Cryotherapy

Cryotherapy uses liquid nitrogen at around -196°C, applied to a lesion with a spray or probe, to freeze and destroy it.

Freezing ruptures the cells and damages the small blood vessels supplying them. The treated tissue dies, forms a blister and then a scab, and separates over one to three weeks as new skin forms beneath.

It is quick, needs no anaesthetic for most lesions, and is done in a single short appointment.

What it suits

• Solar keratoses - the most common indication
• Seborrhoeic keratoses assessed as benign
• Viral warts
• Skin tags
• Molluscum contagiosum
• Some small benign pigmented lesions, once assessed

The limit you need to know

Cryotherapy destroys the lesion. Nothing is left to send to pathology.

That is fine for a lesion a practitioner has examined and is confident is benign, or for a typical solar keratosis. It is not fine for anything uncertain: if a frozen lesion was an early melanoma or a basal cell carcinoma, there is no specimen, no diagnosis, and no record beyond a note that something was frozen off.

So the rule here is the same as everywhere on this site: assessment first, and anything suspicious is excised and tested rather than frozen. See skin cancers and surgical excision.

A lesion that recurs after cryotherapy should be excised and examined, not frozen again.

What to expect

The application takes seconds per lesion. It stings or burns sharply during freezing and for a minute or two afterwards - short, but not painless.

Over the following days:

• Redness and swelling within hours
• A blister, sometimes blood-filled, within a day or two - this is expected, not a complication
• The blister dries into a scab over several days
• The scab separates over one to three weeks
• A pink patch remains, fading over months

Healing on the lower legs is slower - sometimes several weeks - which is worth knowing before treating lesions there.

Aftercare

• Keep the site clean; a simple dressing if it is likely to be rubbed
• Do not pop a blister deliberately; if it bursts, keep the area clean and covered
• Do not pick the scab
• Protect the site from sun while healing, then use sunscreen
• Contact us for increasing pain, spreading redness, pus or fever

What results are realistic

Most treated lesions clear. Thicker lesions sometimes need a second treatment.

The most common lasting effect is a permanently paler patch at the site, because the pigment-producing cells are more sensitive to cold than surrounding skin cells and may not recover. This is the main reason cryotherapy is used cautiously on the face and in darker skin, where a white mark can be more conspicuous than the lesion was.

Cryotherapy treats the lesions present; it does not stop new ones forming on sun-damaged skin. Individual results vary.

Risks

• Pain during and shortly after freezing
• Blistering, sometimes blood-filled
• Hypo-pigmentation - a permanent pale mark, the most common lasting effect
• Hyper-pigmentation, particularly in darker skin
• Scarring
• Infection
• Delayed healing, particularly on the lower legs and in people with diabetes or poor circulation
• Nerve damage causing numbness where a lesion sits over a superficial nerve - fingers and sides of digits
• Loss of hair follicles in the treated area, which is permanent
• Incomplete treatment and recurrence
• Missed diagnosis where a lesion is destroyed rather than examined

Cryotherapy is used with caution, or avoided, in people with cold-sensitivity conditions such as Raynaud's phenomenon or cryoglobulinaemia, and over areas of poor circulation. See risks and complications.

Cost and Medicare

Cost depends on the number of lesions treated. As at September 2024 and including GST, a consultation with a Cosmetic Doctor is $150.

Treatment of solar keratoses and other medically indicated lesions may attract a Medicare rebate; cosmetic treatment does not. Me Clinic is not a no-gap provider.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form.

Related: curettage, surgical excision, solar keratosis, all skin treatments.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.