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Cryotherapy  - Liquid Nitrogen - Memphis Dermatologist

George Woodbury MD 3/15/2023

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Cryotherapy is literally “freezing therapy,” a treatment that Dermatologists use for management of benign growths like Viral Warts and Precancerous Solar Keratoses. Let’s take a look at the pros and cons of this treatment, my perspective being that of a Memphis Dermatologist for over 30 years with Rheumatology and Dermatology Associates, 8143 Walnut Grove Road, Cordova TN 38018 (1-901-753-0168;

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First, what is Cryotherapy?

Cryotherapy is treatment of skin lesions with liquid nitrogen. Liquid nitrogen is a very cold liquid and it basically freezes the lesion r.  It is applied with a Q-tip or spray gun.

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What do Dermatologists treat with Cryotherapy?

Dermatologists generally use Cryotherapy for Viral Wart treatment or Solar Keratosis treatment, or Actinic Keratosis treatment, or and certain other growths on the skin.  It’s not generally effective for management of deeper lesions of the skin, such as moles and skin cancers.

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Does Cryotherapy hurt?

It does sting, but only for a short time after the procedure, in most cases.  (Sometimes deeper lesions such as foot warts will hurt or throb a bit for the rest of the day).  For particularly sensitive people, we can sometimes order a prescription cream called topical lidocaine, to be applied 2 hrs before the procedure to help numb the skin.


Does Cryotherapy scar?

With any treatment, there is a chance of scarring. One of the advantages of Cryotherapy though is that generally this treatment does not leave a scar. But if we don’t use enough Liquid Nitrogen, Cryotherapy also does not effectively remove the lesions. So use of Cryotherapy is similar to a balancing act: too much, and a scar could result – versus too little, and it does not remove the lesion. So Cryotherapy often has to be applied on multiple occasions.

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Can Cryotherapy cause a change of skin pigmentation?

Sometimes Cryotherapy will leave a temporary change in the darkness, or the lightness of the area treated, meaning the pigmentation of the area. This is called post inflammatory hyperpigmentation (or post inflammatory hypopigmentation). This possible side-effect can e managed with use of one of several prescription bleaching creams.

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How is Cryotherapy applied to the lesion or lesions?

Many Dermatologists and Dermatology staff use either a q tip to apply Liquid Nitrogen, or else a spray gun, called a Cryac. Which approach is most helpful varies with the locations or and sizes of the lesions.

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Is Cryotherapy more effective than over-the-counter Wart sprays?

Cryotherapy uses Liquid Nitrogen, which is much colder than over-the-counter Wart aerosol sprays, available at the pharmacy. The temperature of Liquid Nitrogen is -320 degrees Fahrenheit (-196 degrees Celsium), while that of over-the-counter aerosols is about -100 degrees Fahrenheit.

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How expensive is the Cryotherapy treatment?

Coverage for Cryotherapy treatment varies by the insurance company, and the underlying diagnosis of the skin lesion. We would be happy to check with the insurance company, though coverage for this treatment can never be guaranteed until that insurance company processes the claim for treatment.

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Can the lesion or lesions grow back after cryotherapy?

Any lesion can grow back, but the chances are better than not that the liquid nitrogen will remove the lesion.  Warts for instance are due to a virus, and there is no “antibiotic” type medicine for them.  They do sometimes grow back after cryotherapy, but usually not.  It’s often essential to use at least three to four treatments about two to four weeks apart, more than one session of treatment for effective management of Viral Warts.

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What would I as the patient have to do to treated area or areas, after the Cryotherapy, at home?

Liquid Nitrogen treatment (Cryotherapy) will often cause a blister or blisters in the areas treated, and we don’t want infection to set in. Sometimes the blistering occurs within the skin, so no visible blister occurs at the surface. It’s generally best to use a prescription healing ointment twice a day afterwards, such as:

  • Prescription Mupirocin Ointment (Bactroban® Ointment or Bactroban® Cream),

  • Prescription Silver Sulfadiazine Cream (Silvadene® Cream),

  • or Garamycin® Ointment (Gentamycin Ointment).


Alternatives ointments that are over-the-counter include

  • Neosporin® (Neomyxin);

  • Polysporin®(polymyxinsulfate/bacitracin);

  • Triple® Antibiotic (bacitracin/neomyxin/polymyxin sulfate);

  • Mycitracin® Ointment (bacitracin/neomyxin/polymyxin sulfate),

  • or simply Bacitracin ointment

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Does it help to do a salt water compress to the sites after Cryotherapy?

It’s often a good idea to use what’s called an over-the-counter Domeboro Compress to the treated areas. This is a powder that contains aluminum acetate and calcium acetate. It’s mixed according to the instructions with water, and then kept in the refrigerator in a container with a lid, and it can then be used once or twice a day for two or three days after the Cryotherapy Treatment, to help to promote quicker healing of the lesions. 

Alternatives to Domeboro Compresses – with the same ingredients – include Blu-Boro, Gordon’s Boro-Packs and Pedi-Boro Soak Packs. Another alternative is what are called Epsom Salts, available through many pharmacies, the instructions being to mix two tablespoons of Epsom Salts with a pint of tap water. Or one could even use Sea Salt or table salt, at the same ratio: two tablespoons to a pint of water.

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How many days would I have to use the healing ointment at home?

We generally recommend applying these ointment twice a day for about ten to fourteen days. It’s common for the lesion or lesions to then fall off or peel off. It’s then  a good idea to set up a follow-up appointment to have the lesions or lesions reevaluated.

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Are there any restrictions for the patient after Cryotherapy?

It’s a good idea to stay out of the pool or out of the hot tub for five to seven days after Cryotherapy, to enable the lesions to heal without getting infected. It’s generally also best to avoid profuse amounts of sweating for five to seven days.

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My own Memphis Dermatology practice for over thirty years has been with Rheumatology and Dermatology, Cordova TN. Or you can find a Dermatologist closer to you by going to the American Academy of Dermatology website, (, then plugging you zip code into the “Find a Dermatologist” tab.

George R. Woodbury Jr. M.D.

Board-certified Cordova Dermatologist (Memphis Dermatologist) at Rheumatology and Dermatology Associates PC

8143 Walnut Grove Road

Cordova TN 38018



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