What is cryotherapy?

Cryotherapy is made up from 2 ancient Greek words –

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• 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

• liquid nitrogen.

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Gore Street Medical has now the equipment to use liquid nitrogen to freeze off various skin lesions.

 

Liquid Nitrogen

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 are amenable to cryotherapy.

 

Does it hurt?

Freezing lesions can be uncomfortable, many describe it as a stinging sensation. Generally, most adults and children can tolerate the procedure well.

 

Are there any side effects?

After freezing a blister can develop, rarely a large blister develops. Other side effects include pain, discomfort, fainting, bleeding, hair loss (obviously if the scalp is treated), loss of skin colour, or redness of the skin. Scarring is a rare side effect.

 

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.

Contraindications

1. where the diagnosis is not known

2. malignant lesions – e.g. melanoma (Though superficial skin cancer can be treated. If there is recurrence, then the area may need to be excised.)

3. compromised circulation – peripheral vascular disease, Raynaud’s Disease

4. proven sensitivity or adverse reaction to cryotherapy

5. chronic open wound/ulcer

 

The Technique

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, a small lesion on the face needs less freezing than a big wart on the foot! 

 

Reference Am Fam Physician; 2004;15:2365-2372