Cryosurgery is a highly effective treatment for a broad range of benign skin problems like actinic keratosis, solar lentigo, seborrheic keratosis, viral wart, molluscum contagiosum, and dermatofibroma and is a suitable option for treatment patients with light skin and for treatment of lesions in most non–hair-bearing areas of the body. Spray methods include the timed spot freeze technique, the rotary or spiral pattern, and the paintbrush method. Cryosurgery has been used to treat skin lesions for approximately 100 years though over the past 50 years, much experience has been gained in the use of cryosurgery to treat skin lesions.
Besides requiring little time and fitting easily into the physician’s office schedule, this treatment also has the advantage of a short preparation time, low risk of infection, and minimal wound care. In addition, cryosurgery requires no expensive supplies or injectable anesthesia, and the patient does not have to return for suture removal.
Potential side effects include bleeding, blister formation, headache, hair loss, and hypo pigmentation, but rarely scarring. Skin lesions often can be treated in a single session, although some require several treatments.
The first cryogens were liquid air and compressed carbon dioxide snow. Then came liquid nitrogen and currently is the most widely used cryogen. It is particularly useful in the treatment of malignant lesions. Temperatures of −25°C to −50°C (−13°F to −58°F) can be achieved within 30 seconds if a sufficient amount of liquid nitrogen is applied by spray or probe. Generally, destruction of benign lesions requires temperatures of −20°C to −30°C (−4°F to −22°F). Effective removal of malignant tissue often requires temperatures of −40°C (−40°F) to −50°C.