Introduction

If you are suffering from genital warts, one of the treatment options that may be offered to you by healthcare professionals is cryotherapy. While cryotherapy may sound intimidating, this article will explain this treatment to help you make informed decisions about your health.

Overview of genital warts

Genital warts are abnormal growths that can appear as bumps on or inside your genital area, including the penis, vagina and anus after being infected with human papillomavirus (HPV).^1,2 The virus is mainly spreads through sexual contact but non-sexual contact such as virus-contaminated surfaces or mother-to-child transmission during vaginal birth is also possible.^1,2 Of the many types of HPV that you can be infected with, HPV 6 and 11 are commonly linked to genital warts.^1,2 After you have been infected with HPV, it can take some time for the symptoms to appear. Although the main symptoms of genital warts are the skin bumps that can appear differently on each person, they can also cause:¹

• Bleeding
• Itching
• Social and emotional burden from having the warts on your body

Apart from the symptoms mentioned, research has found that there is a potential link between genital warts and the development of some cancers such as anal and oral cancers.² 

There is a possibility that your immune system can clear the genital warts or reduce the virus in your body without treatment but this is not the case for everyone.¹ Therefore, there are a few treatment types that are recommended to target the genital warts itself, not the virus:^1,3,4

• Topical treatments: the medication to apply on the surface of genital warts 
• Surgery: to remove the genital warts from your body
• Laser treatment: to remove the genital warts with heat from the laser beam
• Cryotherapy: to remove the genital warts by freezing 
• Electrocautery: to remove the genital warts by the heat generated by electric current

The recommended treatments depend on your warts, but this article will focus on expanding your knowledge of cryotherapy for genital warts.

Cryotherapy for genital warts

Cryotherapy is a method that has been around for many years and used in many conditions, where extremely low temperatures are achieved using cooling agents such as liquid nitrogen to freeze off and destroy abnormal growth on the body.^3,4 

Cryotherapy in genital warts damages and destroys the warts on your body using this method.^4,5 This can also trigger your immune system to clear and heal the damaged area where the warts were located.³ Cryotherapy is one of the only treatment options for genital warts to be considered if you are pregnant although it is usually done after the baby is born.⁸

How does cryotherapy work?

Cryotherapy is a type of localised treatment that is straightforward and can be performed in a health centre such as a hospital by a trained healthcare professional.^3,5,8 The cooling agent can be applied to the warts and the surrounding area either by spraying it for a few seconds with a device such as a spray gun or by directly applying the agent using a cryoprobe.^3,5,8 This process can be done a few times in each session and the number of sessions depends on how quickly the warts clear from your body. However, treatment typically requires a few months to achieve optimal results.^3,8

How successful is cryotherapy against genital warts?

According to the UK health and social care guidelines produced by NICE, there is no first-line treatment for genital warts. The treatment option depends on the types of warts you have, the number and volume of the warts, the location of the genital warts on your body and your response to previous treatment.⁷ 

However, cryotherapy shows effectiveness against genital warts of different sizes and a success rate between 44%-88%.^4,5,8 The cooling agent used on the genital warts can impact the effectiveness of genital warts removal.³

An advantage of using cryotherapy is that you will see immediate changes in the warts on your body.⁴ Cryotherapy can be used on its own or in combination with other treatment options such as topical treatments which may enhance the effectiveness of treatment against genital warts.^3-5 Although every treatment option for genital warts can be effective and successful depending on the individual, some studies have shown that cryotherapy can be more effective in clearing genital warts compared to the other methods.⁸ The only treatment that is believed to be more effective than cryotherapy is laser treatment but it is more expensive to conduct.^8,9.

Side effects and risks

Similar to other treatments, cryotherapy also poses certain side effects as listed below:^3,4 

The following side effects usually settle within a few days.⁷

• Pain of varied intensity
• Blistering
• Swelling

A review article suggests an increased risk of some of these side effects in people with darker skin.^3,6

Additional side effects are:^3,6,7

• Bleeding
• Hypopigmentation
• Hyperpigmentation

• Tendon or nerve injury
• Numbness
• Rare side effects: scarring
• The formation of ulcers

A potential risk following cryotherapy is the recurrence of genital warts because cryotherapy only treats the warts that can be seen by the visual examination of your body.⁴ People can also have additional risk factors for the recurrence of genital warts such as:⁶  

• Infected with HPV types that have a high risk of leading to cancer development
• People who have suppressed immune systems
• Older patients

After treatment with cryotherapy, it can take a few weeks for the treated area to heal with the help of your immune system and if you take proper care of the treated area. You will receive guidance on how to care for the treated area but it will focus on protecting it from injury or anything that could impact the healing process. 

It is also important to monitor your body for any recurrence of the warts and inform a healthcare professional if you do notice new warts.⁸ Cryotherapy may be given again or another treatment could be opted if your body is not responding well to cryotherapy.

FAQs

Can I still infect someone with genital warts after cryotherapy?

Cryotherapy treats the genital warts itself, not the HPV virus. Therefore, even though you may no longer see the warts, you may still carry the HPV virus and can spread it to others. You must take preventive measures to avoid HPV infection or protective measures to prevent the spread of HPV if you have been diagnosed with it.

Can I freeze the genital warts myself?

Cryotherapy for genital wart removal uses extremely low temperatures that can not be achieved at home. Also, the warts need to be frozen to a specific temperature to destroy them. Therefore, you should not attempt to do it yourself.

Summary

Genital warts are abnormal growths that can appear as bumps on or inside your genital area, including the penis, vagina and anus after being infected with human papillomavirus (HPV). One of the types of treatment available in treating genital warts is cryotherapy where the warts can be destroyed and removed using extremely low temperatures generated by cooling agents. Cryotherapy has a high success rate and is a safe procedure for pregnant women. You may need a few rounds of treatment with cryotherapy depending on how the genital warts respond to the treatment. Cryotherapy can also be used on its own or in combination with other treatments to increase the effectiveness of clearing the warts. Side effects include swelling, pain, or scarring in rare cases.

Please contact a healthcare professional if you would like further information on this treatment option and if it would be the right treatment for you.