# Cryotherapy

> Cryotherapy uses extreme cold, usually liquid nitrogen, to destroy small skin lesions such as warts, verrucas and sun spots. It suits sun spots best, gives mixed results for warts, and often needs several sessions.

Guide in [Treatments](https://footanklelowerlimb.com.au/learn/topics/treatments), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/cryotherapy
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026.
Next review by 27 October 2027.

- **It freezes small skin lesions.** A trained practitioner uses liquid nitrogen to destroy warts, verrucas, sun spots and similar growths.
- **Results depend on the lesion.** It suits sun spots best, is mixed for warts, and is less convincing for plantar warts (warts on the sole).
- **Expect more than one visit.** Warts usually need several sessions, and the full effect can take about 4 weeks.
- **Get a diagnosis first.** Anything unusual, or a wart that bleeds or changes, needs checking before it's frozen.
- **It treats the lesion, not the cause.** New warts can still appear.

## What is cryotherapy, and how does it work?

Cryotherapy (also called cryosurgery or freezing) uses extreme cold to destroy small, superficial skin lesions without the need for surgery [1]. The usual cold source is liquid nitrogen, at -196°C, applied for a few seconds at a time [1].

Freezing kills cells straight away, and then keeps damaging them over the following days [2]. For warts, the localised frostbite is also thought to stimulate your immune system to fight the wart virus [3].

It treats the lesion that's there. It doesn't stop new ones developing in future [4]. Cryotherapy should only be given by appropriately trained staff [3].

## What is cryotherapy used for, and how well does it work?

Freezing is used for viral warts and verrucas (plantar warts), sun spots (actinic or solar keratoses), seborrhoeic keratoses (harmless warty growths), molluscum contagiosum, skin tags, genital warts and Bowen's disease, an early skin cancer [3][4]. How well it works depends on the lesion.

- **Sun spots:** the strongest case. It's rated the most effective and commonly used first-line treatment aimed at individual sun spots [5]. It also cleared more spots than a dummy treatment on the body outside the face and scalp, though confidence in that result is low [6].
- **Common warts:** mixed. Cure rates vary with the method, the type of wart and the person [5], though freezing did better than some other methods [7].
- **Plantar warts:** less convincing. The average cure rate is low [8].
- **Plane warts (flat warts):** freezing is best avoided, as they often clear on their own [9].

## Is cryotherapy right for me?

It suits selected lesions, once a trained practitioner has judged it suitable for you [3]. The lesion needs a diagnosis first. Anything with an unusual history or look, or a wart that bleeds or changes, could be something more serious and needs assessment before freezing [9]. Sun spots need checking for early skin cancer first [2].

For young children, freezing is painful and rarely tolerated under about 7, so it's worth discussing alternatives first [10]. It's also described as best suited to light skin and to areas with little hair [11]. For genital warts during pregnancy, freezing is one option [7].

## What happens during cryotherapy?

Liquid nitrogen is sprayed onto the lesion, or dabbed on with a cotton-tipped swab, usually without local anaesthetic [4]. It's applied from a few seconds up to about 10–20 seconds, until the lesion freezes and turns white, sometimes with a second freeze [12]. The skin is then left to warm up [1].

Afterwards the area usually turns red. A scab may form and drop off over 1–2 weeks [4].

Warts are normally frozen again every 1–3 weeks, and about 70% improve after 3–4 sessions [13]. The full effect can take about 4 weeks to show, and if anything remains after that, you may need more treatment [12]. The best freeze time and gap between sessions isn't clear yet, so your practitioner will decide what suits the lesion [14].

## What are the risks and side effects?

Stinging, pain, redness, swelling and a blister are common, and are a normal response to freezing [3]. Less often, freezing can leave a small scar, skin that ends up lighter or darker than the skin around it (this may be permanent), or an infection [1]. Healing can be slow, and the wart can come back [14]. Deeper freezes take longer to heal [2].

> [!tip] Try this
> After treatment, keep the area clean and dry, and note the date. That makes it easier to tell whether pain is getting worse after 48 hours.

## How does it compare with other options?

For warts, freezing is usually used when other treatments haven't worked, as it can be painful, can scar and may not work [10]. For plantar warts in particular, some antiviral, injected and gel treatments did better than freezing [14], so it's reasonable to ask about them.

For sun spots, adding a cream or gel to freezing seems to clear more than freezing alone [15]. If you have several sun spots, ask whether treating the whole affected area suits you better than freezing single spots [15]. On the head and neck, some creams and light-based treatments came out as most beneficial, though they often cause more side effects early on [16].

## When to see a podiatrist

See your GP or a podiatrist the same day if, after treatment, you have increasing pain, redness or swelling, pus or discharge, pain that's worse after 48 hours or isn't settling with pain relief, or you feel generally unwell [12]. If you have diabetes, the same applies to any blister, sore or colour change on your foot. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic.

See your GP soon if a wart bleeds or changes, or you're worried about a skin growth [9].

See a podiatrist or your GP if the lesion hasn't gone once the skin has fully healed, or a wart has lasted about two years despite treatment [12].

It's also worth asking a trained practitioner to confirm what the lesion is and whether freezing suits it, and about the alternatives, especially for plantar warts or a young child.

