Cryotherapy or cryosurgery
Cryotherapy or cryosurgery is one of the common methods for treating skin lesions that can be performed on an outpatient basis. This method is based on the destruction of target cells with their sudden cooling and is used for a wide range of skin problems. In many cases, cryotherapy of a lesion should be done several times in order to achieve a desirable outcome.
1) Change in skin color (pigmentation): like sunscreens and lentigo
2) Some pre-malignant lesions: such as actinic keratosis Note: The use of cryosurgery in the treatment of melanocytic moles, which is a precursor of pre-cancerous lesions, is prohibited because the intracellular changes result in the tendency to malignancy of these lesions to be accelerated and facilitated.
3) Vascular lesions like: Types of hemangiomas, including Kaposi sarcoma
4) Some viral lesions, such as warts and cantagiosum moloscoma
5) Cysts and lesions of benign tumors such as mildew, skin tag and keratose sebaceous
6) Hypertrophic scars and colloids
The mechanism of the work:
In this process, liquid nitrogen is used and less oxygen and liquid hydrogen (below zero) are used.
The mechanism of cryotherapy can be described in 3 phases: The first phase, the heat transfer phase: The most commonly used material in cryo is liquid nitrogen, which has an oven temperature of -196 ° C, and it has been used on a lesion of a rapid heat transfer phase from the skin to the freezing liquid and the preparations Cell damage is provided at the site of the lesion.
Second Phase, Cell Degradation Phase: Freezing of the lesion results in sudden and rapid cellular damage due to intra-cellular hypertrophy. Studies have shown that after a rapid degradation, the ability to produce collagen fibroblasts is minimized, and this provides the treatment of lesions, such as colloids, in the best possible way.
Third phase, inflammatory phase: This inflammation is accompanied by edema and redness and is a natural response to the cell death process. Failure to properly control this phase can lead to blistering and eventually scarring.
1) Acute Complications: Includes headaches, blisters and pain at the site of the lesion, which is particularly severe in the case of colloids.
2) Delayed complications: involves bleeding, infection, and excessive build-up of tissue (granulation).
3) Permanent complications: Alopecia (permanent loss of hair follicles), atrophy and skin analgesia, permanent scarring, and loss of lesion site (hypopigmentation), which is more common in people with dark skin.
Prohibition of relative consumption: cold intolerance, history of cold hives, cryoglobulinemia (a type of abnormality), history of Raynaud’s syndrome, any disease with high levels of cryoglobulin (such as active ulcerative colitis, severe and active collagen and collagen disease), and in waste Skin around the eyes.
Absolute contraception: Known allergy or unwanted reactions to cryotherapy, patients who are not likely to have hypoepigmentation, some malignancies (melanoma and squamous cell carcinoma), lesions that are present in areas with poor perforation, and lesions that require Biopsy to diagnose.
In the elderly and children: Due to the possibility of formation of blister and scar Diabetics: Due to the possibility of non-recovery and wound healing after cryotherapy People with dark skin: Due to the possibility of changing the color of the lesion site (hypopigmentation) Skin affected (sun exposure, topical use of corticosteroids, etc.): Due to increased risk of blistering and necrosis
Pregnancy: Due to increased cryoglobulins and the risk of excessive response to cryotherapy
Areas around the nerves: Due to the risk of peripheral neuropathy