Removal of keratoma with liquid nitrogen

Keratoma is one of the most common benign formations that can occur on human skin. Outwardly, keratomas are similar to age spots or large freckles, since their color range varies from light yellow to dark brown. Keratomas are localized most often on the arms, shoulders, face and back.

According to dermatologists, keratomas are more likely to appear in people who spend a lot of time in the sun. Also, heredity and predisposition to the appearance of neoplasms play an important role.

In most cases, keratomas do not cause any unpleasant physical sensations, being only a lack of aesthetic properties. Moreover, sometimes they disappear on their own. Nevertheless, it is still not worth taking lightly the appearance of such neoplasms on the skin. The fact is that over time, keratomas tend to increase in diameter and deepen, and their surface becomes keratinized, covered with cracks and can bleed. In this case, it is not worth delaying a visit to the doctor – if the formations cause the slightest discomfort, they must be removed.

When to remove keratomas

The final decision on whether to remove the keratoma, in each case, is made by the doctor. As a rule, formations that do not cause physical discomfort to a person and are located on areas of the skin hidden from prying eyes are not removed. However, sometimes a keratoma needs to be removed, the sooner the better. So, they remove neoplasms that rise significantly above the skin, because of which their surface is injured. Alertness should cause spots that quickly increase in diameter. Also, “for a preventive purpose” it is recommended to remove keratomas for people who, by the nature of their activities, spend a lot of time in the sun.

The aesthetic aspect is also of great importance. Many consider keratomas as a kind of “senile” disease, unambiguously indicating that youth has passed irrevocably. In this case, even small spots, especially if they are located on open areas of the skin, become reasons for complexes, self-doubt and painful experiences. Of course, after consultation with a dermatologist, such keratomas can also be removed.

To date, there are several ways to remove such neoplasms – the final decision on which one to use is made by the dermatologist. To solve this problem, a laser, an electric current, a radioknife are used, and surgical excision can also be performed. The method of removing keratomas with liquid nitrogen (cryolysis) is still popular and in demand, which is one of the best for removing small formations.

The essence of cryodestruction

Cryodestruction today remains one of the most popular methods for removing benign skin tumors. The essence of this method is the use of low temperature in order to remove pathologically altered tissue.

What is the essence of cryodestruction? This method is based on how water reacts to low temperatures in the human body. Being exposed to extremely low temperatures, it turns into ice right in the tissues. First, the intercellular fluid is frozen, and at the next stage, intracellular frostbite occurs. Ice crystals literally “cut” cell membranes. In tissues exposed to low temperatures, blood circulation stops, the supply of oxygen and nutrients stops, as a result of which biochemical reactions are interrupted. As a result, the cells simply die.

Of course, for healthy tissues, such an effect is unacceptable. However, pathologically altered tissues react to low temperatures in exactly the same way – they simply die. It is the point effect of cold on the altered tissue that is the basis of cryodestruction. The substance that is used for this procedure is liquid nitrogen.

Types of cryodestruction

To date, there are two types of cryodestruction: direct exposure to the altered tissue and freezing using an applicator.

The direct exposure method provides that nitrogen is supplied to the treated area. So, for example, cryo-irrigation can be used – direct exposure to the skin surface with a jet of nitrogen or saturated vapors of this substance. It can also use a dosing device that “supplies” nitrogen in drops. This method is used when it is necessary to process objects of small diameter, but in large quantities – for example, multiple keratomas or flat warts.

The application method involves immersion in liquid nitrogen of a metal heat-capacitive probe, which then contacts the tissue. This kind of influence can be passive or active. With passive cooling, the probe gives off cold, heating up on contact with the skin. With active cooling, the probe or applicator plate is connected to a device that guarantees circulation of liquid nitrogen and constant cooling. It is believed that active cooling is more efficient, as it allows for more complete contact and greater freezing depth.

How is the removal of keratoma with liquid nitrogen

Before deciding to remove the neoplasm with liquid nitrogen, it is imperative to visit a dermatologist. He will once again examine the keratoma, accurately establish the diagnosis and decide whether cryodestruction can be used to remove it.

As a rule, the procedure for removing a keratoma with liquid nitrogen takes no more than five minutes. It can be done with or without local anesthesia. As a rule, anesthesia is used if the formation is not too small in diameter or located in areas with sensitive skin. Also, under anesthesia, keratomas are removed for children. Novocaine or lidocaine can be used as an anesthetic. After the injection, at least ten minutes must pass for the medicine to have time to work properly. Only after that the doctor proceeds directly to the removal procedure.

