Clinical Hours: Mon-Fri, 8AM - 3PM(905) 493-5700
1885 Glenanna Road, Suite 220, Pickering, ON, L1V 6R6
Controlled application of extreme cold using liquid nitrogen to freeze and destroy abnormal skin tissue, including warts, actinic keratoses, and superficial skin cancers.
Cryosurgery, also known as cryotherapy or cryoablation, is a minimally invasive dermatological procedure involving the controlled application of extreme cold to destroy abnormal skin tissue. Liquid nitrogen, which reaches temperatures as low as -196 degrees Celsius, is the most commonly used and effective cryogen in clinical practice. This treatment method is widely valued for its simplicity, cost-effectiveness, and safety, making it well suited for outpatient settings.
The therapeutic effect of cryosurgery relies on rapid freezing of targeted tissue to sub-zero temperatures. When applied, the extreme cold causes formation of ice crystals within cells, leading to membrane disruption and cell death. The controlled destruction of abnormal tissue is followed by the body's natural healing and tissue replacement processes.
Cryosurgery is frequently employed to manage a range of benign and pre-malignant skin conditions, including actinic keratoses, seborrheic keratoses, viral warts, molluscum contagiosum, and skin tags. In select cases, it may also be used to treat small, superficial skin cancers such as superficial basal cell carcinoma and in-situ squamous cell carcinoma located on the trunk and limbs. Patients treated for malignant lesions require close follow-up to monitor for recurrence.
Cryosurgery is not appropriate in all situations. It should not be used on undiagnosed lesions or suspected melanomas, as histopathological confirmation is necessary in these cases. The procedure is also avoided in individuals with darker skin tones due to the risk of permanent hypopigmentation, in areas with compromised circulation, and in patients with a history of poor wound healing or previous adverse reactions to cryotherapy. Conditions involving cold sensitivity, such as Raynaud disease, cryoglobulinaemia, or cold urticaria, represent additional contraindications.
Several application techniques are available, selected based on the characteristics of the lesion being treated. In the timed spot freeze or direct spray method, the liquid nitrogen spray is directed at the centre of the lesion from a short distance until an ice ball forms extending slightly beyond the lesion margin. The freeze is maintained for 5 to 30 seconds depending on lesion type and location. A double freeze-thaw cycle may be employed to enhance efficacy for more resistant lesions. Other delivery methods include cotton-tipped applicators, cryoprobes, and the paintbrush technique.
Cryosurgery has demonstrated effectiveness across a range of conditions. For actinic keratoses, a single freeze-thaw cycle may be sufficient, with reported cure rates ranging from 39 to 83 percent. Seborrheic keratoses may require longer or repeated treatments, particularly for thicker lesions. Viral warts may necessitate multiple sessions, especially when hyperkeratotic or large, and pre-treatment with keratolytic agents may improve outcomes. For small, low-risk basal or squamous cell carcinomas, multiple freeze-thaw cycles are used with ice margins extending 3 to 5 millimetres beyond the lesion, though recurrence rates of 6 to 34 percent have been reported.
Although generally well tolerated, cryosurgery is not entirely free of side effects. Immediately following treatment, pain, swelling, blistering, or paraesthesia may be experienced. Delayed effects can include ulceration or bleeding, and complications such as local infection, nitrogen emphysema, or temporary nerve damage may also occur. In some cases, permanent hypopigmentation, atrophic scarring, or localized hair loss may result, particularly in cosmetically sensitive areas.
Post-procedural care is straightforward but essential for optimal healing. The treated area should be gently cleansed with soap and water once or twice daily. While dressings are typically optional, they may be recommended for areas prone to friction or trauma. Topical corticosteroids and oral analgesics can help alleviate swelling and discomfort. Blistering, a common and expected outcome, should not be punctured, and scabs should be allowed to separate naturally to avoid scarring. Healing times vary depending on the treated area and lesion type, with most patients recovering within one to three weeks.
At the Centre for Medical and Surgical Dermatology, cryosurgery is performed by Dr. Maksym Breslavets with careful patient selection and individualized treatment planning to achieve optimal results.
This treatment is classified as a procedural dermatology service. Procedural dermatology services are not covered by OHIP and do not require a physician referral. Appointments may be scheduled directly by contacting the Centre for Medical and Surgical Dermatology.
Your feedback helps us improve our service information
No physician referral is required for procedural dermatology services. These treatments are not covered by OHIP and are available through direct consultation. Contact the clinic to schedule an appointment.