Video Production by Josh Melendez

Learn about Cryo Surgery with liquid nitrogen and how it is used in dermatology.

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Video Transcript:

So in this video we’re gonna be explaining what cryosurgery is, or what dermatologists often refer to as, liquid nitrogen or freezing. This treatment is used on a number of different diagnoses, and the most common are the pre-cancers called actinic keratosis. But we also use them to treat things like warts, or the wisdom spots called seborrheic keratosis, and a whole host of other conditions. So this video is going to be explaining what it is, what to expect, how to take care of it after, and what to watch for.

Liquid-nitrogen surgery is very, very, cold delivered air to an area which causes a little area of localized frostbite. and And that frostbite kill cells. And the cells that we’re typically trying to target with liquid nitrogen therapy, are the keratinocytes, or the top portion of cells and your epidermis, or the top portion of your skin. Ok, so what we have here is a number of actinic keratosis or the pre-cancers. There’s multiple different ways that we can address these. We can freeze with the liquid nitrogen. We can do the creams. We can do the blue light. For this video, we’re going to demonstrate what the freezing is like.

Now this does hurt a little bit. Ouch. Ouch. And then what it does is create a little localized area of frostbite. And then that frostbite destroys the cells and allows new cells from down below to come up and heal. Now for how thick they are, and how raised they are, that will determine how much we freeze, and how long it takes before that little ice ball or that whitening goes away. So there were five, and each one of these range from more thick to less thick. So that will determine how much we freeze the area. Now these areas might blister as they’re healing, and it usually takes about one to two weeks before that blister goes away.

After you’ve had something frozen with liquid nitrogen, the most important thing to do is not let it get scratched, rubbed, or irritated so it can heal properly. And that advice goes for basically any treatment that’s ever done for your skin. So leave it alone. Don’t pick at it. Keep it from being rubbed. If you want you can put a little Vaseline on the area while it heals. The most important thing is a little TLC, a little tender loving care to the area, so it can heal properly. And then when the treatment is done, and the healing is over, and that usually takes two to four weeks to heal, you should be left with normal skin. It shouldn’t be raised, or rough, or scratchy. And if it is not, then you please let your dermatologist know that the area that was treated does not look like it is back to normal, and you might need another treatment.

Now some things like warts oftentimes need serial treatments, over and over again before we can get to the bottom of it. Some things like pre-cancers or actinic keratosis, about 80% of the time that liquid nitrogen therapy will work for that one lesion. The skin that is left behind after treatment with liquid nitrogen or cryosurgery can have different tissue texture changes, and different colorations. So sometimes the skin can be a little lighter in color, sometimes it can be a little darker in color. And if that happens, that coloration change is permanent. So if it’s a concern for you that your skin in that little localized area that’s frozen is a different texture or a different color, then please ask your local dermatologist if there are other treatment modalities that would be better suited for you.

And again, if that area is not resolved back to normal in one month, please let your local dermatologists know. Because all of the things that we treat with liquid nitrogen, should resolve, and if they don’t, we need to reassess to see if the diagnosis was correct, and it just needs another treatment, or if we need to reassess the diagnosis from the start.

About the author

Dr. Anderson with Doctors Quarterly Magazine - Cropped
Dr. Reagan Anderson

Dr. Anderson is a Board Certified Dermatologist and Mohs Micrographic Surgeon. He serves as a Clinical Professor of Dermatology and is actively involved in patient and healthcare provider education on dermatology conditions and treatment.

Colorado Dermatology Institute
8580 Scarborough Drive / 1220 Lake Plaza Drive
Colorado Springs, Colorado