Cryotherapy, cryoablation, cryosurgery treatment; all the previous terminologies are used for describing a procedure that mainly works by using extreme cold or sometimes freezing temperature which almost provided by the liquid nitrogen in order to treat certain skin condition through freezing and then melting the affected cells where the cells are regenerated again within a short period.
The procedure is very common among all dermatologists nowadays due to its extensive use from the 1770s where they were using the procedure for treating and decreasing the muscle spasms and its painful feeling, other use it for slowing the aging signs, and many other health conditions. The usage of liquid nitrogen is then spread especially in treating skin conditions; physicians were performing and treating skin problems through using cotton applicator, then through closed-system apparatus to spray liquid nitrogen, and then through metal probes.
Cryotherapy was developed specially for treating skin cancer diseases such as superficial basal cell skin cancers, and Bowen disease. After then, it was noticed other treatment options where cryotherapy can help in the dermatology field and treat solar related skin abnormalities, viral skin infection warts, seborrheic keratosis, and many other.
In this article, we will mainly cover how cryotherapy works?, how it’s performed?, what else it can treat?, what is the cryotherapy aftercare routine?, what I should expect?, and what are the procedure benefits and side effects?… if you are interested to know the answers; you will just have to scroll down! Keep reading…
How Cryotherapy works?
Cryotherapy is almost similar to procedures that implement high temperature for treating a certain disease, however, cryotherapy works by using a freezing temperature that is able to freeze the cells turning them into ice shards, therefore, causing damage to the affected cells without causing any kind of damage to the neighboring-normal cells found nearby the affected area.
Cryotherapy is performed by using a special spray gun or by the aid of a cotton applicator.
Freezing temperature is easily achieved by using
- Liquid nitrogen temperature –196°C
- Carbon dioxide snow temperature –78.5°C and sometimes, combined with acetone
- DMEP of temperature –57°C
What is it specifically used to treat?
As we said, cryotherapy is almost developed for the treatment of several types of cancer where some precancerous and others are noncancerous as follow;
The natural skin condition that mainly appears as a side effect of skin aging process and it is characterized by its bumpy, waxy, scaly shape with a certain color that ranges from many shades of brown to black.
The available treatment procedure for seborrheic keratosis are many; one of the effective procedure is cryotherapy that is used under your dermatologist consultant where it is applied on the skin barnacle, therefore; you will find that the affected area “freezes”. After few days the skin barnacle falls forming a blister that dries over time then falls by time too.
Basal Cell Carcinoma (BCC)
BCC considered a type of skin cancer, which is mainly arise from the skin’s basal cells, it is characterized by its abnormal formation of uncontrolled lesions that are in form of bumps! It is widely spread all over the world especially in the United States with a percentage that exceeds 4 million cases each year. Cryosurgery procedure is an effective way of treating the BCC as it able to destroy the affected tissue by freezing. As we said, cryosurgery is mainly worked by the implementation of liquid nitrogen on the affected area by using a spray device that immediately causes freezing without the need to anesthesia or even cutting. The affected lesions are then formed blisters, then form a crusty layer that usually falls off within few weeks. Your oncologist will repeat the procedure and will ask you to come within certain intervals for providing full destruction of affected cells.
According to American Cancer Society, it has been found that “Cryotherapy (cryosurgery) can be used for some small basal cell carcinomas, but it’s not usually recommended for larger tumors or those on certain parts of the nose, ears, eyelids, scalp, or legs.
Cryotherapy can also be used to treat large tumors in one treatment session to relieve symptoms from the cancer. The site of treatment often takes a month or two to heal.”
Most of the people will also ask about the cure rate of cryotherapy in this case fortunately, the cure rate is almost around 85-95% which is considered as a hopeful number.
Freckles are annoying especially while wearing your favorite makeup you start to get uncomfortable with the uneven tone of your skin! Cryotherapy can help you to rid yourself of those annoying freckles through applying liquid nitrogen on the affected area, therefore, it freezes and starts to fall off.
Milia, Milky spots; are the small white raised bumps, keratin-filled cysts, each Milium (Singlar) is an almost 1mm diameter, they are usually found under the outer skin layer that is called “Epidermis”. sometimes, they are found all over the upper area of cheek and sometimes they are found in aggregates on the chin area or under eyes.
Milia could be treated and removed by the means of cooling through freezing the affected area; from few years, the procedure was carried out by using liquid nitrogen. However, the process is now more advanced by using the Dermapen Cryo™ device that uses a very precise jet of highly-compressed liquefied nitrous oxide (N2O). based on patient’s reviews for the procedure; it was reported that cryotherapy produces perfect results with minimal downtime, however, there are some side effects that may occur after the procedure, therefore, you must choose a well-known dermatologist that can perform the procedure for you, giving you the maximum benefits with minimal side effects.
The most common ocular cancer, that almost affect children more than adults; this occurs during the development of retinoblasts (Type of cells found in eyes responsible for filling the retina) stop dividing into mature retinal cells and start to enter an uncontrolled growth phase causing cancer “This type of cancer is known as retinoblastoma”. Based on studies, it has been found that retinoblastoma could be early detected and treated by cryosurgery, which is considered as the most effective treatment protocol, the treatment is usually done with the aid of anesthesia and a small metal probe that is cooled to low temperatures causing freezing, as a result, killing the cancer cells. However, some possible side effects may result from this procedure such as blindness, therefore; you should go to a professional ocular oncologist and a pediatric oncologist.
