  • Refrigerated storage


dibutyl squaric acid 1 and 2 percent 

See Also:

Cantharidin Topical Solution


Literature Review


Cutaneous Warts 

Cutaneous warts are common skin lesions that are caused by human papillomavirus. Recurring or recalcitrant warts generally affect children and people who are immunocompromised.(1) “Although several potential treatment options exist for warts, there is no single treatment that ensures a complete response and lack of recurrence.”(1)

Treatments for warts include:

  • Cantharidin
  • Cryotherapy
  • Electrosurgery and curettage
  • Excision
  • Laser treatment
  • Chemical peels
  • Bleomycin
  • Immunotherapy(2)

Treatment of recurrent warts in children is often challenging as destructive options and surgery can be frightening and painful. “Contact immunotherapy offers a less painful approach than destructive measures.”(3)

“Squaric acid (SADBE) is an immunotherapy used to treat common warts.”(4) The treatment activates the immune system to combat the warts.(4)

A study enrolled 188 patients, ages two to 16, who had warts for an average of 17 months. Patients needed to satisfy two of the following criteria: single or multiple sites with several warts, warts resistant to repeated medical or surgical treatments, recurrent multiple warts, and patient or parent refusal to undergo destructive or surgical treatment.(5)

A total of 148 patients completed the therapy. “The treatment consisted of twice weekly applications of serial dilutions of SADBE, 0.03—3 percent for no more than 10 weeks.”(5) The study found complete resolution occurring in 83 percent of patients. There were no serious or unexpected side effects reported.(5)

The study concluded: “Our study substantiates the efficacy of SADBE in the treatment of recurrent/recalcitrant warts in children because of the ability to treat multiple lesions at the same, the high level of tolerability with absence of major side effects, the high clinical response rate with no recurrences or major side effects, and the high clinical response rate, with no recurrences in all of our patients who completed 24-month follow-up.”(5) 

(1) Sefcik, R., Burkhart, C., The Open Dermatology Journal, Wart Immunotherapies: A Short Review https://benthamopen.com/
 (2) American Academy of Dermatology, online article, Warts: Diagnosis and Treatment https://www.aad.org/
 (3) Pandy, S. MD, Wilmer E. MD, Morrell, D. MD, Pediatric Dermatology, Examining the Efficacy and Safety of Squaric Acid Therapy for Treatment of Recalcitrant Warts in Children https://pubmed.ncbi.nlm.nih.gov/
 (4) The Permanente Medical Group, Kaiser Permanente, Protocol: Squaric Acid Dibutylester (SABDE) Home Immunotherapy of Common Warts https://mydoctor.kaiserpermanente.org 
(5) Micali, G., et al, Pediatric Dermatology, Use of Squaric Acid Dibutylester (SADBE) for Cutaneous Warts in Children https://www.researchgate.net/


Herpes Labialis 

Herpes labialis is a common condition characterized by erosions on skin around the lips and nose.(1) Generally, the HSV-1 virus first infects the oral mucosa tissue. It then migrates to sensory organs and establishes latency. “The virus is later activated from latency by events including fever, stress, cold or flu infection, immunosuppression, and sunlight. Upon activation, the virus migrates down sensory neurons to epithelial cells, typically on the vermillion border of the lip, and causes cell lysis and outbreaks as epidermal lesions there.”(2)

Some medical conditions increase the risk of a person getting recurrent cold sores, also called oral herpes. These conditions include:

  • HIV
  • Undergoing chemotherapy
  • Organ recipient
  • Having conditions such as eczema or psoriasis(3)

A study conducted at a major medical center included adults between the ages of 18 to 69, who self-reported having six or more episodes of herpes labialis in the previous year. Half of the subjects received a sensitization dose of squaric acid on the arm at the initial visit; the other half received placebo. When the subjects developed a lesion they received a treatment dose of squaric acid, however 16 out of 28 patients did not experience another outbreak so did not receive another treatment dose. Of the subjects who did develop a lesion, “the median time to event for the placebo group was 40 days versus more than 122 days for the 2.0% SADBE group, which difference was highly significant.”(1)  

(1) Palli, M. M.D., McTavish, H. PhD, et. al., Journal of the American Medical Association/Dermatology, Immunotherapy of Recurrent Herpes Labialis with Squaric Acid, https://www.ncbi.nlm.nih.gov/
(2) McTavish, H. PhD, Zerebiec, K. M.D., et. al., Immunity, Inflammation and Disease, Immune Characteristics Correlating with HSV‐1 Immune Control and Effect of Squaric Acid Dibutyl Ester on Immune Characteristics of Subjects with Frequent Herpes Labialis Episodes https://www.ncbi.nlm.nih.gov/
(3) Medical News Today, What Causes Recurrent Cold Sores? https://www.medicalnewstoday.com/


Register To Order Online 

We are currently licensed to sell to all US states except Alabama and Virginia. Please fill the Form below to create an account. Medical, DEA, or hospital pharmacy licenses will be required to purchase dibutyl squaric acid solution.

Create an account to order

Log-In if you have an account