Frequently Asked Questions
What is Verruca-Freeze?
Verruca-Freeze is a portable cryosurgical device used by physicians and veterinarians to remove superficial skin lesions in an outpatient setting. Verruca-Freeze is FDA-approved for use in the treatment of 21 types of benign lesions, including warts, skin tags, age spots, seborrheic keratoses, and molluscum. The Verruca-Freeze cryosurgical system consists of an aerosol canister of cryogen with two applicator types – cones and buds – and is offered in various sizes and configurations in order to meet the preferences and needs of all customers. Verruca-Freeze is a convenient and cost effective alternative to traditional liquid nitrogen methods as it is designed for hand-held use and completely portable.
How is Verruca-Freeze different from liquid nitrogen?
Verruca-Freeze cryogen does NOT contain any liquid nitrogen. Verruca-Freeze uses a non-flammable, refrigerated gas that is an alternative to liquid nitrogen and freezes at -70°C (-94°F). Liquid nitrogen is extremely cold at -196°C and poses serious safety concerns if not handled properly or if overused on thin skin, which may result in long-term nerve damage.
Treatment with Verruca-Freeze will produce the same results as liquid nitrogen (i.e., freezing of tissue, iceball formation, tissue destruction, scabbing, sloughing of dead tissue, and new healthy tissue growth). With Verruca-Freeze, there is no need for a large, expensive tanks or dewars, no scheduling for gas refill, and most importantly, Verruca-Freeze does not evaporate. Verruca-Freeze cryogen is contained in a small aerosol canister, making it completely portable and allowing for disposal with regular trash when empty.
What makes Verruca-Freeze better than other products on the market?
Verruca-Freeze offers the largest range of product configurations at the lowest cost per freeze of any portable cryosurgical system on the market. With canisters available in 5 sizes and varying quantities of accessories, there is a solution for every practice no matter the size!
Other products on the market typically use the same technique and include an aerosol canister with similar applicators, but you will find that our applicators are what set us apart by being the most user-friendly.
- Our buds feature a hollow handle that allows for insertion directly into the nozzle. Double-sided buds are limited to a two-handed saturation method and often result in a wasted, unused side.
- Our buds have rounded tips that allow for optimal contact with the skin. Arrow-shaped buds typically fall flat while pressing them onto the skin, leading to an unintentional freezing of healthy skin.
- Our cones are one-of-a-kind with a unique two-part composition featuring a flexible sealing tip. These tips ensure a firm seal so cryogen doesn’t leak out and are color-coded for easy distinction between sizes.
- Our cones are also reusable, which means you won’t need to constantly reorder accessories to be able to use your canister.
Overall, Verruca-Freeze will provide the simplest and most valuable user experience for you!
How does Verruca-Freeze differ from over-the-counter products?
Verruca-Freeze reaches a significantly lower freezing temperature than over-the-counter products. Most warts are deeply rooted and require a freezing temperature of -50°C for full destruction. Over-the-counter treatments will not be cold enough to freeze the wart completely, so even if the wart appears to be removed, it is likely to return. The convenience of at-home treatment usually comes with an exceedingly lengthy process of continuous retreatment, whereas Verruca-Freeze will remove a lesion in just 1 visit to the doctor!
What is the freezing temperature of Verruca-Freeze?
With proper application, Verruca-Freeze reaches -70°C (-94°F), the coldest available of all canister-based cryosurgical products. With -50°C being the required temperature for full lesion destruction, Verruca-Freeze will achieve the intended results without the overkill like liquid nitrogen, which freezes at -196°C.
How many treatments will I get from each canister?
The number of treatments, or freezes, per canister will vary depending on applicators used and size of lesions treated. Based on an average size lesion of 5mm, you should expect to get the following number of treatments per canister:
|Number of Treatments
If you are treating lesions smaller than 5mm, you may get more treatments out of your canister. If you are frequently treating lesions larger than 5mm, you will likely get fewer treatments from your canister.