A wooden stick with a cotton applicator is immersed in a vessel with liquid nitrogen, after which they touch the surface of the neoplasm with slight pressure. As a rule, the first exposure lasts from five to thirty seconds, depending on the diameter of the formation. After the first “cauterization” pause for one or two minutes. This makes it possible to evaluate the effectiveness of the impact. Already after the first contact of liquid nitrogen with the skin, the tissues turn white, but they have time to thaw in a minute. After a pause, the manipulation is repeated.

As a rule, the procedure is carried out in three stages – so the doctor can be sure that the depth of freezing exceeds the depth of the keratoma and the cold has affected all cells of the pathologically altered tissue.

After the procedure is completed, the keratoma becomes whitish, with a pinkish tinge. This indicates the start of the process of cell death. After a few days, a slight swelling and a bubble may appear on the treated area, which will eventually disappear on its own.

Many are interested in what sensations the patient experiences during the removal of a keratoma with liquid nitrogen. Those who underwent the procedure without anesthesia, as a rule, feel a slight burning and tingling sensation at the time of exposure to the skin of liquid nitrogen. Patients do not experience pronounced pain.

Pros and cons of cryodestruction of keratoma

Cryodestruction is classified as a method that is on the verge between therapeutic and surgical treatment. Despite the fact that the doctor does not make incisions and punctures, the treated area dies off as a result, so the consequences of cryodestruction are similar to the consequences of invasive treatment.

Removal of keratoma with liquid nitrogen has a number of undeniable advantages:

1. The procedure is practically painless, since the tissue immediately loses sensitivity upon contact with cold.
2. There is no bleeding.
3. The number of relapses is negligible – the probability of re-development of keratoma is no more than 2%.
4. The cost of the procedure is affordable for the general population.
5. There is no need for stitches and bandages.

At the same time, the cryodestruction method also has its drawbacks:

1. Keratomas located on the face are not removed with liquid nitrogen, because the likelihood of scarring and scarring is quite high. For the same reason, the formation of a large diameter is not removed in a similar way.
2. The crust on the treated area is formed for a long time, and its rejection takes more time than when removing the keratoma with a laser or electrocoagulation.
3. They try not to use liquid nitrogen to eliminate keratomas located on the fold of the limbs, because in this case the wound heals quite hard.
4. After the procedure, there is no material for histological examination.
5. The doctor does not have the ability to control the depth of tissue damage with XNUMX% accuracy. He is guided solely by his own experience, and therefore there is a possibility that the cold will not “capture” all the changed cells or, on the contrary, affect healthy tissues.

Cryodestruction and laser: what to choose

Today, in addition to cryodestruction, the method of laser removal of keratomas is also very popular. It is also highly efficient. However, the cost of laser removal is much higher. At the same time, like cryodestruction, it does not provide the opportunity for a histological examination of the removed tissue in order to verify the benign nature of the formation.

The indisputable advantage of the laser is the fact that its impact is more “targeted”, and the treatment area heals faster. At the same time, laser removal has an order of magnitude more contraindications than cryodestruction.

Who is contraindicated for cryodestruction

Removal of keratomas with liquid nitrogen is considered a method that has the fewest contraindications among all methods for removing benign skin lesions. However, in some cases, this procedure is still excluded.

So, there is the concept of “cold allergy” – an individual hypersensitivity to low temperatures, which manifests itself in the form of an allergic reaction. Symptoms of cold allergy are redness of the skin area exposed to cold, severe itching and burning, and urticaria. Of course, those who suffer from such an allergy should not undergo cryosurgery of the keratoma.

A contraindication is also rosacea – vascular “mesh”. The procedure should be temporarily postponed with an increase in body temperature, as well as if the patient has recently suffered a cold or infectious disease. Also, the procedure should be approached with caution if the patient suffers from diseases of the cardiovascular system.

Wound care after cryodestruction of keratoma

After cryodestruction, the wound does not need any specific complex treatment. The appearance of a bladder keratoma at the site of removal should not be frightening – this is absolutely normal and indicates that the mechanism of death of the pathologically altered tissue is running. Doctors categorically do not recommend piercing the bladder – over time, it will come off on its own, and a dark crust forms in its place, indicating the beginning of the wound healing process.

Please note that the crust formed at the site of the removed keratoma cannot be wetted for five to seven days. Also, it should not be scratched so that an unaesthetic scar does not form at the place of removal. If you have any questions or doubts, you should seek medical advice.