Penile warts are diagnosis that a trained doctor can make without a biopsy.  If patients have many warts or ones that look suspicious for other lesions like cancer I often biopsy a representative sample and freeze (with liquid nitrogen) or burn (electrocautery) or laser (C02 or YAG) the rest.  If a patient has warts on the foreskin and wants a circumcision I sent the tissue for biopsy. 

If your doctor didn’t send a biopsy and it didn’t come back that’s fine.  If it keeps coming back and there was never a biopsy ask your doctor to sent a piece to the lab or make sure they are convinced its not cancer.

I hope this post is helpful.  Go to our find a physician tab if you need an evaluation

Thanks,

Dr. A.

Jessica writes:

“I got married 8 months ago, and 2 months ago, for the first time ever i was diagnosed with HPV. According to the Dr, it didnt necessairly come from my hubsand, but i cant help feel like it did. Thankfully, i have no genital warts or currently any cancer causing lesions, but i Do have a brand new, first time ever skin wart on my knee. Ive just started liquid nitrogen treatment for the removal of that.
Im increadably disspaointed, and borderline terrified. This is a first for me, and while some people say “its no big deal”- to me it is a big deal. this is something ive never had to deal with before and to make it worse, i know next to nothing about the Virus. Ther are so many different websites on it that have s many different opinions, i hardly know which one to believe!!

I think the next best step for me is education myself on this virus, how to treat it, and how to NOt spread it!”

Thanks for writing!  First off… you have found a good place to discuss your concerns.  Please do not be terrified.  Warts are quite common.  Instead… lets get educated!

Your Doctor’s advice is correct.  The wart did not necessarily come from your husband.  You may be able to blame him for lots of things… but you can’t point a finger at him for this one.  Further, the type of wart that grows on the skin is typically a different strain of virus than that found in the genital areas.

There are many treatment options for common warts, and Liquid Nitrogen is often a good place to start.
Best of luck, and keep us updated!

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.