Office procedures. Cryotherapy of dermal abnormalities

Sun-induced skin changes

Chronic sun exposure is responsible for changes in skin texture, pigmentation, vascularity, maturation, and production of neoplasms. A 78% decrease in the lifetime incidence of basal and squamous cell carcinoma has been reported with regular use of SPF 15 sunscreen for the first 18 years of life. Actinic keratoses, sun-induced premalignant lesions of the skin, can be eliminated by mechanical and medication therapies. 5-fluorouracil therapy can be effective treatment for widespread actinic damage.

Cryosurgery of benign skin lesions

Cryosurgery is a widely used treatment modality in dermatology. Its place in cutaneous malignant and premalignant disease is well established; however, it also has great utility with benign lesions. Vascular, infectious, fibrotic diseases, solar damage, acne, as well as some cosmetic defects are amenable to freezing. The mechanism of treatment involves inducing tissue damage, vascular stasis and occlusion, as well as inflammation, to destroy unwanted tissue. After destruction of epidermal lesions, healing involves rapid re-epithelialization over a relatively cold-insensitive dermal network. Side effects are common but shortlived and are rarely severe. The equipment required is relatively economical and readily available. The technique is straightforward and reproducible, making cryosurgery an attractive option for many commonly encountered benign skin conditions. This review outlines treatment with the timed spot freeze technique of some commonly encountered benign lesions.