F.A.Q.

Cryotherapy

What is cryotherapy?

Cryotherapy is a procedure that uses extreme cold to destroy tissue. The process is called cryo-necrosis, tissue destruction by freezing.

Liquid nitrogen is colder

Cell destruction in all benign tissues is achieved at  -80°F. N2 (liquid nitrogen at –320°F) and N20 (nitrous oxide at –128°F) both realize the in-tissue temperature of – 113°F within seconds. The excessive power with N2 is not required and may well be an obstacle when precise application of verrucae and molluscum contagiosum in children, and treatment of aesthetic imperfections are needed.

What types of lesions should not be frozen?

All melanomas and recurrent basal cell carcinomas. Melanoma can spread by any of several means including local, lymphatic and blood. Additionally, Melanoma will change to a much more aggressive form if part of the lesion is left behind undetected. Basil cell carcinoma is typically spread by local extension and you may need more extensive surgery if recurrence is suspected.

Can anyone have cryotherapy?

Yes, although cautions about skin type and location should be considered prior to deciding on freeze times. People with high levels of cryoglobulins should be treated with caution. If with really dark skin, one may not want to have cryotherapy, as it will kill the melanocytes around the treated area, making the skin in that area lighter.

How are tissues destroyed during cryotherapy?

Tissue destruction occurs when cells are rapidly brought down to a temperature of at least –80°F and ice crystals will form. The ice crystals break the cell membrane, destroy the cell organelles and protein matrixes. Water then rushes into the surrounding area causing a blister and a disruption of the local blood supply.

What are the quality criteria of cryotherapy treatment and the effect on the treatment?

All starts with the clinical evaluation of the size and the depth of the lesion. The more you can adapt your instrumentation to these parameters, the better will be the outcome of the treatment.

Where on the body can skin abnormalities be removed from?

Care should be taken around areas of very thin skin and areas in which color may be cosmetically important. These areasmay include the face, ears, scrotum and lateral surface of fingers.

How is the freezing achieved?

The Joule-Thomson (JT) effect is a thermodynamic process that occurs when a fluid expands from high pressure to low pressure. The CryoProbe works with very practical cartridges containing with nitrous oxide at 725 psi. The cryogen is accurately applied to the lesion where it expands at –127°F resulting in an in-tissue temperature of –113°F rapidly.

How is cryosurgery better than other methods of removing skin lesions?

Cryotherapy requires no anesthesia and has less scarring than other techniques of skin lesion removal with minimal post-op care. Treatment goes quickly and can perfectly be integrated in daily practice.

Can the CryoPen be used on children?

Yes. Children are most commonly treated for verrucae and Molluscum Contagiosum. Very accurate stress free effective treatment are the key words there.

About Cryopen

What are the features of the CryoPen to achieve this quality?

CryoPen instrument is delivered with multiple interchangeable applicators that will precise  freezing of the lesion only. Various applicators will respond to the different sizes of lesions you will be confronted with. Treatment of the healthy tissue can easily be avoided which makes it a stress free procedure. When necessary patients will accept longer and deeper treatment which will promote more effective treatment and reduce time consuming repeat visits.

How many lesions can I treat with one cartridge?

3 cartridge sizes are available: 8g with 100 seconds, 16g with 200 seconds and 23g with 300 seconds of constant flow time. You can treat up to 5 treatments with 8g, treat up to 10 treatments with 16g and treat up to 15 treatments with 23g.

How to clean and disinfect your CryoPen?

Prerequisites
CryoPen instruments cannot be immersed in disinfecting liquids as the inner switches may suffer from this procedure. No rising.
Procedure
1. Soak a wipe with a noncorrosive disinfecting solution.
2. Apply the wet wipe on the surface of the instrument. Recommended contact duration: 1 to 5min.
3. Always follow the recommendation of the disinfecting solution manufacturer with regards to the concentration and the time of application.

How to clean and disinfect applicators

Prerequisites
CryoPen and their micro-applicator tips are not intended to be immersed in liquids.
Procedure
1. Soak a wipe with a noncorrosive disinfecting solution.
2. Removed the cap.
3. Apply the wet wipe on the surface of the applicator tip. Recommended contact duration: 1 to 5 min.
4. Always follow the recommendation of the disinfecting solution manufacturer with regards to the concentration and the time of application.

Post process

How permanent is the cure?

For most lesions, cryotherapy is a permanent removal. Some lesions are harder to remove than others. In more delicate places a shorter freeze time with repeat procedures may be required to get a final result with the least damage to the surrounding skin. In other instances a deep lesion may take several aggressive treatments to get final results. It is important to have an instrument that is capable of adapting to variable dosing of power.

What are the most common complications after cryotherapy?

The treated area is shifting skin and can potentially become damaged and infected if not cleaned properly.

Will there be permanent discoloration or hyper coloration?

Since melanocytes are the most sensitive cell type, persons with dark pigmentation or prolonged freeze times in any individual may cause extremely long color recovery or permanent color loss, even after the lesion is healed in other respects. It is important to will be careful when dealing with pigmented spots on dark color skin. Extreme attention is required in patients with apparent high shifts of pigment activity (many spots). The risk of post-inflammatory hyper-pigmentation is high in these patients. Always test-wise treat one spot and continue treatment at a checking of the positive result after 3 weeks. Best possible attention should be addressed to the protection against the sun of all treated areas in all cases, disregard the season of the year.

What type of skin abnormalities are most appropriate to freeze?

Almost any unwanted skin lesions are appropriate such as warts, skin tags, actinic keratosis, seborrheic keratosis, lentigos, dermatofibromas, hemangiomas and other benign skin imperfections.

Will patients activities be limited, and for how long, after the procedure?

There are no limitations on activity except to protect the treated area from damage or abrasion. Swimming and showering is not a problem.