as a urologist i see a lot of patient with growths or bumps on the penis

some patients ask do I have cancer? do I need a biopsy? 

Most patients with a classic wart or HPV do not need a biopsy, patient who are uncircumcised or recurrent growths may consider a biopsy.

Freezing a wart with liquid nitrogen, cauterization, or topical treatments like aldara (imiquimod topical cream)

if you have a wart get to a doctor and have it treated.  A biopsy is not a  bad idea but no always necessary

thanks for all of stories and questions I hope this site can help you fight your personal war on warts. 

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by: Michelle Lipke

Liquid nitrogen is a popular destructive treatment for warts.  It is readily available in both dermatology and primary care offices.   Verucca-Freeze and many similar brands available over the counter are a liquid applied from a spray can, but only freeze to -70C.  Warts may not resolve with the over the counter freezing due to the fact that they do not freeze as fast as the liquid nitrogen available in the clinic setting; as well as the proper application technique may not always be used. The wart virus, known as human papilloma virus (HPV), is not destroyed by the freezing procedure.   Liquid nitrogen freezes at -196C and works by destroying the skin cells which in turn release the wart virus.  They body responds to this process by causing an immune response to resolve the wart.

The cryo-spray gun and cotton wool bud are the two main methods for treating common warts with liquid nitrogen.  Different providers often have a personal preference of which method they choose to perform this treatment.   There was no difference in cure rate between cryo-spray gun and cotton wool bud for warts treated every two weeks for three months.

Warts need to be frozen until 1-2 mm of surrounding skin turns white.  Repeat freezing after thawing may cause more effective tissue damage for some wart locations to help them resolve.  Paring the wart down with a scalpel or razor blade may reduce callous which can act as an insulator reducing the effect of the freeze.  Warts are usually treated on average of every two weeks, but sometimes the interval of treatment can depend on how a patient responds to the freezing in regard to side effects.

The common side effects from liquid nitrogen include redness, swelling, blistering and pain.  Plantar wart treatment may temporarily reduce the ability to walk due to pain and blistering.  Excessive blistering may create a ring recurrence around the treated wart which is thought to be caused by bordering dormant wart virus.  The freezing may cause lightening or darkening of the skin after the wart has resolved, especially in dark skinned individuals.  Deeper structures such as tendons, nerves and veins can be damaged with treatment that is too aggressive.