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Cryosurgery for Nonmelanoma Skin Cancer

Surgery Overview

Cryosurgery is the process of destroying a skin cancer (lesion) by freezing it with liquid nitrogen. Liquid nitrogen is applied to the lesion using a cotton applicator stick or an aerosol spray.

The skin may first be numbed with a local anesthetic. The liquid nitrogen is applied or sprayed onto the cancer and the immediate surrounding tissue. The application may be repeated. An antibiotic dressing may be applied to the wound.

Cryosurgery is often used to destroy precancerous skin lesions such as actinic keratoses but is rarely used alone (monotherapy) to treat skin cancer.

What To Expect

An area where skin tissue has been destroyed by freezing with liquid nitrogen usually heals in 3 to 6 weeks. After the procedure, keep the wound clean and dry. A scab will form over the area.

Why It Is Done

Cryosurgery is used more often for precancerous growths such as actinic keratoses than for skin cancer.

Cryosurgery is done to destroy skin cancer if:

  • It is the first time a skin cancer has developed in that specific area (primary lesion).
  • There are multiple skin cancers that need to be destroyed.
  • You have a bleeding disorder.
  • You cannot, or do not want to, use another procedure to remove a skin cancer.

How Well It Works

Cryosurgery is the treatment of choice for superficial actinic keratoses. And it often is successful in treating small lesions of squamous cell carcinoma in situ.footnote 1

If cryosurgery is used to treat skin cancer, there is a small chance that the skin cancer will return after treatment. One study that followed people for 5 years after treatment found that cryosurgery had a cure rate for 99 out of 100 people.footnote 2

Risks

The risks of cryosurgery include:

  • Scarring, including a white spot (hypopigmentation).
  • Pain or stinging during and after the procedure.
  • A longer recovery time than other procedures that remove skin cancers.
  • Infection.

What To Think About

Cryosurgery is an efficient procedure if there are many skin cancers that need to be destroyed or treated.

Cryosurgery wounds heal slowly and can be painful.

Cryosurgery destroys tissue, so there is no way to obtain a sample (biopsy) for diagnosis.

References

Citations

  1. Habif TP (2010). Premalignant and malignant nonmelanoma skin tumors. In Clinical Dermatology: A Color Guide to Diagnosis and Therapy, 5th ed., pp. 801–846. Edinburgh: Mosby Elsevier.
  2. Carucci JA, et al. (2012). Basal cell carcinoma. In LA Goldman et al., eds., Fitzpatrick's Dermatology in General Medicine, 8th ed., vol. 1, pp. 1294–1303. New York: McGraw-Hill.

Credits

ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Amy McMichael, MD - Dermatology

Current as ofMarch 28, 2018


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