From the Guidelines
The recommended number of cryotherapy sessions for treating a plantar wart is at least 3 months or six treatments, with sessions repeated every 2-4 weeks, as suggested by the British Association of Dermatologists' guidelines for the management of cutaneous warts 2014 1. This recommendation is based on the guidelines' suggestion to keep the wart frozen for 15–30 s, repeating every 2–4 weeks for at least 3 months or six treatments. The exact number of sessions needed may vary depending on the size, depth, and stubbornness of the wart.
- Key points to consider when undergoing cryotherapy for plantar warts include:
- The treatment can be painful and may cause blistering
- Patients should keep the area clean between sessions and may use over-the-counter salicylic acid products to help remove dead tissue
- Cryotherapy works by creating ice crystals within cells and damaging blood vessels that supply the wart, effectively killing the tissue infected with human papillomavirus (HPV)
- The treatment may require multiple sessions before complete resolution is achieved, as noted in other studies, such as the sexually transmitted diseases treatment guidelines 2002 1 and 2010 1, which suggest repeat applications every 1–2 weeks.
From the Research
Cryotherapy Sessions for Plantar Warts
- The recommended number of cryotherapy sessions for treating a plantar wart can vary, but most studies suggest that up to 4-5 sessions may be necessary, spaced 2-3 weeks apart 2, 3, 4.
- A study published in 2011 found that cryotherapy with liquid nitrogen, delivered by a healthcare professional, up to four treatments two to three weeks apart, was effective in treating plantar warts 2.
- Another study published in 2022 found that intralesional cryotherapy, which involves injecting liquid nitrogen into the wart, was more effective than cryotherapy spray, with a complete clearance rate of 80.3% compared to 50.8% 3.
- The number of sessions required for complete clearance of plantar warts can vary, but one study found that intralesional cryotherapy required fewer sessions (1.5 ± 0.40) compared to cryotherapy spray (4 ± 1.3) 3.
- A systematic review and meta-analysis published in 2022 found that cryotherapy had lower cure rates than other treatments, but intralesional cryotherapy appeared to be more effective than spray-on cryotherapy 5.
Factors Affecting Cryotherapy Efficacy
- The efficacy of cryotherapy for plantar warts can be influenced by various factors, including the type of cryotherapy used (intralesional vs. spray-on), the number of sessions, and the individual patient's response to treatment 3, 5.
- Some studies suggest that cryotherapy may be less effective than other treatments, such as immunotherapy or topical treatments, but more research is needed to confirm these findings 4, 6, 5.
Treatment Outcomes
- The outcome of cryotherapy for plantar warts can vary, but complete clearance rates ranging from 14% to 80.3% have been reported in different studies 2, 3, 4.
- Recurrence rates can also vary, but one study found that intralesional cryotherapy had a lower recurrence rate (2%) compared to cryotherapy spray (23.3%) 3.