Warts and verrucae are common skin growths caused by human papillomavirus (HPV). While they are usually harmless, they can be uncomfortable or bothersome.
Many people seek treatment to remove them, especially if they are painful, spreading, or persistent.
One of the most effective medical treatments for warts and verrucae is cryotherapy, which uses liquid nitrogen to freeze and destroy the affected tissue.
This guide covers what warts and verrucae are, how to tell the difference between them, what happens if a verruca is left untreated, and how cryotherapy can help get rid of them.
What Is a Wart or Verruca?
Warts and verrucae are small growths on the skin caused by HPV. While many people associate HPV with other conditions, the virus has multiple subtypes that affect different parts of the body.
The most common types of HPV that cause verrucae are subtypes 2 and 4.
How to Tell the Difference Between a Verruca and a Wart?
The only difference between a wart and a verruca is location:
- Warts can appear anywhere on the skin.
- Verrucae (also called plantar warts) specifically occur on the soles of the feet.
Verrucae often have a rough surface and may develop small black dots (which are tiny blood vessels). Because they form on weight-bearing areas, they can grow inward, causing discomfort when walking.
What Happens If a Verruca Is Left Untreated?
Warts and verrucae do not usually require medical treatment and often disappear on their own.
- In children, around two-thirds of warts and verrucae clear within two years.
- In adults, it may take five to ten years for them to resolve naturally.
However, some people choose to have them removed because:
- They spread to other areas, such as the fingers or other parts of the feet.
- They are painful or cause discomfort when walking.
- They worry about passing them to others, particularly in communal areas like swimming pools.
- They do not like the appearance of the wart or verruca.
If left untreated, verrucae may persist for years but rarely cause serious medical issues in healthy individuals.
How Do You Get Rid of a Wart or Verruca?
Many people try at-home treatments before seeking medical treatment. Common options include:
- Salicylic acid creams (available over the counter)
- Home freezing kits (these use a different substance than medical cryotherapy)
However, if home treatments are ineffective or the wart is persistent, cryotherapy performed by a doctor or nurse is a more effective solution.
What Is Cryotherapy for Warts and Verrucae?
Cryotherapy is a medical procedure that uses liquid nitrogen to freeze and destroy warts and verrucae. Unlike home-freezing kits, which do not contain liquid nitrogen, medical cryotherapy reaches much lower temperatures and is only performed by healthcare professionals.
What Types of Warts Can Be Treated with Cryotherapy?
Cryotherapy is effective for treating most types of warts, including:
- Common warts (especially on the hands)
- Plantar warts (verrucae) on the feet
- Skin tags and seborrheic keratoses
Studies suggest that cryotherapy is particularly effective for warts on the hands, sometimes more so than traditional topical creams.
Who Is a Good Candidate for Cryotherapy?
Cryotherapy may be a good option if:
- Over-the-counter treatments have failed.
- You want a quick, effective solution.
However, people who are sensitive to pain, such as young children or elderly individuals, may find the procedure uncomfortable due to the stinging sensation.
How Should I Prepare for My Cryotherapy Appointment?
To improve the success rate of cryotherapy:
- File the surface of the wart or verruca using a nail file or pumice stone (discard it afterward to prevent spreading the virus).
- Soak the area in warm water for 15 minutes to soften the wart before treatment.
These steps help the freezing treatment work more effectively.
What Happens During Cryotherapy?
- Your doctor or nurse may first scrape away the surface of the wart or verruca.
- Liquid nitrogen is applied using a spray or cotton swab.
- The procedure may sting or burn for a few seconds.
- If needed, follow-up sessions may be scheduled for larger or more stubborn warts.
Local anaesthetic is not typically used, as the treatment is very quick.
What Should I Do After the Treatment?
After cryotherapy, you may experience:
- Mild pain for up to three days
- A blister forming over the treated area
If a blister breaks, clean it with an antiseptic wipe to prevent the virus from spreading.
Your clinician may also recommend continuing at-home treatments, such as:
- Salicylic acid applications
- Duct tape occlusion therapy
How Effective Is Cryotherapy?
Cryotherapy has mixed effectiveness, depending on the wart type and location.
- A 2002 study found that cryotherapy successfully treated 60% of common warts.
- The same study found duct tape therapy had an 85% success rate for wart removal.
Success rates may vary, and some people require multiple cryotherapy sessions for complete wart removal.
Are There Any Risks or Complications?
Cryotherapy is generally safe but can have some risks, including:
Possible Complications:
- Infection (symptoms include swelling, pain, fever, pus, or yellow discharge)
- Temporary numbness due to nerve irritation
- Slow healing or ulcer formation
- Scarring or changes in skin pigmentation
- Wart recurrence (requiring additional treatments)
Most side effects are temporary, and any concerns should be discussed with your clinician.
In Summary
Cryotherapy is an effective option for treating warts and verrucae, particularly when home treatments have failed.
While most warts and verrucae disappear on their own, some people choose removal for comfort, appearance, or to prevent spreading the virus.
If you are considering cryotherapy, your clinician can assess whether it is the right treatment for you and discuss any concerns.
References
Duggal and Luo (2023). Cryotherapy: Is freezing warts an effective treatment? Healthline. Available at: https://www.healthline.com/health/skin-disorders/freezing-warts#outlook
Bonnell and O’Loan. (2022). Wartner Wart and Veronica Cryofreeze. Chemist4U. Available at: https://www.chemist-4-u.com/wartner-wart-verruca-cryo-freeze-14ml?gclid=Cj0KCQjwqs6lBhCxARIsAG8YcDi8WBNlwEfG2J5rc3cWYsKQGkUUYqUsRHLS6IArZNW95yaOSVAQaCQaAnAbEALw_wcB
Focht, Spicer, Fairchok. (2002). The efficacy of duct tape vs. cryotherapy in the treatment of verruca vulgaris (the common wart). Arch Pediatr Adolesc Med.;156(10):971–974. Available at: doi:10.1001/archpedi.156.10.971