What is cryotherapy?
Cryotherapy is made up from 2 ancient Greek words –
Cryo - meaning icy cold; and
Therapeía - meaning healing.
So therefore Cryotherapy is a treatment using icy cold substances. In this article I will only discuss using a cold substance locally in order to treat/freeze/destroy various skin lesions. I am not referring to whole body cryotherapy or cryogenics!
The 2 main substances used are:
dry ice; or
Gore Street Medical has now the equipment to use liquid nitrogen to freeze off various skin lesions.
Liquid nitrogen is cold, very cold: minus 195.79 degrees Celsius. Imagine putting that onto the skin – it freezes! That is the point of the treatment! Freeze the skin lesion and the cells of the lesion will be killed – the body then deals with it from there – either coming up as a blister and the lesion falling off with the blister, or the lesion just dries up and falls off. The body re-grows the skin in that area.
What can be frozen off?
Before any skin lesion is frozen off, a proper diagnosis needs to be made. This can be done by inspection or may even need biopsy to obtain a definite diagnosis. Many skin lesions look alike, however experienced doctors making a visual inspection may be enough. Some lesions may not be so obvious – here the old adage – “If in doubt, cut it out!” applies! This is a critical decision to make – the doctor, if unsure, should opt for biopsy first. The most obvious example is a newly formed black mole-like lesion – definitely a melanoma needs to be excluded. I cannot emphasize the severity of the situation if a melanoma is just frozen off! Benign lesions such as warts, solar keratosis, seborrheic warts, skin tags, superficial skin cancers – Basal Cell carcinoma, Squamous cell carcinoma and any other benign lesions are all amenable for cryotherapy.
Does it hurt?
Freezing lesions can be uncomfortable, many describe it as a stinging like sensation. Generally, most people, even children, can tolerate the procedure quite well.
Are there any side effects?
Here we have to differentiate between what is expected from the treatment and what is not. After freezing – a blister develops – this can be normal – a part of the treatment. If the freezing is extreme and a large blister develops – then this is not normal and is caused by the excessive freezing. If the blister gets infected – also not normal – blisters need to be treated like any other wound – keep clean and dry. Do not try to drain the blister. Other side effects include pain/discomfort, fainting, bleeding, headache, hair loss (obviously if the scalp is treated), loss of skin colour, or just the opposite – redness of the skin – though more often than not – is temporary. Scarring can also occur but note that all of these side effects depend on the extent of freezing.
Is it safe?
Generally speaking, cryotherapy is a very safe procedure…. but like any other procedure, the safety is dependent on the experience of the practitioner. There are very few contra-indications and some may be relative contra-indications – some largely depending on the experience of the practitioner.
where the diagnosis is not known
malignant lesions – e.g. melanoma (Though superficial skin cancer can be treated. If there is recurrence, then the area may need to be excised.)
compromised circulation – peripheral vascular disease, Raynaud’s Disease
proven sensitivity or adverse reaction to cryotherapy
chronic open wound/ulcer
The liquid nitrogen is transferred from a big holding tank to a small hand held spray bottle. The lesion is then sprayed with the liquid nitrogen freezing it. The length of spraying depends on how big the lesion is and where it is situated – e.g. a small lesion on the face needs less freezing than a big wart on the foot! Again the technique does depend on the experience of the practitioner.
Reference Am Fam Physician; 2004;15:2365-2372
Dr Peter Baratosy
Integrative General Practitioner
Dr Peter Baratosy is an Integrative GP and Author of "Gut Feelings", "Death by Civilization", "It Could Still be your Thyroid", “You and Your Hormones” and "There Is Always an Alternative". He has recently settled in Tasmania from Adelaide where he gained 25 years experience in treating chronic conditions using an integrative approach, he is especially interested in thyroid conditions, metabolic syndrome and hormonal issues both in men and women and gut problems. He does a very thorough thyroid assessment and adrenal health assessments and uses Bioidentical hormone replacement.
He also does Prolotherapy, a treatment for chronic musculo-skeletal pain/conditions. He is a Fellow of the Australasian College of Nutritional and Environmental Medicine (ACNEM) where he was also on Faculty as a lecturer and as an examiner.