From the Guidelines
Cryotherapy is a recommended treatment for warts, involving the use of liquid nitrogen to freeze the affected area.
Treatment Overview
- Cryotherapy can be used to treat various types of warts, including anal and vaginal warts 1.
- The treatment involves applying liquid nitrogen to the wart, which can be repeated as necessary.
- It is essential to apply the treatment carefully to avoid excessive application, which can lead to unwanted side effects such as pain, blistering, and scarring 1.
Specific Treatment Regimens
- For anal warts, cryotherapy with liquid nitrogen is a recommended regimen, which can be repeated weekly if necessary 1.
- For vaginal warts, cryotherapy with liquid nitrogen is also recommended, but the use of a cryoprobe in the vagina is not advised due to the risk of vaginal perforation and fistula formation 1.
Efficacy and Safety
- The efficacy of cryotherapy for wart treatment can be improved by using a double freeze–thaw cycle, but this may also increase the risk of pain and scarring 1.
- The treatment should be applied carefully to minimize side effects and ensure optimal outcomes.
From the Research
Cryotherapy for Wart Treatment
Cryotherapy is a common and effective treatment for common warts, which are hyperkeratotic, benign cutaneous growths caused by types 1,2, and 7 Human papilloma viruses 2. The treatment involves freezing the wart using liquid nitrogen, which can be applied using a spray method.
Efficacy of Cryotherapy
Studies have shown that cryotherapy is more effective than other treatments, such as trichloroacetic acid (TCA) 90%, in treating common warts 2. A study comparing cryotherapy using liquid nitrogen with TCA 90% found that cryotherapy resulted in a significant decrease in the size of the warts, with a mean percentage of improvement of 90.11% compared to 26.19% for TCA 90% 2. Another study found that a 10-s sustained freeze with liquid nitrogen was more effective than the traditional method of freezing until a halo of ice forms around the wart 3.
Comparison with Other Treatments
Cryotherapy has also been compared with other treatments, such as dimethyl ether and propane (DMEP), which is used in over-the-counter wart-freezing therapies 4. However, studies have found that DMEP is not as effective as liquid nitrogen in treating warts 4. A study comparing cryotherapy with a nitric-zinc complex solution (NZCS) found that cryotherapy had a higher cure rate, but NZCS could be considered a favorable first-line treatment option for plantar warts 5.
Protocols and Safety
Different protocols have been used for cryotherapy, including varying freezing times and intervals between sessions 6. A study comparing two cryotherapy protocols found that a single cycle of 10 seconds of freezing at 2 weekly intervals resulted in a higher cure rate than a single cycle of 20 seconds of freezing at 4-week intervals 6. However, cryotherapy can cause side effects, such as pain, blistering, and dyspigmentation, which can be significant 2, 3.
Key Findings
- Cryotherapy is a common and effective treatment for common warts 2
- Cryotherapy is more effective than TCA 90% in treating common warts 2
- A 10-s sustained freeze with liquid nitrogen is more effective than the traditional method of freezing until a halo of ice forms around the wart 3
- Cryotherapy has a higher cure rate than NZCS, but NZCS could be considered a favorable first-line treatment option for plantar warts 5
- Different protocols can be used for cryotherapy, but the optimal protocol is not yet established 6