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Many vets have started using imiquimod (Aldara), a human wart cream, to treat aural plaque. The cream treats the plaques in many horses when using a 5% solution, by stimulating an immune response in the affected area. This treatment is primarily used if the ear plaque is causing problems or pain for the horse. Some horses and cases of ear plaque won’t respond to imiquimod. Before using the cream, you have to remove the white crusty areas and any other build up on the ears. To remove the ear plaque, use baby oil or another agent to soften the crusty, flaky areas first. Then, carefully and as gently as possible, remove the crusts. Never scrape the flakes off the horse's ear without softening it first. You don't want to cause the horse any additional pain. Scraping the plaque off the ears without taking care to reduce pain can cause head shyness and resistance. Talk to your vet about the recommended treatment schedule for your horse. Generally, the cream is applied every other day for a few months. Some horses may only need to be treated every other week, however. Be sure to follow your vet’s directions in applying the cream.  If your horse is in a lot of pain, your vet may recommend applying the cream twice weekly instead. The wart cream can lead to reactions in some horses. The most common reaction is severe inflammation. The affected areas may become red, start swelling, or ooze.  Some horses may have to be sedated. If the side effects are too much for your horse, your vet may prescribe Phenylbutazone. This is non-steroidal anti-inflammatory (NSAID) that helps with pain and inflammation.   Don’t stop treatment because of side effects – consult with your vet, instead. By stopping early, you may end up losing valuable progress in healing.
Consider using a wart cream. Prepare the ear before using the cream. Apply the cream three times each week or as directed. Be aware of the side effects of the cream.