The
“We
treat people, not just problems.”
John L. Pfenninger, M.D.
(989) 631-4545
Visit our
website at: MPCenter.net
Cryotherapy of Skin Lesions
Preoperative Patient Education
Cryotherapy means treatment with extreme cold. The area that is treated actually
freezes and then falls off. There are several different ways that the
treatments can be carried out.
Liquid
nitrogen
is -196°C. It can either be
poured out into a Styrofoam cup and applied with a cotton-tipped applicator,
or, sprayed onto the growth with a special thermos-like gun.
Another method is to use nitrous oxide in a blue tank.
This gas is -89°C and has a similar effect. It is less cold so it may take a little
longer to achieve the proper effect.
A special unit with different types of points is used to freeze the
tissue.
A third method is to use refrigerants that are compressed
gas in a small can. These are around a -40-50°C and the area to be
treated is sprayed with this gas.
Cryotherapy offers several advantages. It is very effective. Both benign and malignant (cancer)
changes can be treated. One of the advantages of using cryotherapy is that the
final result is generally cosmetically
excellent. There is minimal or no scarring. It is very quick and if there are only a few lesions, relatively painless. If
there are large lesions or numerous lesions, the doctor may want to numb up the
area first. Infection is extremely
rare and there is no bleeding. Postoperative care is minimal except
for washing the area three to four times a day with soap and water and applying
antibiotic ointment. Generally, patients can bathe and go about their usual
daily activities.
There are some disadvantages. The freezing does have some discomfort associated with it as
does the thawing. That is why we will numb up the area if there are large
lesions or multiple lesions present. Many times the treated area will not
completely resolve and will need a second treatment. It is difficult to treat areas where
there is hair growth such as around the eyebrows and eyelashes since hair may
not grow back in the treated areas.
Probably the most significant “hassle factor” is that a blister will often form just as if you
burned yourself. When this blister breaks, there is often a very heavy watery discharge. If the area treated
is under clothing, this area may stick to the clothes and cause discomfort.
Apply antibiotic ointment and keep it covered to prevent this. If you are a light-skinned individual,
cryotherapy is ideal for you. However,
if you are dark-skinned, the area treated may
heal with a lighter color. This may not be of concern if the area is
usually covered, but if it is going to be around the face or some other
cosmetic area, then it may be best not to do cryotherapy.
Preparation
for the office visit. No real preparation is
necessary for the office visit. You
may want to take Tylenol or 600-800 mg of ibuprofen just to help decrease the
swelling afterwards. Let the doctor know if you would prefer to have an injection
to numb up the area.
Who should
not have cryotherapy? If you have any type of
arthritis condition, ulcerative colitis, glomerulonephritis, heart valve
infection, syphilis, mono, cytomegalovirus infection, hepatitis, diabetes,
peripheral vascular disease, Burger’s disease, are on steroids, or are
known to have high levels of cryoglobulins, be sure that your doctor knows. You
may be much more sensitive to the freezing.
As stated above, if you are dark-skinned, you may
want to choose another method of treatment due to possible loss of color in the
area treated.
When should I
see results? If any treated spot has not
totally gone away in six weeks, see the doctor for a recheck appointment.
Copyright, 2011. John L. Pfenninger, M.D.
Cryo preop jw11/10