Keratosis Treatment | Beware Of Liquid Nitrogen

Cryotherapy, also commonly known as cryosurgery, is one of the several treatment modalities for keratosis – along with curettage, laser therapy, electrocautery or even a surgical procedure. According to research reports, it follows surgical procedures in the ranking of procedures most commonly administered to remove skin lesions maybe due to its availability even in the doctor’s office.

Various unwanted skin lesions such as warts, actinic keratosis or seborrheic keratosis are frozen off from the body through the employment of very low temperatures – the process termed as cryotherapy. But this therapy works beyond compare only for flat or slightly-elevated lesions.

So how does cryotherapy work? The arteries and veins, generally known as blood vessels, located at the injury site such as the lesions’ site, are squeezed by cryotherapy. The site then receives lessened blood flow due to this process, commonly known to health professionals as vasoconstriction. Because of lesser blood supply, the cells cannot obtain the nutrients that they normally receive from the blood including oxygen. In the end, the cells then die – a process called necrosis.

There are a few types of cryogens, substances used to obtain very low temperatures, namely, liquid nitrogen, carbon dioxide snow and DMEP or dimethyl ether and propane.   But the cryogen that doctors most commonly use is the liquid nitrogen due to its low boiling point and therefore, its efficiency in freezing off lesions.

At the beginning of the treatment, the physician directly applies the liquid nitrogen onto the skin using a cotton-tipped applicator, a cryospray or a cryoprobe. In the span of a minute, heat from the skin transferring to the liquid nitrogen causes it to disappear instantly. Thawing of the skin lesions then ensues after this short freezing time. This eventually results to leaking out of the cell’s contents which signal the beginning of the real cell injury. Lastly, cell inflammation, characterized by skin redness, edema or swelling, pain and warmth, occurs as the cells’ final response to cell death.

There are generally minimal adverse effects when the physician performs the treatment according to the guidelines. But as with other treatment modalities, one cannot avoid the presence of potential complications. One of this is hypopigmentation, or the loss of skin color due to a reduction in melanin production, which is the result of deep or prolonged freezing by the liquid nitrogen.

Even though the Resource Conservation and Recovery Act does not consider liquid nitrogen hazardous, it still poses harmful effects on humans who come in direct contact with it for this will bring about rapid freezing of the tissues or even tissue death. Exposure to liquid nitrogen can be through inhalation or direct contact. Inhalation exposure is viewed to be critical only if a huge amount of liquid nitrogen, reducing the oxygen levels in the air, is spilled. In order to prevent accidental exposure to liquid nitrogen, strict compliance to safety protocols, particularly in its transportation, must be observed.

Eye contact with liquid nitrogen can happen during its transfer to smaller containers. The skin can also be accidentally exposed to liquid nitrogen.

Everyone must therefore adhere to safety protocols when handling liquid nitrogen. Always wear goggles, face shields or masks, gloves, aprons or other encapsulating suits when handling any objects with liquid nitrogen or liquid nitrogen itself. In cases of leaks, any person not wearing any protective gear must leave the area until cleaning is completed. And remember to soak the skin in tepid water before consulting a doctor when direct exposure to liquid nitrogen occurs.

Keratosis Further Reading Further Reading:

Actinic Keratosis

Seborrheic Keratosis