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Freezing Warts: Cryotherapy Explained

Freezing warts (cryotherapy) is a common medical treatment that uses liquid nitrogen to destroy wart tissue by applying extreme cold directly to the affected area.

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Things worth knowing about "Freezing warts"

Freezing warts (cryotherapy) is a common medical treatment that uses liquid nitrogen to destroy wart tissue by applying extreme cold directly to the affected area.

What is wart freezing?

Wart freezing, medically known as cryotherapy or cryosurgery, is a procedure used to remove warts by applying extreme cold to the affected tissue. The most commonly used substance is liquid nitrogen, which reaches temperatures of approximately −196 °C (−321 °F). The treatment is performed by dermatologists and general practitioners and is well tolerated by most patients.

How does cryotherapy work?

During the procedure, liquid nitrogen is applied directly to the wart using a spray device or a cotton swab applicator. The extreme cold causes the water inside the wart cells to freeze, destroying the cell membranes and killing the abnormal tissue. The surrounding healthy tissue remains largely unaffected.

The typical process involves:

  • The doctor applies liquid nitrogen to the wart for a few seconds.
  • The treated area turns white and hard as it freezes.
  • After thawing, a blister commonly forms.
  • The dead tissue falls off within 1 to 2 weeks.
  • Multiple sessions (usually 2 to 6) are often required for complete removal.

Which types of warts can be treated?

Cryotherapy is suitable for various types of warts:

  • Common warts (Verrucae vulgares): Most frequent type, usually found on hands and fingers.
  • Plantar warts: Warts that grow deep into the skin on the sole of the foot.
  • Flat warts (Verrucae planae): Small and flat, often appearing on the face or arms.
  • Genital warts (Condylomata acuminata): Located in the genital area; require careful medical treatment.

Causes of warts

Warts are caused by the Human Papillomavirus (HPV). The virus enters the skin through small cuts or abrasions and triggers uncontrolled growth of skin cells. HPV is highly contagious and spreads through direct skin-to-skin contact or via contaminated surfaces, such as swimming pool floors or changing rooms.

When to see a doctor

Medical evaluation and treatment are recommended when:

  • Warts are painful or growing rapidly.
  • Warts appear on the face, genitals, or near the eyes.
  • Over-the-counter treatments have not been effective.
  • The diagnosis is uncertain and other skin conditions cannot be ruled out.
  • The patient has diabetes or circulatory problems.

Side effects and risks

Cryotherapy is generally safe but may cause the following side effects:

  • Pain and burning sensation during and after the procedure.
  • Blister formation at the treated site.
  • Scarring with intensive or repeated treatment.
  • Changes in skin pigmentation (lightening or darkening), especially in darker skin tones.
  • Rarely: infection at the treatment site.

At-home cryotherapy

Over-the-counter wart freezing products are also available for home use (typically based on dimethyl ether and propane). These products cool the wart to approximately −50 °C and are less powerful than liquid nitrogen used in a clinical setting. They are best suited for small, uncomplicated warts on the hands or feet. Users should always follow the instructions provided in the product leaflet carefully.

References

  1. Kwok CS et al. - Cryotherapy for cutaneous warts. Cochrane Database of Systematic Reviews, 2012.
  2. Sterling JC et al. - British Association of Dermatologists' guidelines for the management of cutaneous warts, 2014. British Journal of Dermatology.
  3. World Health Organization (WHO) - Human papillomavirus (HPV) and the HPV vaccine: Information for the public, 2023.

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