Evaluation of local anaesthetic infiltration for cryosurgery of hand warts: a prospective comparative study

The pain of cryosurgery for hand warts can lead to poor patient satisfaction and inadequate response to treatment.

To determine if local anaesthetic infiltration using a 30-gauge needle prior to cryosurgery is acceptable to patients.

20 consecutive patients were recruited over a 14-month period who attended a cryosurgery clinic and who had at least two warts between 5 and 10 mm in diameter on different parts of the hands. In each patient, two warts of approximately equal size were treated using standard cryosurgery techniques, one under local anaesthetic (LA) and the other without.

The average pain score of cryosurgery without LA was more than twice the pain score of administering the LA with a 30-gauge needle (p < 0.0005). One out of 20 warts failed to clear in the LA-treated group and 2 out of 20 warts failed to clear in the non-LA-treated group.

This research suggests that for the majority of patients with warts between five and ten millimetres in diameter, cryosurgery is significantly less painful when carried out under LA.