Actinic keratoses (AK) refer to scaly, rough lesions that usually develop on sun-exposed skin areas. The chances of AK development increase with age.
AKs are considered to be carcinomas in situ, which can progress to squamous cell carcinomas (SCC). AK treatment may be necessary for cosmetic reasons, symptom relief, or more critically, the prevention of cancer and metastasis.
Cryosurgery with liquid nitrogen is the most commonly used modality for actinic keratosis treatment. Compressed nitrous oxide or carbon dioxide may also be used. Liquid nitrogen is either sprayed onto the lesions directly or applied via a cotton-tipped swab.
This is a highly effective procedure, with cure rates ranging between 75 and 99 percent. But using the correct technique is vital for effective outcomes.
According to a study, a five-second treatment had a 39 percent cure rate, while treatment of over 20 seconds had an 83 percent cure rate.
Cryosurgery is usually an in-office procedure. It is typically well-tolerated and offers dramatic aesthetic outcomes. The possible side-effects include hypo- or hyperpigmentation, infection, hair loss, and scarring. However, serious responses rarely occur.
Cryosurgery is most suitable for the treatment of thin, well-defined lesions and may be used to address individual lesions or a tiny number of scattered lesions. Hyperkeratotic lesions prove to be more resistant to cryosurgery and should be debrided prior to treatment.
What to Expect
The doctor will inform the patient how to care for the wound following cryosurgery. A blister may develop in the treated site within a day, while a scab may form a few days later.
The doctor may instruct the patient to apply an ointment to the surface. Depending on the location of the actinic keratosis, the scab will peel off with a few weeks.
The patient can cover the scab with a bandage if their clothes rub the site. It is not advisable to pick at the scab or use make-up on the area until it has healed.
The treated site will appear red soon after the procedure as well as blister and swell. The patient should not break open the blister if this happens. They may also see clear drainage on the treated site, which is normal. The treated region will take around seven to ten days to heal.
Cryosurgery rarely causes serious side-effects and does not typically leave behind a scar. It may cause discoloration in the treated site, and this may improve over several months or may be permanent.
The patient may also experience permanent hair loss in the area. While the loss of sensation in the treated site is rare, it may take up to 18 months to resolve if it does occur.
Aftercare for Cryosurgery
- Beginning the day after the procedure, wash the treated site gently with a fragrance-free soap and water every day.
- Let the treated area remain uncovered. If the patient experiences any drainage, they can cover the site with a bandage.
- After the site heals, apply a broad-spectrum sunscreen with an SPF of 30 (or higher) to prevent scar development.
- The patient may have discoloration (redness, pinkness, or lighter or darker skin) at the treated area for up to one year after their procedure.
Board certified dermatologist Dr. Jamie McGinness and Jackie McGinness, FNP (Nurse Practitioner) receive patients from Shiloh, IL; St. Louis, MO, and nearby areas for dermatology treatments.
If you would like to learn more about procedures and treatments at Metro East Dermatology & Skin Cancer Center by Board Certified Dermatologist Dr. Jamie L. McGinness please contact us here or call (618) 622-SKIN (7546)
Taking new patients in and around the greater St. Louis, Missouri and Illinois area: East St. Louis Missouri, Shiloh Illinois, Belleville, Millstadt, Saint Clair County, Madison County and more.