Cryotherapy (freezing) is an effective treatment option for many types of genital warts, but not all. It is useful for warts located on easily accessible areas of the body, such as shaft of the penis, vulva, skin of the genital region, anus.
The procedure is performed by a properly-trained physician and typically takes from 5 to 15 minutes to complete. Usually more than one treatment session is required.
During the procedure physician places liquid nitrogen or nitrous oxide directly on the wart tissue to destroy it on contact.
The extremely low temperature provided by these agents leads to permanent damage of the wart tissue, as well as the surrounding healthy tissues, such as blood vessels and superficial layers of the skin.
Depending on the size and thickness of the lesion, the process of freezing the wart may take longer to complete or involve up to 3 repeat (or even more) applications performed every 1-2 weeks. Limited clinical studies suggest that treatment sessions scheduled at shorter time intervals (every week) are more effective than those occurring less often (every two or three weeks).
How Effective is Cryotherapy for HPV Warts?
Cryotherapy is a very effective form of treatment of genital warts.
It provides clearance rates of 79-88% after the first three treatments (1). This means that up to 88% of warts disappear after cryotherapy.
However, as is also common with other forms of treatment for genital warts, cryotherapy is associated with a recurrence rate of 25-40% (2). The nature of HPV is that the warts are simply an external sign of the infection. Human papilloma virus remains within the body even after all the warts have been destroyed by cryotherapy or other treatment options. Since the virus remains in the body untouched, new warts may develop as soon as the old ones have been destroyed.
Overall, the best results are seen with warts that are small and located on the vulva or the penile shaft (3).
Does Cryotherapy Hurt?
Yes, but it bearable. The process of freezing a wart essentially destroys both healthy tissue and the wart. In some cases it can be rather painful. For this reason, warts located in body areas that are especially tender, are best not treated with cryotherapy.
During the procedure, you may feel unpleasant burning or pain in the area of the wart. This pain typically only lasts a few minutes after the treatment is stopped.
How Soon After Cryotherapy Can I Have Sex?
Skin irritation, redness or blistering usually develop after the procedure. These changes are completely normal and will heal within 1-3 weeks. You should avoid engaging in sexual activity until all lesions have healed.
What Are the Side Effects of Cryotherapy?
Since cryotherapy works by destroying the human tissue (warts, healthy skin, blood vessels, etc.) a number of side effects commonly occur.
LOCAL PAIN AND BURNING
As mentioned earlier, pain and burning sensation usually occur during the procedure and last for a few minutes after the procedure has ended. In most cases the pain is limited. It’s very unlikely that you will need to take pain medication.
In the days after cryotherapy, some patients develop small ulcers in the area treated with liquid nitrogen. In most cases this is a temporary issue that go away as fast as it developed.
Blisters similar to those that develop after a skin burn commonly develop after cryotherapy. Usually they are relatively small, about the size of the original wart and do not pose significant threat. You should never attempt to puncture or in any way “treat” blisters on your own, because of a risk of infection. Blisters typically pop on their own in 1-3 days, by that time there is sufficient amount of newly-formed skin at the base of the blister, that the risk of an infection is significantly lower.
Scars may occur after cryotherapy. Usually they are relatively minimal and do not occur in everyone undergoing cryotherapy. Scars have a tendency to form in patients with significantly large warts that require multiple treatment sessions.
LOSS OF PIGMENTATION
Another side effect of cryotherapy is the loss of skin pigmentation. It becomes apparent a few weeks after therapy has ended and the skin wound had healed. It looks like a light area with a circular or oval shape, about the size of the original wart. It may be slightly larger than that if the doctor also froze healthy skin in the margins of the wart. This loss of skin pigmentation may take years to heal completely, if at all. However, it is a benign finding and there is no need to treat it.
Infections rarely occur after cryotherapy. They may be caused by lack of proper wound care, ulcers and blisters, as well as accidental soiling of the wound. Once the infection develops, it should be treated with antibiotics. Your doctor will decide whether an antibiotic ointment will be sufficient, or if oral antibiotics should used. The vast majority of such infections are successfully treated with antibiotics in a matter of days.
Is Cryotherapy the Best Treatment for HPV Warts?
No. Various clinical studies performed to date report that there is no single best treatment for HPV warts. Additionally, currently there is no treatment for the human papilloma virus infection.
In other words, the various treatment modalities used for the skin exacerbations of the infection (warts), are all equally effective. It is difficult to predict which form of therapy will be best for a specific group of patients.
Now, you should keep in mind that the treatment options that we currently have are only aimed at the skin lesions. There is no treatment for the overall HPV infection within the body. Scientific research suggests that the human body clears the virus on its own within about 2 years in 90% cases.