From the Guidelines
Removing a wart with liquid nitrogen, known as cryotherapy, should ideally be performed by a healthcare professional, with repeat applications every 1–2 weeks, as recommended by the 2010 sexually transmitted diseases treatment guidelines 1. The procedure involves applying liquid nitrogen to the wart for about 5-10 seconds, which freezes and destroys the infected tissue.
- The treatment may require multiple sessions spaced 1-3 weeks apart.
- After treatment, a blister will form over the treated area within 24 hours, which will crust over and fall off within 1-2 weeks, taking the wart tissue with it.
- For aftercare, keep the area clean and covered with a bandage if needed, avoid picking at the blister, and watch for signs of infection such as increasing pain, redness, or discharge.
- Over-the-counter freezing treatments are available but are less effective as they don't reach the extremely cold temperatures of professional liquid nitrogen (-196°C).
- Cryotherapy works by creating ice crystals within the wart cells, rupturing cell membranes and destroying the human papillomavirus (HPV) that causes warts.
- If the wart persists after several treatments or if you have diabetes or circulation problems, consult a healthcare provider for alternative treatments, such as podophyllin resin, trichloroacetic acid (TCA) or Bichloroacetic acid (BCA), or surgical removal 1.
- It is essential to note that cryotherapy can cause pain after application of the liquid nitrogen, followed by necrosis and sometimes blistering, and local anesthesia (topical or injected) might facilitate therapy if warts are present in many areas or if the area of warts is large 1.
From the Research
Instructions for Removing Warts with Liquid Nitrogen
- The process of removing warts with liquid nitrogen is known as cryotherapy 2, 3, 4.
- Cryotherapy involves applying liquid nitrogen to the wart, which freezes the tissue and eventually causes it to fall off 2, 4.
- The treatment is typically repeated every 2-3 weeks for a maximum of 3 months 2.
- Studies have shown that cryotherapy can be an effective treatment for cutaneous warts, with cure rates ranging from 39% to 49% 2, 4.
- However, the effectiveness of cryotherapy can vary depending on the type of wart and the individual patient 3, 4.
Precautions and Side Effects
- Cryotherapy can cause side effects such as pain, blistering, and scarring 3, 4.
- It is essential to follow proper instructions and precautions when using cryotherapy to minimize the risk of side effects 3, 4.
- Patients should be aware that cryotherapy may not be suitable for all types of warts, and alternative treatments may be necessary 2, 3.
Comparison with Other Treatments
- Studies have compared the effectiveness of cryotherapy with other treatments, such as salicylic acid and imiquimod 2, 3, 5.
- While cryotherapy can be an effective treatment, it may not be the most effective option for all patients, and alternative treatments may be more suitable in some cases 2, 5.
- A study found that imiquimod 5% cream can be used safely in children with warts and is equally effective and more effective than cryotherapy in plantar warts 2.