Condyloma Acuminata (Genital Warts)

What is Condyloma Acuminata ?

Condyloma acuminata (genital warts) are benign warts located in the anogenital area and affect both men and women. Condyloma is caused by the human papillomavirus (HPV) and is considered to be the most commonly sexually transmitted disease in the Western world. The warts are highly contagious. Genital warts vary in appearance and can occur individually, several next to each other, or as fused lesions. Often 5-15 are seen in the same area, with a total diameter of 1-5mm . They may cause irritation, itching, pain, and bleeding.

Many patients choose to have genital warts treated because they are concerned about spreading the infection and also because of pain and itchiness. There are various treatment options, including medicine to boost the immune system’s ability to fight the warts, chemical and laser treatments, and cryotherapy. Traditionally cryotherapy utilizes liquid nitrogen, but increasingly providers are turning to alternative portable cryotherapy devices, such as Hydrozid ®.

About Hydrozid®

Hydrozid® combines traditional cryotherapy and modern aerosol technology. Hydrozid® provides instant, safe, and effective treatment of lentigo and a wide range of additional skin lesions.

Hydrozid® comes with a patented delivery system, contained in the spray head. The spray head was developed to ensure that a consistent, controlled spray is delivered every time. Hydrozid® contains the gas norflurane (R134a), which has been used in asthma inhalers for many years and is proven to be safe. Hydrozid® was developed by a family-owned pharmaceutical and medical device company in Denmark. It has been used successfully throughout Europe since 2013. 

When applied to the skin surface, Hydrozid® generates temperatures between -58°F (-50°C) and -65.2°F (-54°C). This is well below the temperatures that result in cell death. The formation of intra- and extracellular ice crystals destroys the top layer of skin – without damaging the healthy tissue. Effective treatment is achieved through repeated freeze-thaw cycles. The procedure is very brief, effective, and patient friendly.

Hydrozid® Cryosurgery device
  • Light, portable, and convenient
  • No product waste
  • Maintains consistent temperature
  • Freeze-thaw method of treatment
  • 100% pharma grade norflurane cryogen
  • 3-year shelf life

Condyloma treatment with Hydrozid®

Before initiating treatment with Hydrozid®, the provider should ensure there is no suspicion of the lesion being malignant. Healthcare providers can use the following CPT codes for billing actinic keratosis treatment with Hydrozid®.

CPT Code:

  • 46916 – Anus, few lesions, simple treatment 
  • 46924 – Anus, extensive treatment, many lesions, or complicated 
  • 54056 – Penis, few lesions, simple treatment 
  • 54065 – Penis, extensive treatment, many lesions, or complicated 
  • 57061 – Vagina, few lesions, simple treatment 
  • 57065 – Vagina, extensive treatment, many lesions, or complicated 
  • 56501 – Vulva, few lesions, simple treatment 
  • 56515 – Vulva, extensive treatment, many lesions, or complicated 

Hydrozid® is applied to the lesion from a distance of 2-3 centimeters. If the lesion covers a sizeable area, circulating the stream within the specific area is recommended to achieve even treatment of the whole lesion. For the treatment of minor lesions, use of the application template is recommended to protect the surrounding healthy tissue. Templates are included with the Hydrozid® canister. The trigger should be squeezed gently to obtain a light, constant stream. The treated area turns white when ice crystals are formed. Allow to thaw for the recommended time and repeat the freeze-thaw cycle if needed.

Condyloma treatment with Hydrozid

Treatment time

The treatment time varies from one patient to another and depends partly on the location, thickness, and appearance of the lesion as well as the patient’s skin type, age, and other individual considerations. We always recommend making your own assessment on how to treat the specific condyloma and only regard the treatment times as general guidelines.

The product guidelines recommend an approximate total freeze time of 12 to 36 seconds, with freeze thaw cycles from 2×6 to 6×6 seconds.

See the Instructions for Use (IFU) for details on indications, contraindications, warnings, and cautions.

After Treatment

Patients should be informed that after treatment the area may appear red, be sore and in some cases swollen. After treatment, scabs or blistering can occur in the treated area, and the patient should keep the treated area clean with daily cleansing, using a mild fragrance-free soap morning and evening.

The patient should avoid sexual intercourse until the treated area is completely treated and fully healed. To avoid new cases of genital warts, current sexual partner(s) should also be informed and examined for genital warts.

The number of treatments is dependent on the individual patient’s clinical response to treatment and should be accessed by the provider. Generally, we recommend the patient see their provider for follow-up 1 week after treatment to assess the healing and determine if additional treatment is needed.

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