HPV Treatment with Cryotherapy
The Wart Freezing Method

What Is Cryotherapy?

Cryotherapy is based on the principle of destroying the wart tissue by freezing it with liquid nitrogen. The freezing process forms ice crystals inside the cell, and these crystals tear the cell membrane apart, creating burn-like damage in the tissue.

As a result of this process, the wart tissue loses its viability, a blister forms within a few days, and then the necrotic tissue sheds and the healing process begins.

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How Is Cryotherapy Applied?

Liquid nitrogen (-196°C) is applied onto the wart with the help of a spray or a cotton-tipped applicator. The application time is usually between 5–30 seconds.

During the procedure, the patient may feel a burning and stinging sensation. After the application, the formation of a fluid-filled blister (bulla) in the area is an expected situation.

The Number of Sessions in Cryotherapy

The destructive effect of cryotherapy is limited. For this reason, especially in large, widespread or deep-rooted genital warts, more than one session may be needed for the same lesion.

The intervals between sessions are usually 2–3 weeks. This can lengthen the treatment period.

The Success and Recurrence Rate of Cryotherapy

Cryotherapy is a local treatment method and only targets the visible wart tissue. The settlement of HPV at the level of the basement membrane may not be sufficiently destroyed.

For this reason, the recurrence rate is similar to other superficial local treatments or, in some series, higher. The likelihood of recurrence is particularly marked in widespread genital warts.

Compared to methods that provide deeper and more controlled ablation, such as laser, weaker results in terms of durability are reported.

The Side Effects of Cryotherapy

• Blistering of the skin (bulla formation)
• Ulceration
• Risk of infection due to local tissue destruction
• Hypopigmentation (loss of colour)
• Rarely, permanent scarring

Because it can be applied during pregnancy without using systemic medication, cryotherapy is one of the methods considered safe in pregnant women.

The Difference Between Laser and Cryotherapy

While cryotherapy cannot provide destruction at a controlled depth, with a fractional carbon dioxide laser the wart and root tissue can be destroyed in a more controlled way.

For this reason, in widespread or recurrent genital warts, laser treatment provides;

• A higher success rate
• A lower recurrence rate
• A shorter treatment period
• More predictable healing

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Cryotherapy can be preferred for superficial and small lesions. However, in widespread, recurrent or deep-rooted genital warts, laser treatment provides more effective and lasting results.