## Common questions

### Does cryotherapy hurt?

It can. Pain is expected during the procedure and usually ends within an hour, and local anaesthetic is generally not needed. You may have a little pain for up to 3 days afterwards, and a blister can add some tenderness. Everyone's tolerance differs, so tell your practitioner if it's too much.

### Can cryotherapy be used on a skin cancer?

Sometimes. It's used for Bowen's disease, an early form of skin cancer, and a dermatologist may occasionally suggest it for a small skin cancer. Any lesion that looks unusual, bleeds or changes needs to be assessed and diagnosed first, rather than simply frozen.

### Do people with diabetes need to take extra care with wart treatment?

Yes. If you have diabetes, or a condition that affects blood flow or feeling in your feet or legs, talk to a healthcare provider before treating warts or verrucas yourself. They can tell you whether freezing or another option is the safer choice for you.

## Further reading

- [Cryotherapy on Clindice](https://clindice.com/cryotherapy)
- [D10363670](https://doclibrary-rcht.cornwall.nhs.uk/GET/d10363670), NHS
- [Cryotherapy for the skin: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/007506.htm), MedlinePlus
- [Cryotherapy - Leeds Teaching Hospitals NHS Trust](https://www.leedsth.nhs.uk/patients/resources/cryotherapy/), NHS
- [Cryotherapy - University Hospitals Sussex NHS Foundation Trust](https://www.uhsussex.nhs.uk/resources/cryotherapy/), NHS
- [G-care: The primary care clinical information system](https://g-care.glos.nhs.uk/clinical-topic/warts), NHS

## Sources

1. Cryotherapy · NHS · 2024. https://www.leedsth.nhs.uk/patients/resources/cryotherapy/
2. Cryotherapy for Actinic Keratosis: Basic Principles and Literature Review · Arisi M, Guasco Pisani E, Calzavara-Pinton P et al. · Clinical, Cosmetic and Investigational Dermatology · 2022. https://doi.org/10.2147/ccid.s267190
3. Cryotherapy - guideline for professionals performing cryotherapy (G061) · NHS. https://www.rightdecisions.scot.nhs.uk/nhs-ayrshire-arran-guidelines/clinical-guidelines/sexual-health/cryotherapy-guideline-for-professionals-performing-cryotherapy-g061/
4. Cryotherapy (liquid nitrogen) · Health New Zealand | Te Whatu Ora. https://www.healthnz.govt.nz/health-topics/tests-and-treatments/medical-tests-and-procedures/cryotherapy-liquid-nitrogen
5. Cutaneous Cryosurgery in Dermatology: Evolving Principles and Clinical Applications for Benign, Premalignant, and Malignant Lesions · Mokbel R, Kodresko A, Mokbel K et al. · In Vivo (Athens, Greece) · 2025. https://doi.org/10.21873/invivo.13865
6. Interventions for Actinic Keratosis in Nonscalp and Nonface Localizations: Results from a Systematic Review with Network Meta-Analysis · Steeb T, Wessely A, Schmitz L et al. · The Journal of Investigative Dermatology · 2021. https://doi.org/10.1016/j.jid.2020.06.021
7. Clinical guideline for the diagnosis and treatment of cutaneous warts (2022) · Zhu P, Qi RQ, Yang Y et al. · Journal of Evidence-Based Medicine · 2022. https://doi.org/10.1111/jebm.12494
8. Topical treatment for plantar warts: A systematic review · García-Oreja S, Álvaro-Afonso FJ, García-Álvarez Y et al. · Dermatologic Therapy · 2021. https://doi.org/10.1111/dth.14621
9. Viral Warts · NHS. https://www.rightdecisions.scot.nhs.uk/ggc-primary-care/dermatology/viral-warts/
10. Treating warts and verrucas · Resource Library - Sheffield Children's NHS Foundation Trust · 2022. https://library.sheffieldchildrens.nhs.uk/treating-warts-and-verrucas/
11. Cryosurgery for common skin conditions · Andrews MD · American Family Physician · 2004. https://pubmed.ncbi.nlm.nih.gov/15168956/
12. Advice following Cryotherapy ML7303 · NHS. https://www.swbh.nhs.uk/wp-content/uploads/2023/12/Advice-following-Cryotherapy-ML7303.pdf
13. Warts and verrucas · Health New Zealand | Te Whatu Ora. https://www.healthnz.govt.nz/health-topics/conditions-treatments/feet-and-ankles/warts-and-verrucas
14. Efficacy of cryotherapy for plantar warts: A systematic review and meta-analysis · García-Oreja S, Álvaro-Afonso FJ, Tardáguila-García A et al. · Dermatologic Therapy · 2022. https://doi.org/10.1111/dth.15480
15. Cryosurgery combined with topical interventions for actinic keratosis: a systematic review and meta-analysis · Heppt MV, Steeb T, Ruzicka T et al. · The British Journal of Dermatology · 2019. https://doi.org/10.1111/bjd.17435
16. Treatment of actinic keratosis: a systematic review · Worley B, Harikumar V, Reynolds K et al. · Archives of Dermatological Research · 2023. https://doi.org/10.1007/s00403-022-02490-5

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This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.