Information and Specialists in Electrocoagulation for Warts

An electric current generates a spark that causes high temperatures at the treatment site. This allows for an extremely precise, pinpoint burn on a wart or other diseased tissue. This procedure is medically referred to as electrocoagulation.

Depending on the current strength and frequency, this leads to irreversible damage to the affected cells. The treated tissue dies off.

The goal of electrocoagulation is to remove and thereby destroy all infected and pathologically altered cells. As a result, the risk of the wart regrowing after the procedure is very low.

 Treatment using electrocoagulation is performed either by a dermatologist or a surgeon specializing in this procedure.

Electric Current as a Surgical Option

Electric current always flows along the path of least resistance from an active electrode to a neutral electrode. Electrocoagulation makes use of this effect. At the point where the current enters the body—the active electrode—the current density is highest. This is also where the highest temperatures occur.

The surgeon places these two electrodes on the patient’s body. The active electrode is the actual surgical instrument used in electrocoagulation. The instrument allows the burns to be precisely confined to a specific area of the skin.

The current density decreases progressively with the distance between the electrodes. For this reason, removing a wart using electrocoagulation does not cause extensive tissue damage.

The typical frequency range for electrocoagulation used to remove warts averages between 300 kHz and 4000 kHz. Higher frequencies are more commonly used in larger surgical procedures.

A Tailored Approach

The exact procedure for electrocoagulation depends on the diagnosis and the method used. In principle, it is possible to either damage the wart or remove it entirely.

Electrocoagulation is purely a thermal treatment. The surgeon cauterizes the wart down to the epidermis. Depending on the individual case,

• the treatment may be localized or cover a larger area,
• a wart is completely removed, and
• if necessary, the underlying tissue is also cauterized.

Sometimes electrocoagulation is performed following a prior curettage of the wart. This provides additional protection against the wart recurring.

Warts are caused by viruses. If these are associated with a disease or an internal infection, additional medication may be necessary.

Some types of warts tend to spread rapidly. This means they form secondary warts. Additional measures may be necessary in these cases as well. Electrocoagulation always treats only specific areas.

The greatest advantage of electrocoagulation is the complete removal of the wart, often in a single session.

Unlike surgical removal methods, the affected blood vessels are also sealed directly. As a result, healing after wart removal using electrocoagulation is usually faster and more comfortable.

Electrocoagulation is also known as an electrosurgical scalpel.

Not every wart can be removed using electrocoagulation. Plantar warts, for example, tend to grow inward rather than outward. In such cases, electrocoagulation is difficult or even impossible. Whether wart removal via electrocoagulation is possible depends on

• the type of wart,
• the condition of the affected skin area,
• the surgical technique used, and
• the experience of the treating physician

.

Warts on very sensitive parts of the body are also a contraindication for electrocoagulation. During electrocoagulation, surrounding areas of the skin may also be damaged under certain circumstances. In the genital area or near the eyes, this could be dangerous. The surgeon’s experience plays a major role here.

Before treatment, the patient must inform the doctor if, for example, they have

• a pacemaker,
• metal screws or plates, or
• implants

in their body. Only then can the surgeon plan the treatment and rule out any risks.

In addition, the patient must not have any

• conductive objects, such as jewelry, and
• electrical devices, such as a hearing aid

on their person during electrocoagulation.

Electrocoagulation is always performed under local anesthesia.

In electrocoagulation, a fundamental distinction is made between the monopolar and bipolar methods.

Monopolar electrocoagulation

The monopolar technique of electrocoagulation is used more frequently than the bipolar method. For this reason, it is also more commonly used in the treatment of warts. 

In this method, the doctor places the neutral electrode as far away from the treatment area as possible. The current thus travels a long distance through the body before exiting again at the neutral electrode.

This ensures that the current density is as low as possible as it travels through the body. This prevents damage to areas of the body other than the intended site. Strict safety measures are taken when placing the neutral electrode to ensure that no unwanted burns occur.

The skin at the neutral electrode does not become noticeably warm during monopolar electrocoagulation.

A modified version of the monopolar technique is the monoterminal method. This method does not require a neutral electrode. Instead, the generator is grounded on one side, and a capacitive resistor completes the circuit.

A disadvantage of this procedure is that touching the patient alters this resistance and, consequently, the effective current. For this reason, the monoterminal method is used only for minor procedures involving low currents. This means that only small warts can be treated with it.

Bipolar Electrocoagulation

In bipolar electrocoagulation, the active and neutral electrodes are placed very close together. Both electrodes are applied directly to the wart. The circuit is closed directly through the tissue located between the electrodes, which are insulated from one another.

The current flows only through this tissue, which is destroyed by the intense heat. Surrounding tissue thus remains unaffected by the current and cannot be damaged.

For this reason, this method of electrocoagulation is preferred for precise applications, such as

• in microsurgery,
• neurosurgery, and
• ENT surgery.

In dermatology, bipolar electrocoagulation is used when the patient’s physical condition does not permit other methods.

Another advantage is that the bipolar electrocoagulation method requires up to 30 percent less energy.

With electrocoagulation, the wart is usually removed or eliminated in just a few minutes. The procedure itself is therefore relatively short—and, thanks to local anesthesia, usually completely painless.

Any wounds are cauterized by the electric current and thus sealed. For this reason, only minor pain usually occurs after electrocoagulation.

Minimal wound pain may or may not occur. The pain caused by electrocoagulation usually feels like a sore spot.

The treated area of skin may be sensitive to touch, cold, or heat in the hours or days following electrocoagulation. However, this can usually be managed very effectively and specifically with

• skin creams,
• tinctures, and
• ointments

. However, these should always be prescribed by the treating physician. Not every healing or wound ointment is suitable for treating the skin after electrocoagulation.

In most cases, electrocoagulation is only one part of a larger treatment plan. Depending on the extent of the infection and the type of wart, the entire treatment can take up to several weeks.

Electrocoagulation usually removes the infected tissue completely. This reduces the risk of new warts forming. If a new wart does form, follow-up treatment is possible. This usually takes only a few minutes as well.

Although electrocoagulation is a very safe and well-established procedure, it does carry risks. These risks can be minimized by an experienced physician.

The greatest risk with electrocoagulation is damage

• to healthy tissue directly surrounding the wart, or
• in other areas of the body during monopore electrocoagulation.

The latter is of particular concern to people with

• a heart defect or
• with electrical devices (such as a pacemaker)

. However, any experienced physician will be able to properly assess these risks and thus largely rule them out. For example, they can use a different method or lower frequencies. The frequency range used in dermatology is comparatively low anyway.

During treatment, muscle twitching (medically known as faradization) may occur. This is unpleasant but not harmful.