Minimally invasive surgery in an outpatient setting
You have been diagnosed with skin cancer or you have skin lesions that you think are benign and you would like a treatment that could be carried out in an outpatient setting without going to the operating room.
Cryosurgery may be a valid option, but do you know if it is the right option to solve your problem?
I am dr.
Verónica Ruiz
Throughout my 15-year professional career as a dermatologist, I have successfully treated numerous superficial skin lesions using cryosurgery with good cosmetic results.
In my opinion, it is a decisive, simple technique that offers good cosmetic results, being able to treat both benign and some superficial malignant skin lesions.
Cryosurgery as a minimally invasive surgery option in the dermatology clinic
With cryosurgery we can solve a large number of superficial skin lesions, either benign or malignant, quickly, easily and with very few complications.
No specific preparation is needed on the part of the patient and it is performed on an outpatient basis.
Cryosurgery, a simple, fast and versatile therapeutic alternative
It is a technique widely used in our daily medical practice in the consultation, simple to perform, effective and with good cosmetic results if done properly.
The therapeutic effect of cold on human tissue has been known since the 19th century, with liquid nitrogen being the most widely used agent in dermatological consultations to carry out this technique. Because it evaporates when exposed to air, liquid nitrogen needs to be stored in cylinders or bottles
What is the mechanism of action of cryosurgery?
When cold is applied, tissue is damaged due to intracellular and extracellular ice formation, with destruction of cell membranes, in addition to causing changes in circulation caused b freeze/ thaw cycles.
In practice, we apply the liquid nitrogen in spray (with different caliber applicators) and the frostbite on the skin begins immediately, observing a whitish discoloration that spreads peripherally from the point of contact.
What skin lesions can be treated by cryosurgery?
Superficial skin lesions, either benign or malignant, are usually treated. On many occasions, we use cryotherapy as a step prior to shaving the injury, since on the one hand, it provides light instant local anesthesia and, on the other hand, the fact of freezing the tissue facilitates the cutting of it.
Some skin lesions tributary to cryotherapy treatment are the following:
Benign lesions
Seborrheic keratosis, fibroids, viral vulgar warts, flat warts, solar lentigos, condylomas, molluscum contagiosum, among others.
Malignant lesions
actinic keratosis, superficial carcinomas.
Frequently asked
questions
I perform cryosurgery in the consultation itself without the need to go to the operating room. It takes a few minutes to perform (depending on the type of skin lesion to be treated) and it has a low rate of complications.
Generally, the patient is recommended to do normal hygiene of the treated area on the same day after the procedure and to apply a topical antiseptic (iodine or alcohol) daily to disinfect and help keep the wound dry and scab formation. The scab will take 2-3 weeks to fall, leaving a more vulnerable area of skin, so it is very important to apply sun protection during the days and months after the technique is performed to avoid the development of little cosmetic spots (hyperpigmentation).
Although it is a fairly safe technique, there are some complications that should be known, as well as how to avoid them.
Treatment safety begins with careful selection of the patient and the injury to be treated.
The appearance of possible is mainly related to the duration of the procedure and the patients skin type.
In general, the dermal collagen network is not significantly altered if the total duration of the freeze pulses lasts less than 30 seconds; if the duration is longer, there is a risk of developing scars (anthropic and hypertrophic).
The most common complications that can occur after cryotherapy are:
1. Pain: The patient usually reports mild-moderate pain during frostbite and a few minutes later. It is generally transient and does not require analgesia.
2. Inflammation and Edema: Immediately after frostbite there is a swelling and redness (erythema) of the treated área that can last several hours (up to 1-2 days). Some drying or astringent solutions can be applied to reduce inflammation and associated local discomfort.
3. Formation of vesicles/blisters: they can appear within a few hours and, in the case of large, tense blisters with a large amount of liquid, they can be punctured to extract the liquid and thus facilitate its drying and alleviate the local nuisance.4. Hypo or hyperpigmentation: it is recommended to use adequate sun protection to avoid hyperpigmentation above all.