Cryotherapy for warts

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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 doctor's office. The liquid nitrogen application usually takes less than a minute.

• Your doctor 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 doctor 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.

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.

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

Cryotherapy can destroy warts. Research shows that cryotherapy is no more effective than salicylic acid.^{1, 2}

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

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 100°F (38°C) or higher with no other cause.

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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Citations

1. Gibbs S, Harvey I (2006). Local treatments for cutaneous warts. Cochrane Database of Systematic Reviews (3). Oxford: Update Software.

2. Luk NM, Tan YM (2007). Warts (non-genital), search date November 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

3. Focht DR III, et al. (2002). The efficacy of duct tape vs. cryotherapy in the treatment of verruca vulgaris (the common wart). Archives of Pediatric and Adolescent Medicine, 156(10): 971–974.