• Indications
  1. Recalcitrant warts
  2. Basal Cell Carcinoma
  • Precautions
  1. Risk for painful scars (even by experienced Doctor)
  2. Lesions larger than 1 cm should be excised instead
  • Precautions
  1. Wear a well-fitted mask (that filters HPV)
    1. Prevents verrucous laryngeal papillomas (rare)
      1. Can result in Squamous Cell Carcinoma
    2. Smoke evacuators also recommended
  2. Undertreat
    1. Avoids painful scarring
  • Technique
  1. Use Local Anesthesia
  2. Use mask and smoke evacuation as described above
  3. Insert electric needle into the wart
  4. Apply low-medium current for 5-10 seconds
    1. Until wart whitens and becomes boggy
  5. Follow current with Light curettage
  6. Coagulate bleeding with pressure and 88% TCA
  7. Residual wart tissue appears as blanched, punctate
  • Follow-up
  1. Apply Topical Antibiotic ointment and dressing
  2. Postoperative pain is less than with Cryotherapy