Warts are a common skin condition caused by the human papillomavirus (HPV), often appearing on the hands, feet, or other areas of the body. While some warts resolve on their own, others may require medical intervention to prevent spreading or persistent irritation.
Cryotherapy is a widely used wart removal technique that involves freezing the wart with liquid nitrogen. This process destroys the wart tissue, causing it to gradually fall off as the skin heals. Cryotherapy is often recommended for smaller, superficial warts but may not always be suitable for deep-rooted or large lesions.
This guide explains how cryotherapy works, which types of warts respond best to freezing, and how it compares to surgical removal. Understanding the effectiveness, pros and cons, and recovery process can help determine whether cryotherapy is the right choice for wart treatment.
How Does Cryotherapy Work for Wart Removal?
Cryotherapy is a non-invasive procedure that uses liquid nitrogen to freeze and destroy wart tissue. The extreme cold temperature damages the wart’s infected skin cells, prompting the body to replace them with healthy new tissue over time.
The Freezing Process Explained
- Application of Liquid Nitrogen – A dermatologist applies liquid nitrogen using a cotton swab or spray device, freezing the wart within seconds.
- Formation of an Ice Burn – The extreme cold causes the wart and surrounding skin to blister, cutting off the wart’s blood supply.
- Cellular Destruction – The freezing process kills the wart tissue, triggering an immune response to clear the affected cells.
- Wart Shedding and Skin Regeneration – Over the next one to two weeks, the wart dries out, scabs over, and eventually falls off.
What Happens to the Wart After Treatment?
- Initial reaction (First 24 hours): The treated area may appear red, swollen, or blistered.
- Healing phase (Days 3-7): A scab forms as the dead wart tissue begins to separate from healthy skin.
- Wart falls off (1-2 weeks): The scab naturally drops off, leaving behind newly formed skin.
Some warts require multiple cryotherapy sessions, particularly if they are larger or deep-rooted. The success rate varies, and while freezing is effective for many patients, warts may return in some cases if the virus remains in the skin.
Which Types of Warts Are Suitable for Cryotherapy?
Cryotherapy is a versatile treatment, but it is most effective for specific types of warts. The location, size, depth, and wart type determine whether freezing is the best option.
When Freezing Works Best
| Wart Type | Description | Suitability for Cryotherapy |
|---|---|---|
| Common Warts (Verruca Vulgaris) | Rough, raised growths, often found on hands and fingers. | Highly suitable, especially for small warts. |
| Plantar Warts (Verruca Plantaris) | Hard, thickened warts on the soles of the feet. Can be painful due to pressure. | Moderately suitable, but deeper plantar warts may require multiple treatments. |
| Flat Warts (Verruca Plana) | Smooth, slightly raised warts that appear in clusters. Common on the face, hands, and legs. | Suitable, but alternative treatments like topical solutions may be preferred. |
| Genital Warts | Soft, flesh-coloured growths in the genital area caused by HPV. | Not usually recommended; other treatments are preferred. |
| Periungual Warts | Warts that form around fingernails or toenails, often painful. | Less suitable, as these can be resistant to freezing. |
Cases Where Alternative Treatments May Be Recommended
While cryotherapy is effective for many warts, it may not always be the best option, particularly for:
- Large, deep-rooted warts – Surgical removal may be more effective for complete excision.
- Warts resistant to previous cryotherapy – Some require alternative treatments such as laser therapy or electrocautery.
- Sensitive areas (e.g., face, genitals, eyelids) – Freezing may cause unwanted irritation or scarring.
- Patients with circulation issues (e.g., diabetes, Raynaud’s disease) – Cryotherapy may not be suitable due to potential complications with healing.
Cryotherapy vs. Surgical Removal
While cryotherapy is a popular choice for wart removal, surgical excision or electrocautery is another highly effective option, especially for larger, deep-rooted, or resistant warts. Understanding the differences between these two treatments can help determine the best approach based on individual needs.
Pros and Cons of Cryotherapy
| Pros | Cons |
|---|---|
| Minimally invasive – No cutting or stitches required. | Multiple sessions may be needed – Some warts require 2-3 treatments for full removal. |
| Quick procedure – Treatment takes only a few minutes. | Can be painful – The freezing process may cause discomfort or stinging. |
| No downtime – Patients can resume daily activities immediately. | Risk of recurrence – If wart cells remain, regrowth is possible. |
| Low scarring risk – Generally heals without significant marks. | Less effective for large or deep-rooted warts – May not fully remove plantar or periungual warts. |
How Surgical Excision Compares for Wart Removal
Surgical wart removal involves cutting out the wart under local anaesthetic, ensuring complete removal of the infected tissue. While it is not always necessary, it can be a better option for stubborn or painful warts.
| Feature | Cryotherapy | Surgical Removal |
|---|---|---|
| Effectiveness | Works well for smaller warts but may require multiple treatments. | Highly effective for large, deep, or resistant warts. |
| Pain Level | Mild to moderate discomfort during freezing. | Local anaesthetic used, so pain-free during the procedure. |
| Healing Time | 1-2 weeks; scab forms and falls off. | 2-4 weeks; stitches may be required in some cases. |
| Scarring Risk | Low risk unless multiple treatments cause skin irritation. | Slightly higher, but careful excision minimises visible scarring. |
| Best For | Common and small plantar warts. | Deep, painful, or persistent warts that haven’t responded to other treatments. |
When to Consider Surgical Removal Over Cryotherapy
Surgical excision may be a better option if:
- Cryotherapy has failed – If freezing does not fully remove the wart, excision ensures complete removal.
- The wart is large or deep-rooted – Some plantar warts or periungual warts do not respond well to freezing.
- There is persistent pain or discomfort – Some warts press on nerves or cause irritation, requiring direct removal.
- A patient prefers a one-time solution – Surgery removes the wart in one session, while cryotherapy may need multiple treatments.
While both cryotherapy and surgical excision are effective, the right treatment depends on the wart’s location, size, and resistance to other treatments. Consulting with a dermatologist or surgeon ensures the best approach for safe and permanent wart removal.
