Why freeze warts

Patients in both study groups were requested to record any complications of therapy, including local irritation, erythema, discharge, pain, or burning. They were also provided with the telephone numbers of study physicians to contact in case of concerns.

Patients who did not return for scheduled follow-up were contacted by telephone on a monthly basis by study physicians to encourage follow-up and to determine if the wart had resolved. Therapy was to be discontinued if the wart became infected or overly irritated. Study physicians and nursing personnel were blinded to the therapy being used. Patients in the duct tape arm were instructed to remove all tape prior to making a return clinic visit.

This was effective in keeping nursing personnel blinded to which treatment arm a patient was in until after they measured the study wart. Nursing personnel then checked the data sheet to see which arm the patient was in for further therapy. The primary outcome measure for the study was complete resolution of the study wart. Patients were categorized as responders if they had complete resolution of the wart after 2 months of treatment.

A secondary outcome measure was time to resolution of the warts. From October 31, , to July 25, , 61 patients were enrolled in the study. Nine patients, 3 from the duct tape group and 6 from the cryotherapy group, were not available for follow-up and were not included in our analysis. One patient enrolled in the duct tape arm lost his study wart in a trampoline toe-amputation accident and was also not included in our analysis. Of the 51 patients completing the study, 25 were in the cryotherapy arm, and 26 were in the duct tape arm.

There were no statistically significant differences in the mean ages or sex of the patients or the baseline size of the warts between the 2 groups Table 1. The most common location for the warts was on the finger in both groups, and there were no differences in the physical distribution of the warts between the 2 groups Table 2. We found that duct tape occlusion therapy of the warts was significantly more effective than cryotherapy. Although patients were followed for a maximum of 2 months, we were unable to accurately record the exact time to disappearance of the warts due to the variability in when patients were contacted for follow-up or returned for more cryotherapy or wart measurements.

Warts subjected to tape occlusion therapy were unlikely to resolve if no response was seen by 2 weeks. Based on this information, average time to resolution between the 2 treatments was comparable. Although no major complications were noted in either group, adverse effects were more common in the cryotherapy arm. The most frequent complaints in the duct tape arm were difficulty in keeping the tape on and minor skin irritation.

The most difficult site to keep the duct tape on was the palmar surface of the hand. No additional techniques were employed to secure the tape.

If the duct tape fell off, parents were instructed to simply apply a new piece of duct tape. The main adverse effects seen in the cryotherapy arm were pain and burning at the site.

Pain following freezing was universal but ranged from mild to severe. One patient undergoing cryotherapy vomited before each application. Our follow-up in this study was limited to the end point of resolution. We did not collect any data on recurrence of the warts following completion of therapy. In our study we found that the simple application of duct tape was more effective than cryotherapy in the treatment of the common wart.

Cutaneous warts are a common diagnosis in the pediatric population, and many therapies exist for the treatment of these warts.

Anecdotal reports have suggested the effectiveness of tape occlusion therapy. However, this is the first randomized, prospective study on the efficacy of tape occlusion therapy for warts.

We also found that the warts that ultimately responded to tape therapy typically showed at least partial resolution after 2 to 3 weeks of treatment.

Warts that were unchanged in appearance by the 3-week mark were unlikely to respond. Several potential benefits exist for using duct tape over cryotherapy. Duct tape is more practical for parents and patients to use, especially when compared with the multiple clinic visits required for freezing of a wart. In today's busy society, it can be difficult for parents to keep follow-up appointments every 2 weeks for cryotherapy of their children's warts.

In our study, the lower success rate of the cryotherapy arm is likely partially attributable to longer-than-optimal intervals between treatments in some patients. There was better compliance with the prescribed treatment regimen within the duct tape group, primarily due to the ease of administration.

Another benefit of tape occlusion therapy is that it is much less costly than cryotherapy. The treatment can be undertaken in the home using inexpensive duct tape. Finally, tape occlusion therapy appears to be less threatening to a young child than freezing. The use of duct tape for the treatment of warts was generally well received by our patients. Although both cryotherapy and tape occlusion therapy are well-tolerated treatments, the adverse-effect profile for tape occlusion therapy appears to be better.

A variety of adverse effects with cryotherapy of warts have been previously reported, including pain during the procedure, erythema, hemorrhagic blister formation, dyspigmentation, recurrence of the wart, infection, and nail dystrophy when treating periungual warts. The only adverse effect observed in the duct tape group during our study was a minimal amount of local irritation and erythema. Practical considerations limiting the use of duct tape therapy include difficulty for some patients in keeping the tape on, potential for exacerbation of underlying skin conditions such as eczema, and the cosmetic impracticality of using duct tape on the face.

In 1 to 3 days, the procedure can be repeated. Topical treatments are sometimes combined with cryotherapy. For this procedure, the healthcare provider puts numbing medicine on the wart.

Then the wart is scraped or cut off. This type of treatment is often not the first line of therapy. Laser surgery. This can vaporize wart tissue or destroy the blood vessels that feed the wart. This is done in the provider's office. Shots injections. That way your provider can rule out any other skin problems. Sometimes a callous or a corn can look like a wart. But the treatments may differ. Treatment can also provide relief from warts that bleed, burn, hurt, or itch.

Genital warts should always be treated. They can spread to other people through sexual contact. And they may cause genital or cervical cancer. After having your warts treated, new warts may still appear. Warts often come back. See your healthcare provider again to talk about this. Your provider can tell you about the treatments that most likely will help clear your skin of warts. A numbing local anesthetic is usually not needed but may be used in some cases.

Your doctor applies the liquid nitrogen to the wart using a probe or a cotton swab. Liquid nitrogen can also be sprayed directly on the wart. Most warts require 1 to 4 treatments, with 1 to 3 weeks between each treatment. Within hours after treatment, a blister may form. If the blister breaks, clean the area to prevent the spread of the wart virus. Avoid contact with the fluid, which may contain the wart virus. The blister will dry up over the next few days, and the wart may fall off.

Multiple treatments may be needed to get rid of the wart. Why It Is Done Cryotherapy is usually used if salicylic acid treatment has not eliminated a wart or if quick treatment is desired.

How Well It Works Cryotherapy can destroy warts. Risks If done carefully, cryotherapy poses little risk of scarring. Some signs of infection include: Increased pain, swelling, redness, tenderness, or heat. Red streaks extending from the area. Discharge of pus. What To Think About If you can tolerate moderate, short-term pain, cryotherapy may be a reasonable treatment option for you. Cryotherapy: Can be painful and expensive but usually does not scar. Is most painful where the skin is thicker palms and soles.

Often takes multiple treatments, especially for thick, larger warts. Is quick and can be done in a doctor's office or at home.