Cryotherapy — Liquid Nitrogen Lesion Treatment

Cryotherapy using liquid nitrogen to freeze and destroy benign and precancerous skin lesions at Derma-plus Tábor. The extreme cold — approximately −196°C — is applied briefly to each lesion using a spray applicator, killing the target cells through ice crystal formation while minimising impact on surrounding tissue. The treated lesion blisters and sloughs over seven to fourteen days, leaving healthy skin underneath. MUDr. Irena Hejcmanová uses cryotherapy particularly for senile warts (seborrheic keratoses) and actinic keratoses — precancerous sun-damaged lesions that if untreated can progress to squamous cell carcinoma.

Cryotherapy — the medical application of extreme cold to destroy diseased tissue — has been a mainstay of dermatological treatment for decades, valued for its simplicity, precision and the absence of systemic side effects. Liquid nitrogen is the standard cryogen used in dermatology: at −196°C, it freezes tissue almost instantly, forming intracellular and extracellular ice crystals that rupture cell membranes and cause lethal cell death within the frozen zone. Because the depth and extent of the freeze can be precisely controlled by the application duration and the technique used — open spray, cryo probe, or cotton bud application — experienced dermatologists can treat a wide variety of lesions at different depths with predictable outcomes. At Derma-plus Tábor, MUDr. Irena Hejcmanová uses liquid nitrogen cryotherapy primarily for two indications. Senile warts (seborrheic keratoses) are benign, rough-surfaced brown or grey growths that accumulate on sun-exposed areas with ageing; they are medically harmless but often cosmetically bothersome or physically irritating when they catch on clothing. Cryotherapy removes them without incision, sutures or laser equipment — a brief freeze of five to fifteen seconds per lesion is typically sufficient for a complete response. Because seborrheic keratoses are very superficial, the freeze depth required is modest and healing is straightforward. Actinic keratoses (solar keratoses) represent a more clinically important indication. These are rough, scaly patches on sun-damaged skin driven by UV-induced keratinocyte dysplasia — they are precancerous lesions with a small but real risk of progression to invasive squamous cell carcinoma if left untreated. Cryotherapy is first-line treatment for individual or few actinic keratoses: a freeze of fifteen to thirty seconds per lesion typically clears the lesion in a single session, with a response rate of 80 to 95% for correctly staged lesions. Patients with field cancerisation — large areas of photodamaged skin with diffuse dysplasia — may require field treatment with topical agents in addition to cryotherapy of individual prominent lesions. After cryotherapy, the treated area blisters within twelve to twenty-four hours. The blister is left intact; it gradually deflates and the overlying skin sloughs over seven to fourteen days, leaving a pink healing base that re-epithelialises from the edges. Temporary post-inflammatory hypopigmentation (lightening) is common and usually resolves over months; permanent hypopigmentation is a recognised risk particularly in darker skin types and is discussed at consultation before treatment.