Here’s how escharotic treatment works: Escharotic treatment has an affinity for HPV-infected and dysplastic cells, clearly causing their destruction as demonstrated with the formation of an eschar or scab. This creates localized inflammation and an immune response ensues. Within hours of cervical cell destruction and inflammation, blood-borne white blood cells, known as monocytes, migrate to the site of destruction and transform into tissue macrophages. These macrophages, known as dendritic cells, gobble up dead cells on the cervix, in the endocervical canal and on the vaginal walls. What is brilliant is that when dendritic cells encounter foreign viruses, they move the viruses to their surface and then “present” this invader to other immune system cells, such as T helper cells. T helper cells are considered the commanders-in-chief of cell-mediated immunity, critical for a robust immune response.
HPV inhibits cell-mediated immunity in its attempt to ‘hide” from the immune system. Therefore, in a strategic move against the virus, T helper cells are called to action by HPV-presenting dendritic cells. In effect, the dendritic cells marshal the troops to go after any and all HPV-infected cells in the region–they cause a localized immune frenzy at the site of HPV infection. Therefore, escharotic treatment does not simply consist of tissue destruction at the hands of a caustic solution, but the selective targeting of abnormal cells by the immune system. The escharotic treatment is “painting a target” on HPV and CIN. Thus, the mechanism-of-action with escharotic treatment is at least two-fold: abnormal cell destruction by sodium-potassium pump inhibition and by the facilitation of a highly selective immune system targeting of the virus.
It is my contention that escharotic treatment is superior to a LEEP. A LEEP is an arbitrary removal of cervical tissue with little regard for healthy versus diseased tissue. It’s comparable to removing an entire foot due to gangrene of one toe. Nor does a LEEP elicit a sustained inflammation or a targeted immune attack as in the case with an 8-12 week course of escharotics. Furthermore, escharotic treatment does not cause scarring of the cervix nor result in the increased risk of pre-term labor as is the case with surgical procedures. Additionally, escharotic treatment does not require downtime for recovery as is the case with LEEP and conization surgery; my patients are in and out of my office in 15 minutes, without restrictions in activities.