Cryotherapy has been around for about 100 years and involves the use of extremely cold temperatures to freeze and destroy abnormal skin lesions such as skin tags. The first freezing agents used for cryotherapy were liquid air and compressed carbon dioxide snow. In the 1940s, liquid nitrogen became available, and it is still the most widely used cryogen, according to the American Family Physician article, "Cryosurgery for Common Skin Conditions" by Dr. Mark D. Andrews of the Wake Forest University School of Medicine. The technique is performed by a dermatologist or a primary care doctor.
The Procedure
Cryotherapy may also be called cryocautery or cryosurgery. It is a simple, inexpensive procedure that can be done during a regular physician's office visit. During cryotherapy, liquid nitrogen is applied to the skin tag with a cotton swab or spray device. The patient will experience mild pain or stinging, but anesthesia is typically not necessary. Skin tags generally can be removed with one visit, although larger tags may require repeated applications.
Side Effects
Redness, swelling and blistering are all normal side effects after cryotherapy. Blisters may be clear or bloody and should be covered with a gauze dressing. Patients are instructed to wash the area several times daily as long as there is drainage from the wound; drainage may last up to two weeks. As the blister dries, a crust forms; this scab will fall off by itself. According to the New Zealand Dermatological Society, risk of infection is small after cryotherapy, and scarring is minimal. Sutures are not required for skin tags, making follow-up visits minimal.
Complications
Cryotherapy is usually well tolerated, even by the elderly, but complications can occur. Infection is uncommon, the New Zealand Dermatological Society says, but it is more likely to happen in areas that take longer to heal, such as the lower legs. Pigment changes, either a lightening or a darkening of skin color, are possible. Hair loss at the site may also occur. Nerve damage is rare but can occur in areas such as the wrist, fingers or behind the ears. Complications may resolve in several months, or they may last longer.
Caution
Diabetes patients should talk in depth with a doctor before having the procedure. Because circulation and healing can be poor in patients with diabetes, risk of infection is higher in these patients when cryotherapy is used on skin tags on the lower legs, ankles and feet.
Recovery
Cryotherapy is an effective method for removing skin tags, and recurrence is uncommon. Patients receiving cryotherapy for skin tags typically resume normal activities the same day. Ibuprofen or other over-the-counter analgesics may ease discomfort.