It is important to always ensure gentle pressure is being applied to the trigger as this will help conserve cryogen. Any overspray will waste cryogen and ultimately reduce the number of treatments that you are able to get from your canister. Overspray is most likely to occur with the non-inserted method of bud saturation. To avoid this, keep the extender tube as close as possible to the tip of the bud while saturating.
What are the reimbursement rates, and which CPT codes should I use?
On average, reimbursements are $150 to $300 for standard benign lesions but, depending on where the lesion is located, may be up to $2,000. This means your canister will pay for itself in as few as 1 to 2 treatments!
Most benign lesions will use the 17000 series of CPT codes, while warts and molluscum use the 17110 code and skin tags use the 11200 code.
All Verruca-Freeze products include an informational sheet with CPT codes most commonly used for cryosurgery and their respective reimbursement rates, based on the national average and updated annually. If you do not have the latest version of this sheet, you can contact us to request an updated copy.
While national averages provide great insight, reimbursement fees vary widely across the country. To set the most appropriate fees, we recommend using pricing information for your specific geographic area.
- For Private Insurance: Contact Optum Coding for a customized fee analyzer
- For Medicare: Visit www.cms.gov to utilize their free physician fee schedule look-up tool
Underpriced fees can cost your practice thousands of dollars each year. Maximize revenue for your practice by filing for reimbursement at the 90th percentile for private insurance carriers and the limiting charge for Medicare.
How much do veterinarians typically charge for each treatment?
Veterinarians typically charge $50 to $75 per treatment when anesthesia is not used. If anesthesia is required, fees will likely range from $150 to $200. If treating multiple lesions on one animal, most veterinarians will charge a flat fee ($50) for the first lesion and a minimal fee ($10) for each additional lesion.
What is the shelf life?
Verruca-Freeze has an indefinite shelf life due to the canister’s positive shut off valve, which prevents leakage and evaporation as well as protects the cryogen against contamination and decomposition.
Is Verruca-Freeze flammable?
No, Verruca-Freeze is non-flammable.
How do I store Verruca-Freeze products?
Verruca-Freeze canisters should be stored at room temperature, away from direct sunlight, and should not be exposed to temperatures over 120°F. We recommend keeping all Verruca-Freeze components in their original box or a Cryo Bag and storing inside a medical cabinet.
Since Verruca-Freeze cryogen is contained in an aerosol canister, there is a pressure release valve located on the bottom. If the canister is subjected to temperatures above 120°F, there is a chance that this valve could be activated and all cryogen will expel from the canister. If you are planning to transport the canister in hot conditions, we advise you to place the canister in a cooler or another area where a temperature under 120°F can be maintained.
Can I take Verruca-Freeze on an airplane?
Yes, Verruca-Freeze can be taken on an airplane; however, the canister must be placed in a checked bag. It is also important to consider your climate as well as that of your destination. While the cargo hold of an airplane is usually temperature controlled, checked bags often sit on the tarmac in direct sunlight. If the canister is subjected to temperatures above 120°F, there is a chance that it will burst.
If traveling internationally, be sure to research airline restrictions for traveling with aerosols to and from that country. Small passenger planes may require travel size only for all liquids, including aerosols, and confiscate any oversized products.
Where can I obtain a Safety Data Sheet?
To request a current copy of our Safety Data Sheet, please contact us.
Do I need a license to use Verruca-Freeze?
Yes, Verruca-Freeze is authorized for use by licensed medical and veterinary professionals only.
What lesions can be treated with Verruca-Freeze?
Verruca-Freeze is FDA-approved for use in the treatment of Warts (including plantar warts), Seborrheic Keratosis, Actinic Keratosis, Achrochordon (Skin Tags), Molluscum Contagiosum, Age Spots, Dermatofibroma, Small Keloids, Granuloma Annulare, Porokeratosis Plantaris, Angiomas, Keratoacanthoma, Basal Cell, Bowen’s Disease, Lentigo Discreta, Chondrodermatitis, Epithelial Nevus, Leukoplakia, Granuloma Pyogenicum, Kaposi’s Sarcoma, and Pyogenic Granuloma.