Cervical Intraepithelial Neoplasia
The abnormal cells that developed on the surface of cervix due to certain infection by human papillomavirus (HPV). According to the World Health Organization (WHO) statistics, it has been found in 2008, that cervical cancer was responsible for 275 000 deaths, of which about 88% occurred in low- and middle-income countries. Cervical cancer is the third most common cancer in women worldwide and the most common cancer in many low- and middle-income countries. Because it has a typically slow progression, from atypical cells to cervical intraepithelial neoplasia (CIN) and to invasive carcinoma, precancerous lesions can be treated and invasive cervical cancer prevented.
Based on the WHO guidelines it has been found that cryotherapy is an effective method in treating the cervical intraepithelial neoplasia, and provides recommendations for treatment of CIN in women who are pregnant, as well as for women who are HIV-positive.
Some people say solar keratosis other say actinic keratosis; the terminology almost describes the rough, white or yellow scaly areas, flat or thickened papule, associated with skin pigmentation! And it has been found that actinic keratosis shows no symptoms other than the previously mentioned symptoms.
They occur due to the long-term exposure to the sun, and increases with age; It usually affects people who are over 40! Moreover, they could affect multiple areas all over the body like ears, forehead, neck, forearms, lips, face, temples, and balding scalp. In severely chronically sun-damaged individuals, actinic keratosis may found on the upper trunk, upper and lower limbs, and dorsum of feet.
Dermatologists usually recommend minimizing the sun exposure as much as possible in order to prevent being affected with actinic keratosis, therefore, preventing its complications that could be skin cancer. Moreover, most of the dermatologists suggest cryotherapy as one of treatment protocols due to its effectiveness; based on studies, it has been found that effectiveness percentage of cryotherapy is estimated and found to be from 75-99 percent.
Another common form of sun damage is the Bowen’s disease that could be also treated by cryotherapy. In one of the research conducted on the efficacy of cryotherapy on Bowen’s disease that was published on the Australasian Journal of Dermatology entitled “Therapeutic options for Bowen’s disease” it has been found that “Cryotherapy is one of the most commonly used modalities to treat Bowen’s disease primarily because of its accessibility, reported efficacy and low cost. The British Association of Dermatology guidelines for treatment of Bowen’s disease list cryotherapy as the treatment of choice for small, solitary areas of Bowen’s disease on sites that heal well. The efficacy rate for this technique is dependent on a number of factors including treatment duration, size, and site of involvement. Recurrences arising from adnexal structures may be prevented with prolonged and repeated (20–30s) freezing cycles. However, with prolonged freezing times, complications such as poor healing and hypo-pigmented scarring are more likely to occur, particularly in poorly vascularized areas.”
Many other cases are treated with the aid of cryotherapy such as prostate, liver, breast tumor problems…etc. however, you should check its side effects before performing the procedure…keep reading.
Cryotherapy Side effects; check before performing,
Melanocytes cells which are responsible for producing skin pigmentation may get adversely affected with the cryotherapy procedure as it usually causes damage due to the sensitivity of this type cells to freezing! Resulting information about permeant pigmentation inconsistencies problems “Hypopigmentation problem”. Some people are at high risk of getting affected by this problem more than others; such as people with dark skin type more than people with light skin type. Based on reports, it has been found that sometimes an increase in skin pigmentation may occur too! but for a different reason other than freezing, some research suggests it is due to inflammation.
Cryotherapy may also cause hair loss therefore, dermatologists usually recommend using cryotherapy in areas that are totally away from eyebrows areas, or hairline. Otherwise, dermatologists use other treatment procedures.
Infection is usually occur in areas that are poor of blood circulation where the wound healing rate is very slow as a result sores may form and cause infection. Some people may also suffer from this process such as diabetic people and those who have vascular problems. Although wound infection is rare it may occur and may get worse if the wound form pus, in this case, you should contact your physician for prescribing some antibiotics medications.
Infection may worsen the situation and cause swelling and redness that may be caused due to infection or due to an immediate response to freezing, however, it usually fades away after few days, in addition to the Formation of blisters around the treated area that usually peel off after few days. However, all the previously mentioned signs are controllable through some pain-relief medications.
Cryotherapy is said to be tolerable however, some stinging pain you may feel during and after the procedure, and sometimes you may experience headache pain if the treated area is located on the forehead.
Cryotherapy is said to have an adverse effect on nerve cells (Sensory cells) this usually occurs if cryotherapy is used for a long period of time.
Based on a case report, it has been found that “Prolonged and repetitive ice application can cause damage to the myelinated motor and sensory nerves. The myelin sheath is rich in lipids. Ice application results in solidification and hardening of the myelin lipid, similar to the application of ice on melting butter. This can lead to an arrest of motor and sensory nerve conduction. Even brief ice application, lasting no more than 20 minutes, can cause transient paralysis of the motor and sensory nerve fibers, lasting as long as one year”
Cryotherapy bottom line; every procedure has its own advantages and disadvantage, the success of a certain procedure mainly depends on its perfect results that are associated with minimal side effects.