What is Cryotherapy?
The term ‘cryotherapy’ literally means ‘treatment using low temperature’ and refers to the removal of skin lesions by freezing them.
How does it work?
Cryosurgery is a technique for removing skin lesions that primarily involve the surface of the skin, such as warts, seborrheic keratosis, or actinic keratosis. It is a quick method of removing the lesions with minimal scarring. The liquid nitrogen needs to be applied long enough to freeze the affected skin. By freezing the skin, a blister is created underneath the lesion. Ideally, as the new skin forms underneath the blister, the abnormal skin on the roof of the blister peels off.
Occasionally if the lesion is very thick (such as a large wart), only the surface is blistered off. The base or residual lesion may need to be frozen at another visit.
Liquid nitrogen is usually applied to the skin by using a spray gun, a metal probe or a cotton bud can sometimes be used instead.
Although there is a slight local pain felt, cryotherapy does not normally require a local anaesthetic, and the procedure itself lasts a matter of seconds; the precise time depends on the thickness and size of the lesion. The frozen skin becomes white and takes one to two minutes to thaw back to normal skin temperature. It may suggest that the process be repeated once the skin has thawed. After a few days, a scab will form, and this will take one to two weeks to fall off (occasionally a little longer, especially on the legs). Usually, the treated area will eventually look normal, although scarring and discolouration is possible, and rarely ulceration, particularly on the lower legs.
Depending on the nature of the lesion, more than one treatment may be necessary, and this is usually repeated at regular intervals.
Potential side effects
Pain – Cryotherapy is usually well tolerated but can sometimes be painful if a deep freeze has been necessary (i.e. to treat a basal cell carcinoma). This discomfort can occur both at the time of treatment and for a variable time thereafter. Painkillers (such as paracetamol) taken for the first 24 hours may relieve the discomfort; also taking a painkiller an hour or so prior to the anticipated treatment may reduce the discomfort.
Swelling and redness – This is a normal immediate response to freezing the skin and usually settles after two to three days. For a short while the treated area may ooze a little waterway fluid. Cryotherapy close to the eyes may induce prominent puffiness of the lower eyelids which settle after a few days.
Blistering – This is also a common consequence of cryotherapy and blisters settle after a few days as the scab forms. Some people blister more easily than others and development of blisters does not necessarily mean that the skin has been frozen too much. Occasionally the blisters may become filled with blood; this is harmless and should only be punctured if a blister is painful and very uncomfortable, using a sterile needle. We would suggest you gain advice from us before doing this treatment.
Infection – Uncommonly, infection can occur, resulting in increased pain and the formation of pus: this may require topical antiseptic or antibiotics from your doctor. Please call us to seek advice.
When is treatment not advisable
You should NOT have this treatment if you are pregnant or breastfeeding. We will of course review your medical history in full during your consultation to ensure this treatment is suitable for you.
Subsequent side effects:
Scarring 0 Rarely, a scar will form, especially if a deep freeze has been necessary (i.e. to treat a basal cell carcinoma).
Hypertrophic/Keloid scarring – Very rarely a raised scar can form following treatment with cryotherapy which appears as a rounded, hard growth on the skin. These are harmless lesions, more common in dark skinned individuals compared to Caucasians.
Pigmentation changes – The skin at and around the treatment site may lighten or darken in colour, especially in dark skinned people. This usually improves with time but may be permanent.
Numbness – If a superficial nerve is frozen, it may result in numbness of the area of skin supplied by that nerve. Normal feeling usually returns within a matter of months.
Treatment may not be effective, or the condition may recur.
Post treatment advice
A plaster can be used for larger blisters or blisters in areas that are more likely to be traumatized- such as fingers and toes. If the area becomes dry or crusted, an ointment (Vaseline, Aquaphor) can also be applied.
Cleans area with mild cleanser such as Dove soap and cool water.
Pat the area dry with a lint-free cloth and apply an ointment(Vaseline or Aquaphor).
Avoid glycolic acids, vitamin C, scrubs, Tretinoin (Retin-A), and Retinol creams for 7 – 10 days.
The area may get wet while bathing.
Avoid swimming or hot tub use for one week.
Within 24 hours, you can expect the area to be swollen and or blistered.
Within one week, the swelling goes down. The top becomes dark red and scab-like. The scab will loosen over the next weeks and should fall off within one month.
(Removal of Skin Tags, Sebaceous Warts & Verrucas)
(You may need more than 1 session)
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