For treating plantar warts, at first paring is done to reduce the thickness of the lesion and determine the size of the wart. This helps in deciding the size of punch required. For all other cryo-amenable conditions, paring is not required. The punch is cut to half the length, and the plastic part is covered with gauze. For smaller punches, a test tube holder is used to hold the punch in place. The punch is kept on the lesion with slight pressure so that there is no gap between the punch metal tip and the skin. This prevents the cryogen from spreading into the normal skin.