Verruca-Freeze can also be used to treat external skin lesions on small, large, and exotic animals. The most commonly treated animal lesions are Papillomas (Warts), Skin Tags, Distichiae, Sebaceous Adenomas, Sarcoids, Follicular Cysts, Granulomas, and Fibroids.
Is anesthesia or numbing required?
No, the use of anesthesia or numbing is not required. However, depending on the patient and/or the location of the lesion being treated, anesthesia may be beneficial. Verruca-Freeze is self-anesthetizing, so although patients may feel a slight sting when the cryogen is initially applied, it will quickly turn numb.
How do I apply the cryogen to the skin?
The Verruca-Freeze cryosurgical system includes two types of applicators, CryoBuds and CryoCones, which are used to apply the cryogen to the skin. Verruca-Freeze should NEVER be applied without an applicator. The purpose of applicators is to protect the healthy tissue around the lesion being treated. An open spray will result in destruction of healthy tissue.
When do I select buds vs cones?
The selection of application method is usually the physician’s preference based on prior experience; however, we strongly encourage selecting an applicator based on the location of the lesion being treated. Buds are recommended for difficult to reach or bony areas of the body, sensitive areas (such as the head, face, neck, and gentiles), hands and feet, thin skin areas, and when treating small children. Cones are recommended for use on areas of fleshy or fatty tissue, where a tight seal can be achieved.
How do I ensure the bud reaches optimal freezing temperature before treatment?
After bud has been saturated to the first drip point, wait approximately 15 seconds before applying it to the lesion. During this time, the temperature drops from -50°C to -70°C, and you will see crystallization on the foam tip.
How long should I freeze the lesion?
Freeze times are based on the size, location and type of lesion. For thin skin and sensitive areas (such as the face, eyes, ears or extremities), a freeze time of 20-25 seconds with a minimum thaw time of 40 seconds is desirable. For these sensitive areas, it is better to under-freeze than over freeze. The treatment can always be repeated if necessary. Lesions that are 6mm or larger in size can be frozen for up to 40 seconds, with a minimum thaw time of 40 seconds. For larger, thicker lesions (such as plantar warts), up to 3 consecutive freeze-thaw cycles may be performed in the same visit, allowing a minimum thaw time of 40 seconds between each freeze.
Detailed freeze time charts can be found in the Instructions for Use, Commonly Treated Lesions sheet, as well as on the inside flap of every box. Visit our Resources page to view or download these training materials.
Can applicators be reused?
Buds can be reused to treat multiple lesions on the same patient; however, buds are NOT interchangeable between patients. Buds should be discarded after use to avoid the risk of cross-contamination with another patient. (Note: The medium and large buds are designed to hold a freeze charge for 90-120 seconds, meaning 2-3 lesions can be frozen on the same patient.)
Cones are reusable but must be disinfected between patients. Refer to question below for details on how to clean cones.
How do I clean the cones?
Cones should be disinfected prior to initial use and after each use on a patient. According to CDC Guidelines for Disinfection and Sterilization, Verruca-Freeze cones are classified as noncritical medical devices and can be disinfected using an EPA-registered intermediate-level or low-level disinfectant (CaviCide® or CaviWipes™ by Metrex are highly recommended). Follow all applicable instructions on the disinfectant product label. Contact time must be at least 1 minute to ensure disinfection. Cones can also be autoclaved on a plastic setting. Refer to autoclave instructions for more information. (Caution: Autoclaving cones may reduce their shelf life.)
Click here for a printable cone cleaning guide.
What is the "freeze-thaw" method?
The freeze-thaw method is the standard for cryosurgery. The process is to first freeze the lesion and then allow it to naturally thaw back to normal temperature. Thaw time is usually 30–40 seconds. A frozen lesion should not be touched while it is thawing as this would prematurely warm the lesion and reverse the treatment.
What is the "double freeze-thaw" method?
The double freeze-thaw method is the process of treating a lesion with two consecutive freeze-thaw cycles. This method is often used for deep or difficult lesions, such as plantar warts, as well as lesions over 7mm in size. Ensure the lesion has fully thawed from the first freeze before applying a second freeze.
