Cryotherapy for warts

Surgery Overview

Cryotherapy involves freezing a wart using a very cold substance (usually liquid nitrogen). Cryotherapy is a standard treatment for warts and can be done in a health professional's office. The liquid nitrogen application usually takes less than a minute.

• Your health professional may pare the skin over a wart before applying liquid nitrogen.
• Cryotherapy is painful. A numbing local anesthetic is usually not necessary but may be used in some cases.
• Your health professional applies the liquid nitrogen to the wart using a probe or a cotton swab. Liquid nitrogen can also be sprayed directly on the wart.

Most warts require 1 to 4 treatments, with 1 to 3 weeks between each treatment.

What To Expect After Surgery

Pain from cryotherapy can last up to 3 days. Healing is generally quick (7 to 14 days) with little or no scarring.

Within hours after treatment, a blister may form.

• If the blister breaks, clean the area to prevent the spread of the wart virus. Avoid contact with the fluid, which may contain the wart virus.
• The blister will dry up over the next few days, and the wart may fall off.

Multiple treatments may be needed to get rid of the wart.

Why It Is Done

Cryotherapy is usually used if salicylic acid treatment has not eliminated a wart or if quick treatment is desired.

How Well It Works

Cryotherapy can destroy warts. Research indicates that cryotherapy is:

• Effective about 35% to 65% of the time.¹
• No more effective than salicylic acid.^{2, 1}

One small study has indicated that cryotherapy is not as effective as using tape over the wart.³

Risks

If done carefully, cryotherapy poses little risk of scarring.

If a wart is thick and requires extensive or repeated freezing, nerves around the wart can be damaged, scarring may occur, and the skin may take a long time to recover.

There is a small chance of infection associated with cryotherapy. Some signs of infection include:

• Increased pain, swelling, redness, tenderness, or heat.
• Red streaks extending from the area.
• Discharge of pus.
• Fever of 38°C (100°F) or higher with no other cause.

What To Think About

If you can tolerate moderate, short-term pain, cryotherapy may be a reasonable treatment option for you.

Cryotherapy:

• Can be painful and expensive but usually does not scar.
• Is most painful where the skin is thicker (palms and soles).
• Often takes multiple treatments, especially for thick, larger warts.
• Is quick and can be done in a doctor's office.

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Author:	Douglas Dana Sabra L. Katz-Wise Ralph Poore	Last Updated: January 10, 2007
Medical Review:	Adam Husney, MD - Family Medicine Randall D. Burr, MD - Dermatology Andrew Swan, MD, CCFP, FCFP - Family Medicine
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