Warts: Liquid Nitrogen Treatment

Warts are growths on the skin caused by a virus. They differ in size and how they look. Warts are usually on the hands or feet but may be anywhere on the skin. They spread from person to person through touch. Some warts go away in weeks or months without treatment, but some may last years.

What to Expect

Your child’s wart may be treated with liquid nitrogen. Liquid nitrogen freezes and destroys the wart and a small area of skin around it.

• A spray bottle or a cotton swab is used to put liquid nitrogen on the wart. It takes about 10 to 20 seconds to apply. The liquid nitrogen is cold. It may sting like frostbite or feel like an ice cube stuck to the skin. As the skin gets warmer (thaws), it may feel hot or like it’s burning.
• Some warts are very thick. The extra skin on top must be removed for the treatment to work better. Your child’s doctor or health care provider will do this.
• A blister or scab will form where the liquid nitrogen is applied. It may take longer to form depending on where the wart was and how thick the skin around it was. A blister may be clear or filled with blood. This is normal.
• After 4 to 7 days, the blister or scab will break or dry up and fall off. The area may be sore.
• Treatment doesn’t usually leave a scar. The treated area may be lighter in color and take a few months to return to normal. If the wart is around the fingernail, there may be a short-term change in the nail, like a groove.
• Most warts need to be treated a few times with liquid nitrogen, with 4 to 6 weeks between treatments. The number of treatments depends on the size of the wart and how it responds to treatment.
• Your child’s doctor or health care provider may want them to use another medicine between treatments. The medicine may be over-the-counter or a prescription. It will help the treatments work better. Wait until irritation from the liquid nitrogen goes away before using the medicine.
• Most warts go away with liquid nitrogen treatment. The wart may get bigger, or a ring of smaller warts may form around the treated area. This is rare.

What to Do

• Wash the treated area each day with soap and water. If there is still a blister or scab, dry the area well and cover it with a bandage. If the blister broke or the scab fell off, dry the area well and apply double antibiotic ointment (Polysporin^®) or triple antibiotic ointment (Neopsorin^®). Cover the area with a bandage.
• Give acetaminophen (Tylenol^®) or ibuprofen (Advil^® or Motrin^®) to your child as needed for pain. Read the label to know the right dose for them. Do not give them aspirin or any product that contains aspirin.

When to Call the Doctor

Infections after treatment aren’t common. Call your child’s doctor or health care provider if:

• They have a fever of 100.4˚ Fahrenheit (F) or 38˚ Celsius (C) or higher.
• The blister opens after treatment and doesn’t heal.
• The blister is red, swollen, feels hot, or drains pus.

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