Are there any after-treatment instructions for the patient?
After treatment, patients can resume all normal activities, including bathing. Once a scab or blister forms over the treated area, it is recommended to not pick at or irritate it. Every Verruca-Freeze prouct includes a tear pad with Post-Treatment Patient Instructions that details what to expect and how the patient should care for the treated area. If additional sheets are needed, please contact us to request an additional tear pad or visit our Resources page to download and print these instructions.
How many treatments are necessary?
For most patients, only one treatment is necessary. Some lesions may, however, require a second treatment. A follow-up visit is always recommended.
What should I do if cryogen drips or leaks onto a patient?
Any freeze can be reversed by immediately placing your hand over the frozen area. The warmth from your hand will quickly thaw the frozen area and prevent a full freeze from being achieved.
Can Verruca-Freeze be used during pregnancy?
Safety in pregnancy has not been established.
Do you offer any training?
Every Verruca-Freeze product includes detailed Instructions for Use as well as guidance on treatable types of lesions, treatment times for each type, and which CPT codes to use for reimbursement. We recommend thoroughly reading through all literature provided, reviewing the content on our Resources page, and watching our Instructional Videos prior to first-time use. All kits also include a practice pad, which can be used to perfect the technique before treating patients. We do not offer any in-person training. However, you should find that the cryosurgery procedure is relatively simple and easy to learn.
Are there any techniques to enhance treatment?
In addition to the double freeze-thaw method, a technique called ballooning is often used. This is most commonly used by podiatrists when treating plantar warts and veterinarians when treating sarcoids on large animals. The ballooning technique involves injection of lidocaine with epinephrine beneath the lesion. This injection seperates the lesion from the blood supply and causes vaso constriction of the blood vessels, effectively reducing the heat sink and allowing the freeze to penetrate deeper and last longer.
Orders & Shipping
How do I order Verruca-Freeze?
Verruca-Freeze products can be purchased directly from our online Shop or through your preferred medical supply distributor.
As a first-time user, which product should I start with?
We reccommend that first-time users start out with a Verruca-Freeze Kit, which includes a full set of cones and buds as well as a practice pad for self-training. All Kits include the same amount of applicators, so select a Kit based on the number of treatments, or freezes, desired. Keep in mind that the actual number of treatments achieved per canister will vary depending on the size of lesions treated and the number of practice sessions performed. We suggest using the smallest size applicator for practice sessions in order to conserve cryogen. Replacement Canisters and applicators may be purchased seperately at a lower cost.
Do you offer any free samples?
No, we do not offer any free samples of Verruca-Freeze. Our products have a low-upfront cost and high reimbursement rates, so you can recoup your investment in as few as 1 to 2 treatments! We are confident you will experience complete satisfaction with Verruca-Freeze, and the additional revenue it generates for your practice will prove worth your while.
Are there any special shipping requirements or hazmat fees?
Verruca-Freeze canisters are pressurized aerosols, which are considered Hazardous Materials (HAZMAT) but in a limited quantity. There are no HAZMAT fees associated with Verruca-Freeze products. The U.S. Department of Transportation (USDOT) requires ground-only shipment for our products, meaning we cannot offer expedited or overnight delivery and shipping to certain states or regions may not be possible. See our Shipping Policy for more information.
How long does shipping take?
All orders are processed and shipped within 1-2 business days, and the average shipping time for ground service is approximately 1-5 business days. We are proud to offer free shipping on all orders within the contiguous United States! For more information, please see our Shipping Policy.
Where do I apply promo codes?
Promo codes can be applied in your cart or at checkout.
What is the return policy?
All sales are final once an order has shipped. We do not offer exchanges, returns or refunds for any products purchased on our website or through a distributor. Any order changes or cancellation requests must be made before the order is shipped. Once an order has shipped, we cannot make any changes.
If there are mistakes with your order, or products arrive defective/damaged at the time of receipt, we will make it right by:
- Sending you replacement parts or accessories, or
- Replacing the entire product
- And we will cover the cost of any return shipping.
For more information, see our full Return Policy.