Definition and Overview

Freezing (cryotherapy) is the standard form of treatment for gynaecological warts. It is proven to be safe and highly beneficial for patients who are seeking treatment for their abnormal skin growth but want to avoid surgery.

Cryotherapy freezes warts with liquid carbon dioxide or liquid nitrogen over multiple sessions until they dry up and eventually fall off. Although highly effective, this technique comes with certain risks when not properly carried out, so it is important to work only with trusted medical professionals.

Who Should Undergo and Expected Results

The freezing of gynaecologic warts will benefit any patient, male or female, who has any of the different types of genital warts listed below:

  • Condyloma
  • Penile or venereal warts
  • Vulval warts
  • Cervical warts
  • Anal warts
  • Vaginal warts


Genital or gynaecologic warts are small, non-malignant, skin-colored growths or tumours that appear on the surface of the skin in the genital and anal areas. Along with flat warts, plantar warts, filiform warts and periungual warts, genital warts are caused by the HPV or human papillomavirus. However, unlike other warts, they cannot be treated with over-the-counter or at-home cryotherapy kits.

These warts can range from small to large; the bigger their size, the more challenging it is to treat them. They can also grow on either moist or dry skin, with studies showing that warts on moist skin respond to treatment better. Typically, the initial course of treatment involves the use of topical ointments that contain salicylic acid. Cryotherapy only becomes an option if ointments do not work or if the warts are recurrent.

Many prefer cryotherapy because it does not only remove an existing wart but also helps prevent it from growing back. The healing process is also very short and the risk of scarring is very minimal.

How the Procedure Works

The freezing of gynaecologic warts can be performed in a dermatologist’s or gynaecologist’s office or clinic on an outpatient basis. It often requires around 1 to 4 sessions that are spaced 1 to 3 weeks apart. The bigger and the thicker the wart is, the more sessions will be necessary. Each session will take only around 10 to 15 minutes including all preparations, but the actual procedure of freezing warts only takes a minute.

Typically, the procedure begins with the doctor trimming the wart. If anaesthetics will be used, it is administered at this point. Once the anaesthesia has taken effect, liquid nitrogen or liquid carbon dioxide will be applied to the surface of the wart using a cotton swab or probe. Each application will last for about 2 to 3 minutes, although in some cases, it is possible to apply the substance just once but for a longer period of 5 minutes. The patient is free to go home following the application of the freezing agent, and will be asked to come back for the next session, and so on until the wart dries up and falls off all by itself.

The patient may feel some localized pain or discomfort during the first three days following each session, and it may take up to a week or two for full recovery after all sessions have been completed.

Possible Risks and Complications

The risks that are associated with the procedure include:

  • Pain – It is normal to experience some pain during the procedure particularly for those patients with thicker warts.

  • Allergic reaction to anaesthetics – Patients who opt to have local anaesthesia during the procedure are facing the risk of developing allergic reactions to the anaesthetic agents.

  • Blistering – Blisters may form on top of warts within a few hours after treatment. These need to be managed carefully to keep them from breaking, which will allow the virus inside the wart to spread to other parts of the skin. When managed properly, the blister will dry up and will fall off along with the wart within a few days following the last session.

  • Scarring – There is a small risk that the procedure will leave a scar, but this does not occur in the majority of cases. It is, however, linked to the size of the wart, with studies showing that bigger and thicker warts tend to leave noticeable scars.

  • Infection – Cryotherapy is associated with a minimal risk of infection. If the common signs of an infection are observed in a patient who recently underwent the procedure, it is best to seek medical care. The symptoms of an infection include increasing pain, swelling, redness, tenderness, a warm sensation in the area where warts were located, red streaks surrounding the area, pus discharge, and a high fever with no known cause.

Despite these risks, the procedure still offers an effective way to get rid of genital warts and thus protect patients from suffering from further bouts of human papillomavirus infection. If these warts remain untreated, it is possible for them to get infected or become more painful and difficult to remove.

References:

  • Habif TP. Warts, herpes simplex, and other viral infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, PA: Mosby Elsevier; 2009:chap 12.

  • Beard JM, Osborn J. Common office procedures. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 28.

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