Cryotherapy operates by utilizing a cryogen to cool the targeted lesion to sub-zero temperatures, resulting in direct tissue necrosis. The thawing process induces osmolarity changes that also lead to tissue damage.

Liquid nitrogen

Cryotherapy using liquid nitrogen involves using a cryospray, such as the Freezpen. The dose, freeze-time, and delivery method depend on the location, depth, size, and tissue type of the lesion.

With the timed spot freeze technique, the spray is positioned 1 to 1.5cm above the centre of the skin lesion and sprayed until an ice ball encompasses the lesion (and required margin). Depending on the lesion and depth of freeze, the ice field is then maintained for 5 to 30 seconds. In some cases, the treatment is repeated once thawing has been completed. This is known as a ‘double freeze-thaw’.

A Cryotherapy Session in Detail

Personalized Evaluation

Each person is unique and deserves a personalized assessment. Because everyone has different expectations and needs, it is essential that we advise you on the best possible treatment and provide a cost estimate.

Taking of Photographs

It is important to take pictures before and after your treatment. Pictures allow us to visualize the areas to be treated correctly. In addition, they are the most effective way for you to see the evolution of your results, as your satisfaction is our top priority.

Cryotherapy Treatment

The Freezpen sprays a focused liquid nitrogen spray applied directly to the lesion. During treatment, you may feel a slight burning sensation that may last a few minutes.

After Treatment

Once the lesions have been treated, they return to their normal color a few minutes after being frozen. Usually, swelling and inflammation occur around the lesion. Following treatment, a water blister filled with clear fluid or blood that settles in the treatment area may form. This reaction is completely normal, and you should not worry. Do not rip off any skin; it will make the healing process much longer. An average healing time of 10 to 14 days should be expected after a liquid nitrogen treatment.

Follow-Up After Treatment

Although cryotherapy treatment is effective, additional treatments may be needed.

Cryotherapy is a simple and relatively safe procedure; however, it can require several treatments to work. The resultant pain can also hinder compliance.

• Actinic and seborrheic keratoses
• Benign lesions secondary to sun damage can be highly amenable to cryotherapy.
• Actinic keratoses often require only one freeze-thaw cycle, and complete cure rates vary from 39% to 83%.
• Seborrheic keratoses may require longer treatment times and multiple freeze-thaw cycles if lesions are thicker.
• Viral warts
• Clearance rates of verrucous lesions can vary depending on the degree of hyperkeratosis and the size of the wart.
• Several treatment sessions may be needed, and the overall cure rate at three months varies from 39% to 84%.

Cryotherapy is generally safe and well-tolerated when performed correctly and appropriately, which explains its popularity in dermatology. However, nothing is entirely risk-free, and cryotherapy is no exception. Below are the potential risks and side effects that may occur.

 Common side effects

• Blistering and redness.
• Mild to moderate pain during and after treatment.
• Pigmentation changes (especially in people with darker skin tones).
• Temporary swelling or numbness.

Less common side effects

• Scarring
• Incomplete removal of lesions which may necessitate additional treatments.
• Infection can occur if the treatment area is not kept clean.

Other complications

• Secondary wound infections
• Infection can present as increased pain, swelling, thick yellow blister fluid, purulent discharge, and/or redness around the treated area.
• Treated with topical antiseptics and oral antibiotics.
• Nitrogen emphysema (rare)
• Local nerve damage (usually temporary)
• Permanent hypopigmentation or scar
• Atrophic scarring
• Alopecia
• Persistent or recurrent skin lesions requiring further cryotherapy, surgery, or other  

    treatments  

Looking after the treated area

• It is essential to follow up on wound care instructions and remain vigilant about potential complications.
• Generally, no special attention is required during the healing phase.
• The treated area can be gently washed once or twice a day with soap and water, and it should be kept clean. A dressing is optional but advisable if the affected area is prone to traumaor if clothing rubs against it.
• The treated area is likely to blister within a few hours, depending on the depth and duration of the freeze. It may contain clear fluid or blood, which is harmless.
• When the blister dries into a scab, apply petroleum jelly and refrain from picking at it. The scab typically peels off after 5–10 days on the face and 3 weeks on the hand. However, a sore or scab on the lower leg may last for as long as 3 months because healing in this area is often slow.

Cryotherapy operates by utilizing a cryogen to cool the targeted lesion to sub-zero temperatures, resulting in direct tissue necrosis. The thawing process induces osmolarity changes that also lead to tissue damage.