Cryotherapy (Cryosurgery) for Genital Warts
British Columbia Specific Information
Genital warts are a sexually transmitted infection (STI) caused by infection from the human papillomavirus (HPV). Genital warts can be treated using topical medication or freezing. These treatments do not get rid of the HPV infection; a person who has been treated may still pass it on, even if the warts are no longer visible. For information about genital warts and HPV, see HealthLinkBC File #101a Human Papillomavirus (HPV) Infection and Genital Warts. Please speak with your health care provider to discuss the best treatment option for you.
You may also be interested in exploring HPV vaccination. Health Canada approves the HPV vaccines Cervarix® (HPV2) and Gardasil® (HPV4) for use in women up to the age of 45, and Gardasil® for men ages 9 and older. Both vaccines protect against infection by HPV types that cause most cases of cervical cancer and several less common cancers. Gardasil® also protects against infection by the HPV types that cause most cases of genital warts. The vaccines prevent HPV infection but do not get rid of the infection once it has occurred. For more information on the HPV vaccines, see HealthLinkBC File #101b Human Papillomavirus (HPV) Vaccines.
For more information on STIs, sexual health information, where to get tested and other sexual health services in your area, visit SmartSexResource.
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.
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 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.
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. 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.
- Buck HW (2010). Warts (genital), search date December 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- American College of Obstetricians and Gynecologists (2005, reaffirmed 2009). Human papillomavirus. ACOG Practice Bulletin No. 61. Obstetrics and Gynecology, 105(4): 905–918.
Current as of: May 22, 2015
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