Cryosurgery for nonmelanoma skin cancer

Surgery Overview

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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 After Surgery

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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

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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

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When cryotherapy is used to treat actinic keratoses, the cure rate is nearly 99 out of 100.¹

If cryosurgery is used to treat skin cancer, there is a small chance that the skin cancer will return after treatment. A 5-year study of basal cell skin cancer treated with cryosurgery led to a cure for 99 out of 100 people.²

Risks

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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

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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.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

References

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Citations

1. Duncan KO, Leffell DJ (2003). Actinic keratosis section of Epithelial precancerous lesions. In IM Freedberg et al., eds., Fitzpatrick's Dermatology in General Medicine, 6th ed., pp. 719–725. New York: McGraw-Hill.

2. Carucci JA, Leffell DJ (2003). Basal cell carcinoma. In IM Freedberg et al., eds., Fitzpatrick's Dermatology in General Medicine, 6th ed., pp. 747–754. New York: McGraw-Hill.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Patrice Burgess, MD - Family Medicine
Specialist Medical Reviewer	Alexander H. Murray, MD, FRCPC - Dermatology
Last Updated	November 22, 2006