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Cryotherapy (Cryosurgery) for Genital Warts

British Columbia Specific Information

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs). HPV can cause genital warts and cancers of the anus, cervix, mouth and throat, penis, vagina, and vulva. The HPV vaccines protect against infection from certain types of HPV, however, they do not get rid of the infection once it has occurred.

Health Canada has approved 2 HPV vaccines:

  • Cervarix® (HPV2)
  • Gardasil®9 (HPV9)

To determine if you are eligible to receive the free vaccine, see HealthLinkBC File #101b Human Papillomavirus (HPV) Vaccines, visit ImmunizeBC – HPV (Human Papillomavirus), or speak with a public health nurse at your local public health unit. Those not eligible for the free HPV vaccine can purchase it at most pharmacies and travel clinics and at some sexual health clinics.

To learn more about HPV infection, see HealthLinkBC File #101a Human Papillomavirus (HPV) Infection and Genital Warts. For more information on STIs, sexual health information, where to get tested and other sexual health services in your area, visit SmartSexResource.

Treatment Overview

Cryotherapy (cryosurgery) destroys genital warts by freezing them with liquid nitrogen.

  • A doctor applies liquid nitrogen to and around the warts.
  • First, the tissue is frozen with liquid nitrogen. Then, the tissue is allowed to thaw. The tissue is frozen again, if needed. The time of application varies by the doctor who applies the liquid nitrogen and the size of the warts.
  • The size and thickness of the warts determine the number and length of freeze/thaw cycles. Up to three treatments may be needed.
  • You may have a mild to moderate burning sensation during the treatment.
  • Genital warts in the urethra or anus usually require the most treatments because the warts may be inside the opening.

Cryotherapy is usually done in your doctor's office or clinic. A magnifying instrument may be used to see the abnormal tissue better.

What To Expect After Treatment

Recovery time depends on the location and number of warts removed. Healing usually occurs in 1 to 3 weeks. After treatment, the following may occur:

  • Irritation, soreness, or mild pain may occur.
  • You may have swelling.
  • You may have dead tissue shed off.
  • Sores or blisters may form.

Men and women

For men and women who have had cryotherapy for external genital warts, call your doctor for any of the following:

  • A fever
  • Continued bleeding
  • Bad-smelling or yellowish discharge, which may indicate an infection
  • Continued pain

Avoid sexual intercourse until the treated area heals and the soreness is gone.

Women

Be aware of the following after treatment for vaginal or cervical warts:

  • A watery vaginal discharge may occur for about 1 to 3 weeks.
  • Sanitary napkins should be used instead of tampons for 2 to 3 weeks.
  • Avoid sexual intercourse or douching until the treated area heals, usually in 1 to 3 weeks.

Men

Men treated for genital warts on the penis, scrotum, or in the urethra should avoid sexual intercourse until the treated area is healed and the soreness is gone. This is usually 1 to 3 weeks, depending on the size of the area treated.

Why It Is Done

Cryotherapy may be done when genital warts are visible, growing in a small area (especially near the anus), and bothersome.

Cryotherapy usually is not used when genital warts are widespread.

How Well It Works

Experts agree that cryotherapy can be helpful in removing genital warts.footnote 1 In some studies, cryotherapy removed warts in up to 90 out of 100 cases.footnote 2 But warts may grow back. More than one treatment may be needed.

The removal of genital warts does not cure a human papillomavirus (HPV) infection. The virus may remain in the body in an inactive state after warts are removed.

Risks

There are few complications after cryotherapy. Scarring is a slight risk.

The number and severity of side effects depend on the number of freeze/thaw cycles used during cryotherapy and how large an area was treated.

What To Think About

Cryotherapy for external genital warts can be used safely during pregnancy.

Treating genital warts does not cure infection with human papillomavirus (HPV), the virus that causes genital warts. The virus may remain in the body in an inactive state after warts are removed. A person treated for genital warts may still be able to spread the infection. Latex condoms may help reduce the risk of HPV infection, but they do not protect the entire genital area against skin-to-skin contact.

The benefits and effectiveness of each type of treatment need to be compared with the side effects and cost. Discuss this with your doctor.

References

Citations

  1. Buck HW (2010). Warts (genital), search date December 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
  2. American College of Obstetricians and Gynecologists (2005, reaffirmed 2009). Human papillomavirus. ACOG Practice Bulletin No. 61. Obstetrics and Gynecology, 105(4): 905–918.

Credits

Current as of:
February 26, 2020

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Thomas M. Bailey MD - Family Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Kirtly Jones MD - Obstetrics and Gynecology
Kevin C. Kiley MD - Obstetrics and Gynecology